Table 3.

Characteristics of Sources of Evidence.

Authors, Year	Discipline of First Author	Country	Purpose	Design	Sample	Measures of Symptom Burden	Main Findings Related to Symptom Burden
Cagnacci et al., 2016	Obstetrics and Gynecology	Italy	To examine the association of climacteric symptoms (vasomotor, anxiety, depression, somatic, sexual) and urinary incontinence in postmenopausal women.	Cross-sectional	1502 postmenopausal White women, mean age 55.8 ± 5.8 years at the menopause outpatient service at a university hospital from January 2010 to December 2015.	Greene Climacteric Scale, State Trait Anxiety Inventory, Zung’s Scale for Depression.	Postmenopausal women with urinary incontinence had a higher symptom burden in terms of vasomotor, anxiety, depression, somatic, and sexual symptoms than those without urinary incontinence.
Melville et al., 2005	Obstetrics and Gynecology	United States	To evaluate the prevalence and associated factors of major depression among women with urinary incontinence.	Cross-sectional	3563 women aged 30–90 years at a health maintenance organization in 2002; race and ethnicity data not specified.	Patient Incontinence Severity Assessment, Incontinence-Quality of Life scale with three subscales (avoidance and limiting behaviors, psychosocial impacts, social embarrassment), Patient Health Questionnaire nine-item for depression.	Women with comorbid urinary incontinence and major depression had higher incontinence symptom burden, functional impairment, and reduced quality of life than those with urinary incontinence alone.
Saiki, 2015	Nursing	United States	To explore the impact of female urinary incontinence on the intimate partner dyad in terms of symptom severity, relationship satisfaction, biographical, and relationship factors.	Dissertation; mixed methods	57 women aged 45–65 years with urinary incontinence and 43 male intimate partners; 21.1% Hispanic/Latina, 71.9% White, 7% Other.	Incontinence Severity Index, three Incontinence Questions, Couples Satisfaction Index, Rosenberg Self-Esteem Scale, Body Image Scale, Hospital Anxiety and Depression Scale, Sexual Quality of Life Scale.	As symptom burden increases, relationship satisfaction decreases and intimate partners may not successfully cope together.
Strickland, 2014	Nursing	United States	To summarize and analyze the literature focusing on reasons for not seeking care from clinicians among older women with urinary incontinence.	Literature review	Community-dwelling women aged 50 years and older with urinary incontinence; 18 articles (quantitative studies n = 12, qualitative studies n = 6).	N/A	Symptom perception affects care-seeking behavior and many women choose not to seek formal care, which perpetuates symptom burden.
National Association for Continence (n.d.b)	Not specified	United States	To advise patients how to talk to clinicians about urinary incontinence.	Patient education document	N/A	N/A	More than one set of symptoms can be discovered through patient generated data that require multifaceted treatment plans.
Tenfelde et al., 2021	Nursing	United States	To investigate the feasibility and effect on symptom burden, quality of life, and inflammatory biomarkers of a gentle yoga program for women with urge urinary incontinence.	Prospective quasi-experimental pretest/posttest	12 community-dwelling, English speaking women aged 20–70 years (mean age 55 ± 9.08 years) with urge urinary incontinence in 2015; 50% White, 41.7% African American, 8.3% Unknown.	Pelvic floor distress inventory–20, Overactive Bladder Symptom and Quality of Life Short Form, Center for Epidemiologic Studies Depression Scale.	Symptom burden significantly improved in women who completed an 8-week gentle yoga program.
Tenfelde & Janusek, 2014	Nursing	United States	To summarize the potential benefits of yoga to improve the quality of life of women with urge urinary incontinence.	Review article	N/A	N/A	Symptom distress among women with urge urinary incontinence can be reduced by yoga, which targets stress-associated inflammatory pathways and offers psychological and biological benefits.
National Association for Continence, n.d.a	Not specified	United States	To discuss the impact of urinary incontinence on physical, mental, and financial well-being.	Non-professional literature article	N/A	N/A	Symptom impact of urinary incontinence negatively affects physical (decreased physical activity, increased risk for falls), mental (shame, decreased quality of life, depression, caregiver burden, and financial ($19.5 billion spent in the United States in the year 2000 on incontinence care) domains.