Assistência fisioterapêutica a mulheres com incontinência urinária na atenção básica


IBICT - Instituto Brasileiro de Informação em Ciência e Tecnologia




The female urinary incontinence is considered a public health problem due to the high morbidity in patients, its association with high costs for the system, high prevalence and number of absences from work. The treatment of women with this health condition, in Primary Health Care, is necessary to improve quality of life in this population. As the pelvic floor muscle training is the first line treatment for women with urinary incontinence and it is not usually carried out in Primary Health Care, the objectives of this study were to identify the occurrence, severity and urinary incontinence impact on quality of life of women using the Primary Health Care Unit and investigate the effectiveness of two physical therapy assistance strategies for women with urinary incontinence, in this level of health care. Materials and Methods: A longitudinal study was conducted involving women with urinary incontinence of two Primary Health Care Units in Belo Horizonte city. It was given two treatment options for the participants to choose according to their availability and interest: home care treatment and group treatment in the Primary Health Care Unit in addition to home care. The participants assessments were made at four times: admission (beginning), half of the intervention (6 weeks), discharge of the treatment (discharge) and at a follow-up one month after discharge (1 month). The outcomes investigated were: the amount of urine loss measured by the 24 hours Pad-test; frequency of leakage obtained from the 24 hours Voiding Diary; and the impact of urinary incontinence on quality of life measured by the ICIQ-SF. Descriptive statistics were applied to identify the occurrence of women with urinary incontinence and describe the sample in relation to sociodemographic and clinical characteristics and for the investigated outcomes. ANOVA was applied to test for changes in outcomes over time and to make the comparison between treatments at each time investigated. Results: The occurrence of urinary incontinence in the studied population was 64.38% and 60 women completed the study, 30 underwent treatment at home and 30 had their treatment carried out in the Primary Health Care Unit in addition to home care. Regardless of the type of treatment, there was a significant reduction, over time, of the amount of urine loss (p = 0.004), of the frequency of leakage (p = 0.015) and of the urinary incontinence impact on quality of life (p <0.001), and these changes have already begun to be statistically significant from six weeks of starting treatment for such outcomes. No differences was found when comparing the amount of urine loss, frequency of urinary incontinence and the urinary incontinence impact on quality of life between the two groups for assistance in the four assessments (p = 0.773, p = 0.741, p = 0.849) , respectively. Conclusion: The occurrence of urinary incontinence found in this study appears to be greater than described in the literature. The two types of assistance seem to be effective for the female urinary incontinence treatment in Primary Health Care, this result guides managers and physiotherapists on the need and possibilities for physical therapy approach for this population, at the primary level of health care.


urina incontinência teses. mulheres teses. serviços de saúde teses. fisioterapia teses.

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