Thesis (M. P. H.)--University of Hong Kong, 2007.

Thesis (M. P. H.)--University of Hong Kong, 2007. / Also available in print.

Thesis (M.S.)--University of Michigan, 1992.

Thesis (M.S.)--University of Michigan, 1992.

Η ακράτεια ούρων είναι ένα πρόβλημα ιδιαίτερα συχνό σε ηλικιωμένα άτομα αλλά αφορά και άλλες ηλικίες. Υπάρχουν διάφοροι τύποι ακράτειας, διαφορετική συμπτωματολογία, αίτια πρόκλησης καθώς και τρόποι αντιμετώπισης. Πολύ συχνή διαταραχή αποτελεί το σύνδρομο υπερδραστήριας κύστης με συμπτώματα που μπορούν να δημιουργήσουν πολλά και ποικίλης φύσεως προβλήματα και να επηρεάσουν την ποιότητα ζωής των ασθενών. Για την εκπόνηση της εργασίας έγινε αρχικά μία θεωρητική προσέγγιση και έπειτα διερεύνηση με ερωτηματολόγια σε άτομα διαφορετικού φύλου και ηλικίας. Οι απαντήσεις συγκεντρώθηκαν και επεξεργάστηκαν μέσω κατάλληλου στατιστικού λογισμικού προγράμματος (SPSS). Η παρούσα έρευνα αποτυπώνει καθαρά πως η ακράτεια ούρων και πιο συγκεκριμένα το σύνδρομο υπερδραστήριας κύστης αφορά ένα σημαντικό ποσοστό (35%) του πληθυσμού στη χώρα μας. Είναι ένα πρόβλημα που επηρεάζει περισσότερο τις γυναίκες και άτομα πάνω από 55 ετών. Τα συμπτώματα που συνοδεύουν το σύνδρομο επηρεάζουν αρκετά την καθημερινότητα των ασθενών, οι οποίοι στην πλειοψηφία είναι εσωστρεφείς με το πρόβλημά τους και απογοητευμένοι από τις μέχρι τώρα λύσεις. Η άγνοια των ίδιων αλλά και όσων δεν αντιμετωπίζουν πρόβλημα υπερδραστήριας κύστης κάνει αναγκαία την επίλυση του γιατί πέρα από πρόβλημα υγείας παραμένει και πρόβλημα κοινωνικό. Για αυτό και η ενημέρωση από ανθρώπους ειδικούς μπορεί να δώσει στους ασθενείς πραγματικές λύσεις που θα αλλάξουν και θα βελτιώσουν την ποιότητα της ζωής τους και θα αλλάξει την λανθασμένη αντίληψη της κοινωνίας γύρω από τη φύση της ασθένειας. / -

Urinary incontinence (UI) is a condition commonly experienced by women worldwide. Many women suffer in silence as they refrain from or delay seeking help. Pelvic Floor Muscle Exercises (PFME) have proven to be effective and are recommended as the first line of treatment. Regular exercise of the pelvic floor muscles can prevent symptoms developing. However, there is evidence of lack of motivation and poor adherence to exercises. The use of mobile phone applications have been suggested as an effective resource for health behaviour interventions, especially for sensitive or embarrassing conditions. A mixed methodology was used to gather evidence about the experience of community dwelling women in the North of Scotland over a three month period. Of the twenty three participants who completed a three month explanatory randomised controlled trial, fifteen participants exercised at least daily on average by the end of the trial. Of the fifteen who exercised at least daily, five continued average exercise of at least daily at the twelve month follow-up. Taking part in the study helped women to focus on the exercises and this had a positive impact on their adherence. Eleven out of the fifteen participants with incontinence experienced an improvement in their symptoms after twelve weeks. This had a positive impact on their quality of life. Of those who experienced UI, the women who had the biggest increase in level of exercise also had the biggest improvement in symptoms. Participants in the intervention group of the trial were provided with apps for PFME. Six out of the ten of intervention group participants who completed the trial reported that the apps were not useful and of the four who found them useful, their level of use was varied. The data from this study suggests that simply being provided with apps or equipment to use the apps cannot be linked to improved levels of participation in the study. This suggests that the provision of technology is insufficient in itself to engage with individuals in health behaviour change and has important implications for future service provision in continence promotion and mHealth.

Background: The definition of urinary incontinence is involuntary loss of urine that is objectively detectable and results in a social and hygienic inconvenience for the individual. There are different types and causes of urinary incontinence and the symptoms often occur more frequently with higher age. Women are affected to a greater extent than men. Urinary incontinence may affect everyday life and lead to changes in quality of life. Aim: To illuminate women's experiences of living with urinary incontinence. Method: A literature study was conducted using qualitative analysis through five steps. An analysis of ten qualitative articles was carried out. Results: Four main themes emerged, a suffering in everyday life, perceived body perception, feelings about sexuality and hope and despair. The results showed that living with urinary incontinence affected everyday life activities. The women felt limited and learned to cope through different strategies. Urinary incontinence affected the women's body image and could result in less confidence and the feeling of powerlessness. The complex situation sometimes leads to negative sexual effects. Women lived with the hope to recover but at the same time there were feelings of despair for what the future would hold for them. Conclusion: Women suffering from urinary incontinence experience restrictions in their everyday life, in physical, mental and social aspects. It creates a feeling of loss of control. And many women suffer in silence without seeking help. Urinary incontinence has a negative effect on their quality of life.

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Orientador: Adriano Dias / Banca: Monica de Oliveira Orsi Gameiro / Banca: Maria Luiza Riesco / Banca: Gabriel Negretti Guirado / Banca: José Tadeu Nunes Tamanini / Resumo:- Não disponível / Abstract:- Not available / Doutor

Orientador: Adriano Dias / Coorientador: Angélica Mércia Pascon Barbosa / Banca: Iracema de Mattos Paranhos Calderon / Banca: Tânia Terezinha Scudeller Prevedel / Resumo: Evidências apontam que as mulheres incontinentes no período gestacional podem apresentar redução na função muscular do assoalho pélvico, favorecendo a ocorrência de incontinência urinária tardia, que pode ser prevenida com fisioterapia. O objetivo do trabalho foi desenvolver um protocolo cinesioterapêutico com exercícios para o assoalho pélvico e analisar a efetividade de sua aplicação sobre a função muscular e continência urinária em primigestas. Um ensaio clínico aleatorizado pragmático foi realizado com 87 gestantes primigestas, avaliadas longitudinalmente em seis encontros ao longo da gestação, divididas em três grupos: GS, que praticou exercícios supervisionados pelo fisioterapeuta; GO, que praticou exercícios sem supervisão e GR que não praticou exercícios. O GS e GO apresentaram aumento da função muscular do assoalho pélvico até o 4º encontro, e no 5º e 6º encontro apresentaram redução dessa função. O GR apresentou declínio da função muscular a partir do 2º encontro. No 1º encontro, 58,6% das gestantes do GS apresentavam incontinência urinária, 51,7% do GO, e 48,3% do GR. No último encontro, o GS apresentou 6,9% das gestantes com incontinência urinária, o GO também com 6,9%, e o GR com 96,6%. Os resultados mostram que exercícios perineais realizados durante a gestação aumentam significativamente a função muscular do assoalho pélvico e diminuem a ocorrência de incontinência urinária. Dada a alta prevalência da incontinência urinária, apontada como conseqüência da perda da função muscular do assoalho pélvico, é essencial desenvolver modelos de intervenção para prevenção, e que possam ser implantados na saúde pública. / Abstract: Evidence shows that women incontinent during pregnancy may have reduced muscle function of the pelvic floor, causing the occurrence of late urinary incontinence, which can be prevented by physiotherapy. The objective was to develop a protocol with kinesthetic exercises for the pelvic floor and analyze the effectiveness of its application on muscle function and urinary continence in primigravidae. A pragmatic randomized clinical trial was conducted with 87 primiparous women as measured longitudinally in six meetings throughout pregnancy, divided into three groups: GS, who practiced exercises supervised by physical therapist, GO, who practiced exercises without supervision and that GR had not performed. The GS and GO showed increases in muscle function of the pelvic floor to the 4th meeting, and at 5 and 6 meeting showed a reduction of this function. The GR has decreased muscle function from the 2nd meeting. In the 1st meeting, 58.6% of the women's GS had urinary incontinence, 51.7% of GO, and 48.3% of GR. In the last meeting, the GS had 6.9% of pregnant women with urinary incontinence, the GO also with 6.9% and 96.6% with GR. The results show that perineal exercises performed during pregnancy significantly increase the function of the pelvic floor muscle and decrease the occurrence of urinary incontinence. Given the high prevalence of urinary incontinence, identified as a result of loss of muscle function of the pelvic floor is essential to develop models of intervention for prevention and that can be deployed on public health. / Mestre