Knowledge and understanding of urinary incontinence: survey of family practitioners in northern Alberta.

OBJECTIVE To investigate family physicians' knowledge of, attitudes toward, and understanding of urinary incontinence (UI), as well as their perceptions of barriers to continence care, as a foundation for designing interventions to improve service provision for those in northern Alberta who suffer from UI. DESIGN Descriptive survey using a standardized instrument. The survey instrument was completed either by telephone interview or on paper copy faxed back to the researchers, depending on participant preference. SETTING Northern Alberta. PARTICIPANTS Random sample of family physicians (N=158). MAIN OUTCOME MEASURES Physician knowledge of and attitudes toward UI, UI management practices, and barriers to providing UI care. RESULTS Survey response rate was 10.6% (158 of 1488); 84.2% (133 of 158) of respondents practised in urban settings, 44.9% (71 of 158) had been in practice for fewer than 15 years, 24.1% (38 of 158) reported having no training in UI management since graduation, and 53.8% (85 of 158) reported that they proactively discussed UI with their patients. Overall, 70.0% of respondents felt fairly confident in managing UI. Most family physicians referred patients for specialist care, with few referrals to community services. Respondents thought that continence services were scarce, with long waiting times, and that such services were generally overstretched; they believed that although high-quality continence care was a personal priority, it was not a priority focus for their practice partnerships or networks. In terms of the highest ranked areas for improvement in UI management, increased awareness and understanding among physicians (ranked first by 28.5% of respondents), followed by dedicated incontinence clinics or nurses for referral (17.7%) and improving patient awareness and understanding (12.0%). CONCLUSION There continues to be considerable variation in knowledge about UI management and a relative overreliance on specialist care, despite well recognized difficulties in gaining access to services. Respondents believed that increased awareness among patients and health care providers coupled with greater access to continence services were key factors in improving care delivery.