Doreth Teunissen | Radboudumc Nijmegen - The Netherlands (original) (raw)

Papers by Doreth Teunissen

Family Practice, 2019

Background Endometriosis is an invalidating gynaecological condition in women of reproductive age... more Background Endometriosis is an invalidating gynaecological condition in women of reproductive age, and a frequent cause of infertility. Unfortunately, the condition is characterized by a long interval between onset of symptoms and diagnosis. GPs in the Netherlands are educated to provide basic gynaecological care and serve as gatekeepers for specialist medical care. Therefore, it is of great importance that they recognize signs and symptoms possibly caused by endometriosis to initiate adequate actions. Objective The main objective of this study was to identify barriers and facilitators to the timely diagnosis of endometriosis from the GPs’ perspective. Methods Semi-structured focus group discussions with GPs were organized throughout the Netherlands. The participants were encouraged to brainstorm about their perspective on daily practice regarding endometriosis and suggestions for interventions to enable early diagnosis and treatment. Analysis was based on grounded theory methodolog...

Huisarts en wetenschap, 2018

SamenvattingDe hulpmiddelenwijzer biedt uitkomst voor patiënten met continentieproblemen.

Tijdschrift voor praktijkondersteuning, 2016

SamenvattingUrine-incontinentie is een veelvoorkomend probleem dat patiënten hindert in het dagel... more SamenvattingUrine-incontinentie is een veelvoorkomend probleem dat patiënten hindert in het dagelijks leven. De aandoening kan op verschillende manieren worden behandeld, zowel in de eerste als in de tweede lijn. Daarnaast zijn er initiatieven om de incontinentiezorg te verbeteren, zoals het betrekken van wijkverpleegkundigen en praktijkondersteuners bij de incontinentiezorg, ouderen screenen op incontinentie en e-health. Deze nascholing geeft een overzicht van de mogelijkheden.

Tijdschrift voor praktijkondersteuning, 2014

SamenvattingOngewild urineverlies is een veelvoorkomend probleem. De prevalentie neemt toe met de... more SamenvattingOngewild urineverlies is een veelvoorkomend probleem. De prevalentie neemt toe met de leeftijd. Men schat dat, afhankelijk van de definitie, 15-30% van de zelfstandig wonende ouderen lijdt aan urine-incontinentie, een percentage dat oploopt tot 50% van de bewoners in verzorgingstehuizen en 90% in verpleegtehuizen.

Tijdschrift voor praktijkondersteuning, 2011

Praktische huisartsgeneeskunde, 2019

Urine-incontinentie is een veelvoorkomend probleem bij ouderen. Er zijn grofweg vijf vormen van u... more Urine-incontinentie is een veelvoorkomend probleem bij ouderen. Er zijn grofweg vijf vormen van urine-incontinentie: stressincontinentie, urgencyincontinentie, gemengde incontinentie, overloopincontinentie en functionele incontinentie. Door het afnemen van een goede anamnese, het in kaart brengen van de incontinentiebevorderende factoren, een vaardig lichamelijk onderzoek en een mictiedagboek kan in de meeste gevallen het type incontinentie bepaald worden en een behandeling worden ingesteld. Aanpak van de incontinentiebevorderende factoren is de eerste stap in de behandeling. Bij onvoldoende effect heeft het toevoegen van oefentherapie de voorkeur. Bij stressincontinentie vaker dan twee keer per week is te overwegen om met de vrouw te overleggen of een verwijzing voor een mid-urethraal bandje de voorkeur heeft boven oefentherapie.

International Journal of General Medicine, 2021

Background: In recent years, research on sex-gender differences in health care has increasingly r... more Background: In recent years, research on sex-gender differences in health care has increasingly recognized that men and women differ in the way symptoms occur, in risk factors for certain conditions and in the way they respond to the same treatment. A disease that is known to often present differently in women and men is irritable bowel syndrome (IBS). Given the difference in prevalence, predominant symptoms and possible other pathophysiology, it is conceivable that a difference in treatment effectiveness in men and women is a discovery waiting to be found. Purpose: To determine whether there are differences in treatment effectiveness between men and women with irritable bowel syndrome. Materials and Methods: We searched on PubMed and EMBASE, selecting randomized controlled trials comparing IBS treatment in men and women over 18 years old. One researcher performed the inclusion process, and two researchers independently performed a quality assessment. A descriptive analysis was conducted. Results: Twelve studies, randomizing 1847 men and 3562 women, were included in this review. Treatment with serotonin antagonist alosetron, treatment with ibodutant and crofelemer and adding cognitive behavioral therapy to medical treatment found significant differences between men and women in favor of effectiveness towards women in either satisfactory relief of overall IBS symptoms or percentage of pain-free days. Conclusion: Sex-gender can be a determining factor in the effectiveness of IBS treatment. Due to the limited number of studies per treatment option, no recommendations can be made on the choice of a specific treatment. It is clear, however, that so as not to miss beneficial treatment options for either sex, the inclusion, analysis and description of data on the basis of sex is of the utmost importance.

Huisarts en wetenschap, 2020

BMC Medical Education, 2020

Background Sex and gender influence health and disease outcomes, therefore, doctors should be abl... more Background Sex and gender influence health and disease outcomes, therefore, doctors should be able to deliver gender-sensitive care. To train gender-sensitive doctors, relevant sex and gender differences have to be included in medical education. In order to develop appealing, relevant, and effective education for undergraduate medical students, education should be tailored to students’ level and anticipated on their ideas and assumptions. Therefore, we wanted to answer the following research questions: 1. What do aspiring medical students want to learn about gender medicine?; 2. How would they like to learn about gender medicine?; and 3. What are their ideas and assumptions about sex and gender differences in health and disease? Methods We performed an explorative thematic document analysis of educational assignments made by successful applicants (n = 50) during the selection procedure of their entry into medical school. To test aspirants’ capacity for self-directed learning, studen...

JMIR Research Protocols, 2019

BMC Family Practice, 2019

Background: Stress urinary incontinence (SUI) is the most prevalent subtype of urinary incontinen... more Background: Stress urinary incontinence (SUI) is the most prevalent subtype of urinary incontinence and is a bothering condition in women. Only a minority of those with SUI consult a general practitioner (GP). EHealth with pelvic floor muscle training (PFMT) is effective in reducing incontinence symptoms and might increase access to care. The role of the GP regarding such an eHealth intervention is unknown. The aim of the study is to gain insight into the attitudes towards a PFMT internet-based, eHealth, intervention for SUI. Methods: A qualitative study was conducted. Data were collected through semi-structured interviews among purposively sampled GPs. Audio records were fully transcribed, and analysed thematically. Results: Thirteen GPs were interviewed, nine females and four males. Three themes emerged: appraisal of eHealth as a welcome new tool, mixed feelings about a supportive role, and eHealth is no cure-all. GPs welcomed eHealth for SUI as matching their preferences for PFMT and having advantages for patients. With eHealth as stand-alone therapy GPs were concerned about the lack of feedback, and the loss of motivation to adhere to the intervention. Therefore, GPs considered personal support important. The GP's decision to recommend eHealth was strongly influenced by a woman's motivation and her age. GPs' treatment preferences for elderly are different from those for young women with SUI; both PFMT and eHealth are perceived less suitable for older women. Conclusion: EHealth with PFMT fits into the GPs' routine practice of SUI and adds value to it. Although there is evidence that eHealth as a stand-alone intervention is effective, GPs consider personal support important to supplement the perceived shortcomings. Probably GPs are not aware of, or convinced of the existing evidence. Training should address this issue and should also focus on common misunderstandings about regular care for women with SUI, such as the idea that PFMT is not suitable for the elderly. Improving GPs' knowledge that eHealth can be a stand-alone therapy for SUI facilitates the implementation in daily care.

Huisarts en wetenschap, 2018

International Urogynecology Journal, 2018

Introduction and hypothesis Stress urinary incontinence (SUI) is a common condition with a major ... more Introduction and hypothesis Stress urinary incontinence (SUI) is a common condition with a major impact on quality of life (QoL). Various factors prevent women from seeking help. However, eHealth (Internet-based therapy) with pelvic floor muscle training (PFMT) is an effective and satisfying intervention for these women. We hypothesize that women with symptoms after regular therapy will profit from eHealth. This study explores the expectations regarding an eHealth intervention among women who still suffer from SUI despite treatment. Methods A qualitative study with semistructured interviews was conducted using a grounded theory approach. The study included women with SUI who had ever sought help for their condition. Results Thirteen women were interviewed, most whom had experience with PFMT and still suffered from moderate-to-severe incontinence. Two themes emerged from data analysis: the need to meet, and eHealth as a tool to bridge obstacles. Women greatly emphasized that a healthcare professional, preferably one they know, should be available with eHealth. Several women indicated that the absence of personal contact caused lack of trust in success. However, several women were willing to use eHealth because its anonymity and flexibility could overcome obstacles in regular care. Conclusions eHealth based on PFMT is currently not a preferable treatment modality for women who still suffer from SUI despite treatment. eHealth cannot act as a substitute for their positive experience with personal contact. Some women are willing to use eHealth because of its advantages over regular care. Future experiences with eHealth might enable women with SUI to trust digital care.

The European journal of general practice, 2018

The gap between the relatively high prevalence of provoked vulvodynia (PVD) in the general popula... more The gap between the relatively high prevalence of provoked vulvodynia (PVD) in the general population and the low incidence in primary care can partly be explained by physicians' lack of knowledge about the assessment and management of PVD. To recognize barriers and facilitators of GPs in the diagnostic process of women presenting with recurrent vulvovaginal complaints. A qualitative focus group study in 17 Dutch GPs, five men and 12 women. An interview guide, based on the scientific literature and the expertise of the researchers, including a vignette of a patient, was used to direct the discussion between the GPs. The interviews were audiotaped and transcribed verbatim. A systematic text analysis of the transcripts was performed after data saturation was reached. Analysis of the interviews generated three major themes: Identifying and discussing sexual complaints, importance of gender in professional experience, and coping with professional uncertainty. Within these themes, th...

Health Informatics Journal, 2017

There is a gap in knowledge of women’s perceptions of e-health treatment. This review aims to inv... more There is a gap in knowledge of women’s perceptions of e-health treatment. This review aims to investigate women’s expectations and experiences regarding e-health. A search was conducted in MEDLINE, EMBASE, CINAHL and PsycInfo in March 2016. We included articles published between 2000 and March 2016, reporting on e-health interventions. The initial search yielded 2987 articles. Eventually, 16 articles reporting on 16 studies were included. Barriers to e-health treatment were lower for women than barriers to face-to-face treatment, such as feelings of shame and time constraints. Women were able to develop an online therapeutic relationship. As reduced feelings of obligation and lack of motivation were women’s greatest challenges in completing e-health treatment, they expressed a wish for more support during e-health treatment, preferably blended care. e-Health lowers the threshold for women to seek healthcare. Combining e-health interventions with face-to-face sessions may enhance wom...

BJGP Open, 2017

BackgroundA recent Dutch study in general practice showed a clear relationship between the diagno... more BackgroundA recent Dutch study in general practice showed a clear relationship between the diagnosis of vulvovaginal candidiasis (VVC) and symptoms suggestive of provoked vulvodynia (PVD). PVD accounts for the largest group of vulvar pains, but is often not recognised by GPs.AimTo investigate whether diagnostic uncertainty about VVC in general practice could also point to the diagnosis of PVD, and whether and how this diagnostic uncertainty affects management.Design & settingAn observational study in 2014 in Dutch general practices of the NIVEL Primary Care Database.MethodWomen with an uncertain diagnosis of VVC were distinguished from those with certain VVC based on the occurrence of recurrent episodes and persisting complaints, despite treatment. Factors known to be associated with PVD were hypothesised to be more prevalent in women with uncertain VVC. Data on symptom management by GPs were collected.ResultsIn total 7066 women with VVC or uncertain VVC were included. Uncertain VVC...

Huisarts en wetenschap

Item does not contain fulltex

Journal of Evaluation in Clinical Practice, 2015

ABSTRACT

The British journal of general practice : the journal of the Royal College of General Practitioners, 2005

Only a small proportion of older people with urinary incontinence seek help, despite the availabi... more Only a small proportion of older people with urinary incontinence seek help, despite the availability of adequate treatment. To ascertain the patient- and disease-specific factors that determine whether medical care for urinary incontinence is sought by independently living older people with urinary incontinence. Qualitative and quantitative analyses of interview data. All independently-living older patients aged 60 years or over from nine family practices involved in the Nijmegen Monitoring Project. All the independently-living patients aged 60 years or over with uncomplicated urinary incontinence were interviewed at home using the Protection, Amount, Frequency, Adjustment, Body image (PRAFAB) assessment tool, the Incontinence Impact Questionnaire, and the Urogenital Distress Inventory (UDI). In total, 56 men and 314 women were interviewed. Half of the patients had sought help from a GP. Help-seeking was related to the duration of symptoms, the severity of incontinence, the impact ...

Family Practice, 2019

Background Endometriosis is an invalidating gynaecological condition in women of reproductive age... more Background Endometriosis is an invalidating gynaecological condition in women of reproductive age, and a frequent cause of infertility. Unfortunately, the condition is characterized by a long interval between onset of symptoms and diagnosis. GPs in the Netherlands are educated to provide basic gynaecological care and serve as gatekeepers for specialist medical care. Therefore, it is of great importance that they recognize signs and symptoms possibly caused by endometriosis to initiate adequate actions. Objective The main objective of this study was to identify barriers and facilitators to the timely diagnosis of endometriosis from the GPs’ perspective. Methods Semi-structured focus group discussions with GPs were organized throughout the Netherlands. The participants were encouraged to brainstorm about their perspective on daily practice regarding endometriosis and suggestions for interventions to enable early diagnosis and treatment. Analysis was based on grounded theory methodolog...

Huisarts en wetenschap, 2018

SamenvattingDe hulpmiddelenwijzer biedt uitkomst voor patiënten met continentieproblemen.

Tijdschrift voor praktijkondersteuning, 2016

SamenvattingUrine-incontinentie is een veelvoorkomend probleem dat patiënten hindert in het dagel... more SamenvattingUrine-incontinentie is een veelvoorkomend probleem dat patiënten hindert in het dagelijks leven. De aandoening kan op verschillende manieren worden behandeld, zowel in de eerste als in de tweede lijn. Daarnaast zijn er initiatieven om de incontinentiezorg te verbeteren, zoals het betrekken van wijkverpleegkundigen en praktijkondersteuners bij de incontinentiezorg, ouderen screenen op incontinentie en e-health. Deze nascholing geeft een overzicht van de mogelijkheden.

Tijdschrift voor praktijkondersteuning, 2014

SamenvattingOngewild urineverlies is een veelvoorkomend probleem. De prevalentie neemt toe met de... more SamenvattingOngewild urineverlies is een veelvoorkomend probleem. De prevalentie neemt toe met de leeftijd. Men schat dat, afhankelijk van de definitie, 15-30% van de zelfstandig wonende ouderen lijdt aan urine-incontinentie, een percentage dat oploopt tot 50% van de bewoners in verzorgingstehuizen en 90% in verpleegtehuizen.

Tijdschrift voor praktijkondersteuning, 2011

Praktische huisartsgeneeskunde, 2019

Urine-incontinentie is een veelvoorkomend probleem bij ouderen. Er zijn grofweg vijf vormen van u... more Urine-incontinentie is een veelvoorkomend probleem bij ouderen. Er zijn grofweg vijf vormen van urine-incontinentie: stressincontinentie, urgencyincontinentie, gemengde incontinentie, overloopincontinentie en functionele incontinentie. Door het afnemen van een goede anamnese, het in kaart brengen van de incontinentiebevorderende factoren, een vaardig lichamelijk onderzoek en een mictiedagboek kan in de meeste gevallen het type incontinentie bepaald worden en een behandeling worden ingesteld. Aanpak van de incontinentiebevorderende factoren is de eerste stap in de behandeling. Bij onvoldoende effect heeft het toevoegen van oefentherapie de voorkeur. Bij stressincontinentie vaker dan twee keer per week is te overwegen om met de vrouw te overleggen of een verwijzing voor een mid-urethraal bandje de voorkeur heeft boven oefentherapie.

International Journal of General Medicine, 2021

Background: In recent years, research on sex-gender differences in health care has increasingly r... more Background: In recent years, research on sex-gender differences in health care has increasingly recognized that men and women differ in the way symptoms occur, in risk factors for certain conditions and in the way they respond to the same treatment. A disease that is known to often present differently in women and men is irritable bowel syndrome (IBS). Given the difference in prevalence, predominant symptoms and possible other pathophysiology, it is conceivable that a difference in treatment effectiveness in men and women is a discovery waiting to be found. Purpose: To determine whether there are differences in treatment effectiveness between men and women with irritable bowel syndrome. Materials and Methods: We searched on PubMed and EMBASE, selecting randomized controlled trials comparing IBS treatment in men and women over 18 years old. One researcher performed the inclusion process, and two researchers independently performed a quality assessment. A descriptive analysis was conducted. Results: Twelve studies, randomizing 1847 men and 3562 women, were included in this review. Treatment with serotonin antagonist alosetron, treatment with ibodutant and crofelemer and adding cognitive behavioral therapy to medical treatment found significant differences between men and women in favor of effectiveness towards women in either satisfactory relief of overall IBS symptoms or percentage of pain-free days. Conclusion: Sex-gender can be a determining factor in the effectiveness of IBS treatment. Due to the limited number of studies per treatment option, no recommendations can be made on the choice of a specific treatment. It is clear, however, that so as not to miss beneficial treatment options for either sex, the inclusion, analysis and description of data on the basis of sex is of the utmost importance.

Huisarts en wetenschap, 2020

BMC Medical Education, 2020

Background Sex and gender influence health and disease outcomes, therefore, doctors should be abl... more Background Sex and gender influence health and disease outcomes, therefore, doctors should be able to deliver gender-sensitive care. To train gender-sensitive doctors, relevant sex and gender differences have to be included in medical education. In order to develop appealing, relevant, and effective education for undergraduate medical students, education should be tailored to students’ level and anticipated on their ideas and assumptions. Therefore, we wanted to answer the following research questions: 1. What do aspiring medical students want to learn about gender medicine?; 2. How would they like to learn about gender medicine?; and 3. What are their ideas and assumptions about sex and gender differences in health and disease? Methods We performed an explorative thematic document analysis of educational assignments made by successful applicants (n = 50) during the selection procedure of their entry into medical school. To test aspirants’ capacity for self-directed learning, studen...

JMIR Research Protocols, 2019

BMC Family Practice, 2019

Background: Stress urinary incontinence (SUI) is the most prevalent subtype of urinary incontinen... more Background: Stress urinary incontinence (SUI) is the most prevalent subtype of urinary incontinence and is a bothering condition in women. Only a minority of those with SUI consult a general practitioner (GP). EHealth with pelvic floor muscle training (PFMT) is effective in reducing incontinence symptoms and might increase access to care. The role of the GP regarding such an eHealth intervention is unknown. The aim of the study is to gain insight into the attitudes towards a PFMT internet-based, eHealth, intervention for SUI. Methods: A qualitative study was conducted. Data were collected through semi-structured interviews among purposively sampled GPs. Audio records were fully transcribed, and analysed thematically. Results: Thirteen GPs were interviewed, nine females and four males. Three themes emerged: appraisal of eHealth as a welcome new tool, mixed feelings about a supportive role, and eHealth is no cure-all. GPs welcomed eHealth for SUI as matching their preferences for PFMT and having advantages for patients. With eHealth as stand-alone therapy GPs were concerned about the lack of feedback, and the loss of motivation to adhere to the intervention. Therefore, GPs considered personal support important. The GP's decision to recommend eHealth was strongly influenced by a woman's motivation and her age. GPs' treatment preferences for elderly are different from those for young women with SUI; both PFMT and eHealth are perceived less suitable for older women. Conclusion: EHealth with PFMT fits into the GPs' routine practice of SUI and adds value to it. Although there is evidence that eHealth as a stand-alone intervention is effective, GPs consider personal support important to supplement the perceived shortcomings. Probably GPs are not aware of, or convinced of the existing evidence. Training should address this issue and should also focus on common misunderstandings about regular care for women with SUI, such as the idea that PFMT is not suitable for the elderly. Improving GPs' knowledge that eHealth can be a stand-alone therapy for SUI facilitates the implementation in daily care.

Huisarts en wetenschap, 2018

International Urogynecology Journal, 2018

Introduction and hypothesis Stress urinary incontinence (SUI) is a common condition with a major ... more Introduction and hypothesis Stress urinary incontinence (SUI) is a common condition with a major impact on quality of life (QoL). Various factors prevent women from seeking help. However, eHealth (Internet-based therapy) with pelvic floor muscle training (PFMT) is an effective and satisfying intervention for these women. We hypothesize that women with symptoms after regular therapy will profit from eHealth. This study explores the expectations regarding an eHealth intervention among women who still suffer from SUI despite treatment. Methods A qualitative study with semistructured interviews was conducted using a grounded theory approach. The study included women with SUI who had ever sought help for their condition. Results Thirteen women were interviewed, most whom had experience with PFMT and still suffered from moderate-to-severe incontinence. Two themes emerged from data analysis: the need to meet, and eHealth as a tool to bridge obstacles. Women greatly emphasized that a healthcare professional, preferably one they know, should be available with eHealth. Several women indicated that the absence of personal contact caused lack of trust in success. However, several women were willing to use eHealth because its anonymity and flexibility could overcome obstacles in regular care. Conclusions eHealth based on PFMT is currently not a preferable treatment modality for women who still suffer from SUI despite treatment. eHealth cannot act as a substitute for their positive experience with personal contact. Some women are willing to use eHealth because of its advantages over regular care. Future experiences with eHealth might enable women with SUI to trust digital care.

The European journal of general practice, 2018

The gap between the relatively high prevalence of provoked vulvodynia (PVD) in the general popula... more The gap between the relatively high prevalence of provoked vulvodynia (PVD) in the general population and the low incidence in primary care can partly be explained by physicians' lack of knowledge about the assessment and management of PVD. To recognize barriers and facilitators of GPs in the diagnostic process of women presenting with recurrent vulvovaginal complaints. A qualitative focus group study in 17 Dutch GPs, five men and 12 women. An interview guide, based on the scientific literature and the expertise of the researchers, including a vignette of a patient, was used to direct the discussion between the GPs. The interviews were audiotaped and transcribed verbatim. A systematic text analysis of the transcripts was performed after data saturation was reached. Analysis of the interviews generated three major themes: Identifying and discussing sexual complaints, importance of gender in professional experience, and coping with professional uncertainty. Within these themes, th...

Health Informatics Journal, 2017

There is a gap in knowledge of women’s perceptions of e-health treatment. This review aims to inv... more There is a gap in knowledge of women’s perceptions of e-health treatment. This review aims to investigate women’s expectations and experiences regarding e-health. A search was conducted in MEDLINE, EMBASE, CINAHL and PsycInfo in March 2016. We included articles published between 2000 and March 2016, reporting on e-health interventions. The initial search yielded 2987 articles. Eventually, 16 articles reporting on 16 studies were included. Barriers to e-health treatment were lower for women than barriers to face-to-face treatment, such as feelings of shame and time constraints. Women were able to develop an online therapeutic relationship. As reduced feelings of obligation and lack of motivation were women’s greatest challenges in completing e-health treatment, they expressed a wish for more support during e-health treatment, preferably blended care. e-Health lowers the threshold for women to seek healthcare. Combining e-health interventions with face-to-face sessions may enhance wom...

BJGP Open, 2017

BackgroundA recent Dutch study in general practice showed a clear relationship between the diagno... more BackgroundA recent Dutch study in general practice showed a clear relationship between the diagnosis of vulvovaginal candidiasis (VVC) and symptoms suggestive of provoked vulvodynia (PVD). PVD accounts for the largest group of vulvar pains, but is often not recognised by GPs.AimTo investigate whether diagnostic uncertainty about VVC in general practice could also point to the diagnosis of PVD, and whether and how this diagnostic uncertainty affects management.Design & settingAn observational study in 2014 in Dutch general practices of the NIVEL Primary Care Database.MethodWomen with an uncertain diagnosis of VVC were distinguished from those with certain VVC based on the occurrence of recurrent episodes and persisting complaints, despite treatment. Factors known to be associated with PVD were hypothesised to be more prevalent in women with uncertain VVC. Data on symptom management by GPs were collected.ResultsIn total 7066 women with VVC or uncertain VVC were included. Uncertain VVC...

Huisarts en wetenschap

Item does not contain fulltex

Journal of Evaluation in Clinical Practice, 2015

ABSTRACT

The British journal of general practice : the journal of the Royal College of General Practitioners, 2005

Only a small proportion of older people with urinary incontinence seek help, despite the availabi... more Only a small proportion of older people with urinary incontinence seek help, despite the availability of adequate treatment. To ascertain the patient- and disease-specific factors that determine whether medical care for urinary incontinence is sought by independently living older people with urinary incontinence. Qualitative and quantitative analyses of interview data. All independently-living older patients aged 60 years or over from nine family practices involved in the Nijmegen Monitoring Project. All the independently-living patients aged 60 years or over with uncomplicated urinary incontinence were interviewed at home using the Protection, Amount, Frequency, Adjustment, Body image (PRAFAB) assessment tool, the Incontinence Impact Questionnaire, and the Urogenital Distress Inventory (UDI). In total, 56 men and 314 women were interviewed. Half of the patients had sought help from a GP. Help-seeking was related to the duration of symptoms, the severity of incontinence, the impact ...