Avaliação do conhecimento, atitude e prática de gestantes sobre incontinência urinária: estudo observacional

Abstract

The study aimed to assess the knowledge, attitude and practice (CAP) of pregnant women on Urinary Incontinence (UI), identify the prevalence of UI during pregnancy, assess the impact of this condition on the quality of life of pregnant women and identify the factors associated with Inadequate CAP of pregnant women in relation to UI. This is a cross-sectional study, involving 237 pregnant women, selected for convenience, who underwent prenatal care at two outpatient clinics linked to the Federal University of Ceará (UFC). Data collection took place from May to November 2019, using an electronic form containing two instruments. The first with questions related to sociodemographic and obstetric data and evaluation of urinary losses; and the second directed to CAP assessment on UI. The data were analyzed using IBM SPSS® Statistics version 20.0 for Windows, using the Chi-square test for dichotomous variables and the T test for interval variables. The project was submitted to and approved by the Research Ethics Committee of the Maternity Escola Assis Chateaubriand, with opinion number 3,284,173 and complied with the rules of Resolution No. 466/12 of the National Health Council. The sample consisted of women aged 18 to 43 years, most of whom were married or in a stable relationship (86.1%) and had completed high school (50.6%). The prevalence of UI was 49.3%, with a minimum frequency of urinary loss 2 to 3 times a week (50%), in “small quantity” (84.2%) and with a low impact on quality of life (Md: 4.0 ± 3.6 points). Regarding the evaluation of the CAP, the majority had knowledge (89.6%) and practice both to prevent (89.2%) and to treat (78.8%) inadequate. More than half of pregnant women recognized UI as a problem (55.2%) that affects more women (91%) and that can occur at some stage in life (91%). During pregnancy, the majority (57.2%) considered urinary loss normal. Many pregnant women had already heard about UI (84.8%), however, low percentages of correct answers were detected in relation to the knowledge of risk factors (46.8%), prevention (43.8%) and treatment of UI (42.8%). Among those with UI (49.2%), only 21 (21.2%) sought professional help. Despite this, the attitude was assessed as adequate for most women (98.5%). Most reported feeling very comfortable reporting the UI complaint to the health professional (92.0%) even though he was male (80.1%) and practically all (99.0%) acknowledged the pre -natural with an appropriate time to talk to a health professional about ways to prevent or treat the loss of pee. Not receiving guidance on preparing the perineum for delivery during prenatal care (p = 0.019), having low schooling (p <0.001), lighter UI (p = 0.027) and being a high-risk pregnant woman (p = 0.004 ) were associated with inappropriate practice. Lack of guidance on preparing the perineum was also associated with inadequate knowledge about UI (p <0.001). No variable was associated with an inappropriate attitude or practice (prevention) and having inadequate knowledge was associated with the practice for inadequate treatment (p = 0.019). It is concluded that the knowledge about the causes, ways to prevent and treat UI is insufficient and interferes in the practice to manage this condition. Despite having a high prevalence during pregnancy, the theme is still little addressed during this period and even women who have already sought professional help have not received adequate guidance, showing the need to develop interventions aimed at this population and focused, especially, on the factors that are associated inadequate CAP.