Avaliação do conhecimento, atitude e prática (CAP) de usuárias da Atenção Primária sobre a incontinência urinária: estudo transversal

Abstract

Urinary Incontinence (UI) is characterized by the complaint of involuntary urine loss, representing a public health issue due to its high prevalence and the delay in seeking treatment. Given these factors, it is necessary to understand the Knowledge, Attitude, and Practice (KAP) of women in order to intervene adequately in the domains identified as insufficient and propose improvements in health care. This study aimed to assess KAP regarding UI among women using the Primary Health Care service. This is a cross-sectional observational study involving 345 women aged over 18 years who were awaiting care at Primary Health Care Units (UAPS) in the municipality of São Gonçalo do Amarante, Ceará, Brazil. Data collection occurred between May and November 2023 through face-to-face interviews, using an electronic form containing the following instruments: a questionnaire with sociodemographic, obstetric and clinical data; the International Consultation on Incontinence Questionnaire - Short Form (ICIQ-SF) to assess urinary losses and severity; the King’s Health Questionnaire (KHQ) to evaluate quality of life; and the KAP-UI instrument to measure knowledge, attitude, and practice about UI. Data were analyzed using Fisher’s exact test or Pearson’s chi-square test for dichotomous variables, means and standard deviation, and the t-test for interval variables. The prevalence of UI was 35.3%, with the most common subtype being stress urinary incontinence (SUI) (87.2%). Regarding KAP, most participants showed inadequate knowledge (55.7%) and inadequate practices, both for prevention (81.4%) and treatment (61.8%). Although the majority recognized UI as a problem (99.7%), 22.3% could not name any risk factor, and more than half were unable to identify any prevention method (55.7%). Concerning treatment, 31.9% were unaware of available options. Among those with UI, only 21 women (21.2%) sought professional help, and only 14 underwent any form of treatment. Despite this, attitude was considered adequate for the majority of women (99.7%). Low educational level, income below the minimum wage, and being a housewife or retired were associated with inadequate knowledge (p < 0.05). No sociodemographic or obstetric variable was associated with practice. It is concluded that knowledge about the causes, prevention, and treatment of UI was insufficient and interferes with the management of this condition, highlighting the need for interventions targeted at this population within UAPS, especially focusing on the factors associated with inadequate KAP.