Lower urinary tract symptoms: social influence is more important than symptoms in seeking medical care


R. Wolters, Centre for Quality of Care Research, WOK 229, PO Box 9101, 6500 HB Nijmegen, the Netherlands
e-mail: r.wolters@hsv.kun.nl


Objective  To determine associations among lower urinary tract symptoms (LUTS), symptom severity, subjective beliefs and social influences when seeking primary medical care in men aged ≥ 50 years.

Subjects and methods  A population-based survey was conducted among 5052 men aged ≥ 50 years, using patient registers of 22 general practitioners (GPs) in the Netherlands from November 1999 to May 2000. The questionnaire contained items concerning age, educational level, International Prostate Symptom Score (IPSS), bothersome score (BS), and questions from the Health Belief Model on attitude and social influences. The study population comprised men with an IPSS openface> 7. The odds ratios (ORs) corrected for the IPSS were calculated.

Results  In all, 3544 questionnaires (70.2%) were returned. Two groups of men with an IPSS openface> 7 were compared: those who consulted their GP in the previous 2 years because of voiding problems (268 cases) and the controls (272) who did not visit a GP for these symptoms. Cases more often thought a physician could improve their condition (OR 2.85), appeared to be more often advised by others to seek medical care (OR 6.36) and thought more often that this advice influenced their decision (OR 13.95). They also had more frequently received information from the media (OR 2.66) which affected their attendance (OR 12.52). In a multiple regression analysis, advice from others or information from the media were stronger predictors of seeking care than the influence of symptoms on daily life, the IPSS or the BS.

Conclusion  Social influences, i.e. advice from others or the media, were more important factors in the decision to seek medical care than symptom severity.