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With great interest we read the article of Leydon et al. [1] in which
it was shown that women attributed urinary tract infection (UTI) to
lifestyle habits and behaviours, such as poor hygiene, general
"negligence" and even a "penalty of growing old." There is an increasing
amount of evidence to suggest that patient education and counselling for
people with a chronic disease are essential for effective preventive
disease management. This is also true for UTI [2], but information about
the knowledge of this patient group is limited.
We assessed disease-related knowledge among 469 women with recurrent UTIs
participating in a UTI prevention study. We used a questionnaire
consisting of 10 questions on five basic themes: (1) causes of UTIs, (2)
female pelvic anatomy, (3) prevalence of UTIs, (4) preventive practices,
and (5) antibiotic use and resistance. There were three multiple-choice
questions, six true/false questions and one figure to fill in correct
words question, respectively. We used logistic regression to identify
patient and disease characteristics associated with a correct/incorrect
answer to the questions.
A total number of 246 women responded (mean age 56.7 years, median number
of UTI 6/year). Most (77.6%) knew that gut bacteria are the cause of most
UTIs. However, one in eight women (12.6%) were convinced that most UTIs
are caused by viruses. More than 80% of women had knowledge of anatomical
factors that make women more prone to UTIs than men. On the other hand,
about one third of women were not familiar with female pelvic anatomy.
Especially, the position of the vagina in the female pelvis was unclear to
a lot of women, 35 women (14.2%) interchanged the position of the vagina
with that of the urethra. With regard to the prevalence of UTIs, only 54
women (22.0%) knew that about half of all women will experience a UTI at
least once in a lifetime. Twenty-eight percent believed that every woman
will experience one or more UTIs during their lifetime. 144 women (58.5%)
knew that prevention of UTIs has nothing to do with a lack of hygiene.
Even in this group of women with recurrent UTIs who probably used
antibiotics frequently, 72 women (29.3%) believed that antibiotics can
kill viruses. However, the definition of antibiotic resistance is well-
known in this group, and most women knew that it is important to use
antibiotics as little as possible to prevent antibiotic resistance. In
contrast, once resistant bacteria have emerged, 35.8% of women supposed
that they would not get rid of those bacteria. We also found that
especially lower educated and older women with recurrent UTIs had less
knowledge about certain aspects of their disease than younger and higher
educated women. Physicians may use the results of this study to fine-tune
patient education to the individual patient.
References
1. G M Leydon, S Turner, H Smith, P Little, on behalf of the UTIS team
Women’s views about management and cause of urinary tract infection:
qualitative interview study. BMJ 2010;340:c279.
2. Lumsden L, Hyner GC. Effects of an educational intervention on the rate
of recurrent urinary tract infections in selected female outpatients.
Women Health 1985;10:79-86.
Competing interests:
None declared
Competing interests:
No competing interests
22 February 2010
Marielle A. Beerepoot
MD
Gerben ter Riet, Corianne de Borgie,Theo de Reijke and Suzanne E. Geerlings
Infect Dis Dept. CINIMA, AMC, 1105 AZ, Amsterdam, The Netherlands
What do women with recurrent urinary tract infections know about their disease?
With great interest we read the article of Leydon et al. [1] in which
it was shown that women attributed urinary tract infection (UTI) to
lifestyle habits and behaviours, such as poor hygiene, general
"negligence" and even a "penalty of growing old." There is an increasing
amount of evidence to suggest that patient education and counselling for
people with a chronic disease are essential for effective preventive
disease management. This is also true for UTI [2], but information about
the knowledge of this patient group is limited.
We assessed disease-related knowledge among 469 women with recurrent UTIs
participating in a UTI prevention study. We used a questionnaire
consisting of 10 questions on five basic themes: (1) causes of UTIs, (2)
female pelvic anatomy, (3) prevalence of UTIs, (4) preventive practices,
and (5) antibiotic use and resistance. There were three multiple-choice
questions, six true/false questions and one figure to fill in correct
words question, respectively. We used logistic regression to identify
patient and disease characteristics associated with a correct/incorrect
answer to the questions.
A total number of 246 women responded (mean age 56.7 years, median number
of UTI 6/year). Most (77.6%) knew that gut bacteria are the cause of most
UTIs. However, one in eight women (12.6%) were convinced that most UTIs
are caused by viruses. More than 80% of women had knowledge of anatomical
factors that make women more prone to UTIs than men. On the other hand,
about one third of women were not familiar with female pelvic anatomy.
Especially, the position of the vagina in the female pelvis was unclear to
a lot of women, 35 women (14.2%) interchanged the position of the vagina
with that of the urethra. With regard to the prevalence of UTIs, only 54
women (22.0%) knew that about half of all women will experience a UTI at
least once in a lifetime. Twenty-eight percent believed that every woman
will experience one or more UTIs during their lifetime. 144 women (58.5%)
knew that prevention of UTIs has nothing to do with a lack of hygiene.
Even in this group of women with recurrent UTIs who probably used
antibiotics frequently, 72 women (29.3%) believed that antibiotics can
kill viruses. However, the definition of antibiotic resistance is well-
known in this group, and most women knew that it is important to use
antibiotics as little as possible to prevent antibiotic resistance. In
contrast, once resistant bacteria have emerged, 35.8% of women supposed
that they would not get rid of those bacteria. We also found that
especially lower educated and older women with recurrent UTIs had less
knowledge about certain aspects of their disease than younger and higher
educated women. Physicians may use the results of this study to fine-tune
patient education to the individual patient.
References
1. G M Leydon, S Turner, H Smith, P Little, on behalf of the UTIS team
Women’s views about management and cause of urinary tract infection:
qualitative interview study. BMJ 2010;340:c279.
2. Lumsden L, Hyner GC. Effects of an educational intervention on the rate
of recurrent urinary tract infections in selected female outpatients.
Women Health 1985;10:79-86.
Competing interests:
None declared
Competing interests: No competing interests