Cognitive, Affective, and Behavioral Dimensions of the Lower Urinary Tract Symptom Experience in Men With Parkinson's Disease.

Objective: Lower urinary tract symptoms (LUTS) in persons with Parkinson's disease (PD) have received little research attention. To address this gap in our knowledge, we examined the LUTS experience in men with PD, guided by The Theory of Unpleasant Symptoms.

Methods: A qualitative design was used to explore the LUTS experience in this population. Participants were recruited from a Veterans' Affairs PD Center. Maximum variation sampling was used to select diverse participants for audiotaped open-ended interviews. Additional data sources included field notes collected during interviews and observation of a PD support group. The template organizing analytic approach was used to code transcribed interviews and field notes.

Results: Cognitive, affective, and behavioral dimensions of the LUTS experience were identified. Participants attributed LUTS to aging, medications, and effects of motor symptoms on their ability to respond to the urge to void. There was little awareness of the neurologic contributions of PD to LUTS, and most viewed LUTS as "something that you have to put up with." Negative effects of LUTS on self-identity were noted, which jeopardized relationships, intimacy, participation in social activities, and travel. Affective responses to LUTS, particularly embarrassment, had a profound impact on quality of life. Behavioral strategies to manage LUTS focused on "being prepared to go when you need to go" and consisted mostly of trial-and-error efforts.

Conclusion: Misconceptions about LUTS among men with PD may result in underreporting, missed opportunities for professional assistance, and diminished health-related quality of life. Future research should focus on developing and testing nursing interventions to address cognitive, affective, and behavioral aspects of the LUTS experience in men with PD.