Table 5.

Triangulating women’s and health professionals’ views to inform the content and delivery of the self-management package

No.	Theme	Women’s views	Health professionals’ views	Implications for content	Final content
1	Older women see UI as a fact of life	Many attributed UI to their age, seeing it as a ‘fact of life’. They had modest aspirations to have better control of UI and worry less, rather than hoping to be rid of it		Provide facts on causes of UI, educate that UI is not a fact of life for older women and that it treatable and potentially curable	Stage 1: recognition and awareness Stage 3: understanding the cause
		Most were upset and bothered by their UI and were making significant changes to their lives. Clear concern about finding public toilets when out		Acknowledge the physical, social and emotional challenges of living with UI, share other women’s experiences, educate on public toilet resources	Stage 1: recognition and awareness Stage 4: learning to manage your UI
		Two-thirds did not discuss UI with anyone, keeping it private		Acknowledge that talking about UI can be difficult, share other women’s reasons for not discussing it with friends and family	Stage 1: recognition and awareness
2	Access to information and high-quality professional support is limited	Most had not accessed information about UI	Were providing women with written UI resources	Provide guidance on where women can access good information on UI	Stage 6: how can you find out more?
		Very few were accessing professional support. Even less had accessed specialist support. Those who had were very positive about it	Older women may not think services are available to them because nothing can be done. Multiple referral pathways available	Encourage women to seek professional support (that the UI can be treated) and provide guidance on how to access services	Stage 2: getting the support you need Stage 6: local healthcare support that may help you
3	Trial and error with different self-management strategies	All had tried/were using different self-management strategies with varying success	Self-management is hard, some do better than other. Employing multiple strategies to motivate women. Good relationship seen as critical to success	Educate on the important of self-management. Acknowledge the challenges of self-management. Advice on self-management including developing a self-management plan	Stage 4: learning to manage your UI Stage 5: developing a self-management plan—managing expectations and thinking positively
		All were routinely using continence pads, usually buying them. 3 women were bothered by this cost. Seen as effective but uncomfortable and associated with worry. 2 women wanted guidance on correct type and size	Continence pads used by most patients in the continence clinic. Some noted that some women use pads as easier than other self-management strategies. 2 women mentioned that it is important for women to use the correct type and size	Educate that pads are not a treatment for UI. Advise on their correct use, the different sizes and where available for free	Stage 4: learning to manage your UI
		None were routinely doing pelvic floor exercises. Key barriers were poor understanding, concerns about getting up/urinating and not seeing them as effective	All were teaching pelvic floor exercises for stress UI, considered them effective for most women were done correctly over time, acknowledging the challenge for women to remain motivated	Educate on the value of pelvic floor exercises and how to do them. Acknowledge the challenge of staying motivated when improvement takes time. Share other women’s experiences	Stage 4: learning to manage your UI—pelvic floor muscle exercises
4	Self-management strategies	Two thirds were using bladder training strategies. No one commented on how well this was working	Several advised women with urge UI to train their bladder, while acknowledging effectiveness can be affected by how long poor toilet habits have been in place	Educate on the value of bladder training for urge UI and how to do it. Provide a bladder diary and recommend to use it	Stage 4: learning to manage your UI—bladder training Stage 5: developing a self-management plan
		Two-thirds had changed their drinking habits and found this to be effective	Fluid management strategies used with women and seen as effective, especially for urge UI	Educate on the importance of balancing fluid intake and provide guidance. Provide a fluid intake diary and recommend to use it	Stage 4: learning to manage your UI—lifestyle changes Stage 5: developing a self-management plan
		Half had been prescribed medication with mixed views on effectiveness. Key barriers to adherence were side effects	Medication seen as an option for UI when other strategies not worked, while acknowledging the side effects and that does not work for everyone	Explain reason for UI medication, acknowledge side effects
5	Delivery preferences	Mixed views. Some favoured reading it before meeting with a health professional so they are prepared with questions. Others preferred to go through it first time with a health professional for personalised support	Mixed views. Some (especially those in the urogynaecology department) wanted to go through it with their patients to ensure understanding. Others said if the package was good enough it could be used independently with support as needed

UI, urinary incontinence.