Coping Stages by Military Women with Stress Urinary Incontinence

Purpose/Design: This descriptive, exploratory study was conducted to investigate how symptom distress associated with stress urinary incontinence (SUI) and barriers to continence affect coping and quality of life (QOL) in military women while in the field environment. Methods: After receiving consent from commanders and approval from internal review boards, the researcher mailed recruitment letters to the military women at the performance sites. The subjects consented to participate in the study by returning the screening portions of their recruitment letters. After return of the recruitment letter, the principal investigator (PI) distributed the cover letters and study questionnaires. The cover letter explained the purpose of the study and discussed what would happen to the study findings. All research data were kept in a locked file cabinet in the PI's office. Upon receipt of the completed, anonymous surveys, the PI entered data into the Statistical Package for Social Sciences (SPSS) and conducted data analyses using the .05 level of significance. After data entry, frequency distributions were performed to identify missing data, outliers, and errors in data entry. Sample: The sample included 69 active duty and reserve military women with SUI who had spent at least 10 days in the field environment. Instrumentation: Six instruments were used to measure the variables in this study: demographic data form, Incontinence Impact Questionnaire, Military Field Barrier Checklist, Military Field Coping Checklist, Ways of Coping Questionnaire, Urogenital Distress Inventory. Analysis: Correlation and regression were used to answer the research questions. Hierarchal regression examined the mediating effect of coping on symptom distress and QOL. Descriptive statistics were used to report coping strategies or barriers to coping with incontinence. Alpha coefficients measured the internal consistency of instruments. Findings: As SUI symptom distress increased, the women used a wide variety of problem and emotion focused coping strategies. With higher levels of symptom distress and increased field barriers to coping with incontinence, QOL decreased (r (58) .52, p = .001). Symptom distress emerged as the best predictor of quality of life. However, coping mediated that relationship. Nursing Implications: Because deployments are inevitable for military personnel, more research is needed to better understand the relationships between SUI symptom distress, coping, and QOL. Future research should explore options that would decrease the burden of the field environment for military women with SUI, such as (1) replace all buttons, including on the trousers, with Velcro on the field uniform or provide female-specific trousers with elastic waistbands, (2) provide all female soldiers with a mini hygiene pack before deploying, (3) provide "just-in-time" training for all women before field exercises, and (4) educate women in all military basic courses about female hygiene issues and coping strategies. In conclusion, the findings from this study should be used to develop preventative treatment protocols or training programs, such as stress inoculation training, to help women develop coping skills prior to deployment.

Final report is available on NTRL: https://ntrl.ntis.gov/NTRL/dashboard/searchResults/titleDetail/PB2008112...