Urinary incontinence (UI) is a prevalent health condition affecting individuals across various demographics worldwide. Its impact extends beyond physical discomfort, often leading to psychological distress and diminished quality of life. Despite its widespread prevalence and detrimental effects, UI remains underdiscussed due to stigma and misconceptions surrounding the condition [1]. 

There remains a scarcity of evidence regarding the effectiveness of educational interventions in raising awareness of pelvic floor dysfunctions. However, numerous studies focusing on various health conditions, both acute and chronic [2], have highlighted the significance of raising awareness and sensitizing patients to their conditions. Increasing health literacy regarding UI has the potential to empower individuals to make informed decisions, thereby averting unnecessary expenditures on ineffective solutions.
The objective of this study was to evaluate the immediate impact of an educational session on older adults' understanding of urinary tract dysfunctions, with a specific focus on UI.

A quasi-experimental study was conducted involving a sample of older adults. The session was publicized within the community through the local council's communication channels. Registration was compulsory, yet participation was free of charge. The session was held in an auditorium provided by the council and was accompanied by a council representative. At the beginning of the session, the study objectives were presented to all participants. They were assured that participation did not necessitate completion of questionnaires, and individuals could opt out at any point voluntarily. Additionally, participants who encountered difficulty in reading the questions or statements were offered assistance in completing the questionnaire upon request. Throughout the presentation, active engagement was encouraged, and participants were invited to ask questions and seek clarification as needed.
Sociodemographic, anthropometric, and medical history data were collected via questionnaire. UI symptoms were assessed by the ICIQ-UI-SF. Knowledge pertaining to UI was assessed using the Incontinence Quiz Questionnaire, Portuguese version [3], administered both before and after the educational session. It comprises 14 statements encompassing 4 categories: 1) Relationship of aging and UI (questions 1 and 2), Causes of UI (questions 3, 8, 10, and 12), Physician-patient discussion about UI (questions 7 and 9), and Treatments and effects of UI (questions 4, 5, 6, 11, 13, and 14). One point is awarded for each correct answer, resulting in a total score ranging from 0 to 14. Higher scores indicate greater knowledge and more positive attitudes about UI. Six statements are correct (questions 3, 6, 8, 11, 12, and 14), while the remainder are incorrect. The educational session was thoughtfully designed to cater the study objectives and the target population. Topics covered included the definition of UI, types of UI, associated risk factors, diverse beliefs surrounding UI, socioeconomic implications of the condition, available treatment options, and appropriate bladder behaviors.
To analyze changes in correct answers before and after the educational session, McNemar's test was employed. Additionally, the Mann-Whitney U test was utilized to compare the total IQQ score, determined by the number of correct answers, before the educational session, stratified by sex and the presence of UI symptoms. The significance level was set at p < 0.05.

A total of 72 individuals, encompassing both sex, participated in the educational session, with 67 consenting to complete the questionnaires. The median age (Interquartile Range) of the participants was 73 (69-73) years. The majority of the participants were female (n=46; 68.7%), predominantly with a low level of education (n=51; 76.1% having only attended primary school), and reported symptoms of UI (n=48; 71.6%). Among the reported types of UI, mixed UI was the most prevalent (n=24; 50%), followed by Urgency UI (n=18; 37.5%) and Stress UI (n=6; 12.5%).

Prior to the educational session, approximately nine out of the fourteen questions garnered correct answers from approximately less than 50% of the participants. Following the educational session, there was a notable increase in correct responses, in eleven out of the fourteen questions. Moreover, in nine out of the fourteen questions, this increase reached statistical significance.

No associations were found between the total score on the IQQ and either sex or the presence of urinary incontinence symptoms.

Overall, the educational session demonstrated immediate effectiveness in increasing UI literacy. Specifically, there was an improvement in correct answers observed in the Relationship between ageing and UI category, with both statements showing enhancement. In the Treatments and effects of UI category, there was a significant increase in correct answers in 2/3 of the questions. Additionally, In the Causes of UI and Doctor-patient discussion about UI categories, significant changes were observed in half of the responses.
Interestingly, no significant associations were found between sex and the presence of UI symptoms with greater literacy in this dysfunction. Therefore, it appears that information actions aimed at preventing dysfunction are necessary and seem to be independent of certain demographic characteristics.

The findings highlight the transformative potential of educational sessions in enhancing health literacy on UI among older adults. Empowering affected individuals with the required knowledge and skills to understand and effectively manage their condition is paramount, as it facilitates their ability to seek appropriate management and support. Moreover, educational sessions have the capacity to mitigate UI-related stigma and contribute to overall well-being enhancements.

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Carvalhais A, Araújo F, & Ferreira M. Incontinence Quiz: Translation, validation, and reproducibility in Portuguese women. Neurourology and Urodynamics, 39(8) (2020), pp. 2490–2497. https://doi.org/https://doi.org/10.1002/nau.24521

Continence 12S (2024) 101418
DOI: 10.1016/j.cont.2024.101418