Effect of health literacy on help-seeking behavior: A comparison of patients accepting surgery and refusing surgery for urinary incontinence.

OBJECTIVE(S): To compare the health literacy (HL) of the adult females with SUI complaints in terms of their acceptance or non-acceptance of surgery. METHODS: In this cohort study, the European Health Literacy Survey Questionnaire (HLS-EU- Q47) scores as a measure of health literacy were compared among the two groups of patients who accepted to undergo surgery for SUI and the ones who did not. Demographic features, weight and BMI values, comorbidity, menopausal status, duration and type of UI, socioeconomic characteristics (marital status, educational level, level of income) and HLS-EU- Q47 survey results of the two groups were compared. We also investigated the reasons regarding the acceptance or refusal of SUI surgery. RESULTS: Among the patients who were offered surgery 474% accepted to undergo operation. Total HLS-EU-Q47 score was 30.04 in the group of patients who accepted surgery and 23.46 in the group who refused surgery. The patients that refused surgery had more often insufficient health literacy level (p=0.001). An excellent health literacy level was higher for patients who agreed to anti-incontinence surgery (p=0.021). CONCLUSIONS: Health literacy score of patients with urinary incontinence (UI) who refused surgery was lower than those who accepted surgery. Acceptance of surgery may be increased by providing more understandable and clear information, especially for women with lower HL levels.

Factors affecting doctor visits of postmenopausal women with urinary incontinence.

OBJECTIVE: This study analyzed the reasons for avoiding visiting a doctor among women aged ≥50 years with urinary incontinence (UI), as well as factors influencing visits to the doctor. METHODS: In all, 402 women aged ≥50 years who were enrolled in Bursa healthcare centers, 150 with UI and 252 without UI, participated in the study. This study was conducted between January 2018 and August 2018. Participants were asked to complete the International Consultation on Incontinence Questionnaire - Short Form (ICIQ-SF) questionnaire. Quality of life was evaluated using the Incontinence Impact Questionnaire, Short Form (IIQ-7) questionnaire. RESULTS: The prevalence of UI was 37%. Of the women with UI, 52 (34.67%) visited a doctor for complaints. The most frequent reason for seeing a doctor because of UI was that it had started to affect activities of daily living. The most frequent reason for avoiding visiting a doctor was the belief that UI was normal. Scores on the ICIQ-SF were higher among women who visited a doctor. Physical activity, social relationships, and mental health scores on the IIQ-7 were also higher among patients who visited a doctor. CONCLUSIONS: Patients who suffer from severe UI and whose quality of life is affected more negatively are more likely to visit a doctor. Women who believe that UI is normal are less likely to visit a doctor. Awareness about UI should be increased in order to increase the rate of visiting a doctor for this condition.

Thiol/disulfide homeostasis in pregnant women with obstructive sleep apnea syndrome.

Background: Repetitive episodes of hypoxia and reoxygenation during sleep in patients with obstructive sleep apnea syndrome (OSAS) resemble an ischemia-reperfusion injury. We aimed to test the hypothesis that oxidative stress occurs in pregnant women with OSAS. We also aimed to compare thiol/disulfide homeostasis with ischemia-modified albumin (IMA) and total antioxidant capacity (TAC) as markers of ischemia-reperfusion injury in pregnant women with and without OSAS and healthy control. Methods: This study included 29 pregnant women with OSAS, 30 women without OSAS in the third trimester applying for periodic examinations, and 30 healthy women. Serum IMA and TAC (using the ferric reducing power of plasma method) were measured. Serum thiol/disulfide homeostasis was determined by a novel automated method. Results: The mean age of the pregnant women with OSAS was 31.0 ± 4.7 years with a mean gestational age of 36.5 ± 3.0 weeks. The mean age of pregnant women without OSAS was 29.8 ± 4.9 years with a mean gestational age of 36.9 ± 2.7 weeks. The mean age of the nonpregnant control group was 29.7 ± 6.4 years. Both native thiol (291 ± 29 µmol/L versus 314 ± 30 µmol/L; p = .018) and total thiol (325 ± 32 versus 350 ± 32, p = .025) levels were lower in pregnant women with OSAS compared to pregnant women without OSAS, respectively (p < .01). Conclusions: This is the first study demonstrating the thiol/disulfide homeostasis in pregnant women with OSAS. Native thiol and total thiol levels were lower in pregnant women with OSAS compared to those without OSAS. However, dynamic thiol/disulfide homeostasis parameters cannot provide valuable information to discriminate OSAS in pregnant women.