{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,4]],"date-time":"2026-05-04T19:57:10Z","timestamp":1777924630304,"version":"3.51.4"},"reference-count":21,"publisher":"SAGE Publications","issue":"2","license":[{"start":{"date-parts":[[2025,3,20]],"date-time":"2025-03-20T00:00:00Z","timestamp":1742428800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"funder":[{"DOI":"10.13039\/100000056","name":"National Institute of Nursing Research","doi-asserted-by":"publisher","award":["T32NR007969"],"award-info":[{"award-number":["T32NR007969"]}],"id":[{"id":"10.13039\/100000056","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000133","name":"Agency for Healthcare Research and Quality","doi-asserted-by":"publisher","award":["R01HS027742"],"award-info":[{"award-number":["R01HS027742"]}],"id":[{"id":"10.13039\/100000133","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Nurs Sci Q"],"published-print":{"date-parts":[[2025,4]]},"abstract":"<jats:p>Lack of conceptual clarity about symptom burden causes urinary incontinence to remain undertreated. We conducted a concept analysis using Rodgers\u2019 evolutionary method. A database and gray literature search were performed. Eight records were included. Attributes include genitourinary symptoms, psychological morbidity, and a negative sense of self. Antecedents are disruption to the pelvic floor, knowledge and perception, healthcare access and utilization, and patient and clinician-led interventions. Consequences are reduced quality of life, undesirable lifestyle modifications, stigma, and financial distress. Future research should include diverse populations and comprehensive measurement tools, and address barriers to care to improve health equity and outcomes.<\/jats:p>","DOI":"10.1177\/08943184241311908","type":"journal-article","created":{"date-parts":[[2025,3,20]],"date-time":"2025-03-20T07:21:22Z","timestamp":1742455282000},"page":"174-184","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":0,"title":["Symptom Burden: A Concept Analysis"],"prefix":"10.1177","volume":"38","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-3265-6667","authenticated-orcid":false,"given":"Danielle","family":"Scharp","sequence":"first","affiliation":[{"name":"Columbia University School of Nursing, New York, NY, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sarah E.","family":"Harkins","sequence":"additional","affiliation":[{"name":"Columbia University School of Nursing, New York, NY, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Maxim","family":"Topaz","sequence":"additional","affiliation":[{"name":"Columbia University School of Nursing, New York, NY, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"179","published-online":{"date-parts":[[2025,3,20]]},"reference":[{"key":"e_1_3_2_2_1","doi-asserted-by":"crossref","unstructured":"Brady S. S. Bavendam T. G. Bradway C. K. Conroy B. Dowling-Castronovo A. Epperson C. N. Hijaz A. K. Hsi R. S. Huss K. Kim M. Lazar J. Lee R. K. Liu C. K. Loizou C. N. Miran S. Mody L. Norton J. M. Reynolds W. S. Sutcliffe S. Zhang N. Hokanson J. A. (2022). Noncancerous genitourinary conditions as a public health priority: Conceptualizing the hidden burden. Urology 166(2) 39\u201349. https:\/\/doi.org\/10.1016\/j.urology.2021.08.040","DOI":"10.1016\/j.urology.2021.08.040"},{"key":"e_1_3_2_3_1","doi-asserted-by":"crossref","unstructured":"Cagnacci A. Palma F. Carbonne M. M. Grandi G. Xholli A. (2016). Association between urinary incontinence and climacteric symptoms in postmenopausal women. Menopause 24(1) 77\u201384 https:\/\/doi.org\/10.1097\/GME.0000000000000727","DOI":"10.1097\/GME.0000000000000727"},{"key":"e_1_3_2_4_1","doi-asserted-by":"crossref","unstructured":"Chen Z. He G. Zhao Y. Han C. Xu L. Jian H. Chu Q. He Y. (2022). Symptom burden and emotional distress in advanced lung cancer: the moderating effects of physicians' communication skills and patients' disease understanding. Support Care Cancer 30(11) 9497\u20139505. https:\/\/doi.org\/10.1007\/s00520-022-07323-9","DOI":"10.1007\/s00520-022-07323-9"},{"key":"e_1_3_2_5_1","doi-asserted-by":"crossref","unstructured":"Cleeland C. S. (2007). Symptom burden: Multiple symptoms and their impact as patient-reported outcomes. Journal of the National Cancer Institute Monographs 37 16\u201321. https:\/\/doi.org\/10.1093\/jncimonographs\/lgm005","DOI":"10.1093\/jncimonographs\/lgm005"},{"key":"e_1_3_2_6_1","doi-asserted-by":"crossref","unstructured":"Coyne K. S. Wein A. Nicholson S. Kvasz M. Chen C. I. Milsom I. (2013). Comorbidities and personal burden of urgency urinary incontinence: A systematic review. International Journal of Clinical Practice 67(10) 1015\u20131033. https:\/\/doi.org\/10.1111\/ijcp.12164","DOI":"10.1111\/ijcp.12164"},{"key":"e_1_3_2_7_1","doi-asserted-by":"crossref","unstructured":"Gapstur R. L. (2007). Symptom burden: A concept analysis and implications for oncology nurses. Oncology Nursing Forum 34(3) 673\u2013680. https:\/\/doi.org\/10.1188\/07.ONF.673-680","DOI":"10.1188\/07.ONF.673-680"},{"key":"e_1_3_2_8_1","doi-asserted-by":"crossref","unstructured":"Haylen B. T. de Ridder D. Freeman R. M. Swift S. E. Berghmans B. Lee J. Monga A. Petri E. Rizk D. E. Sand P. K. Schaer G. N. International Urogynecological A. International Continence S. (2010). An International Urogynecological Association (IUGA)\/International Continence Society (ICS) joint report on the terminology for female pelvic floor dysfunction. Neurourology & Urodynamics 29(1) 4\u201320. https:\/\/doi.org\/10.1002\/nau.20798","DOI":"10.1002\/nau.20798"},{"key":"e_1_3_2_9_1","doi-asserted-by":"crossref","unstructured":"Lenz E. R. Pugh L. C. Milligan R. A. Gift A. Suppe F. (1997). The middle-range Theory of Unpleasant Symptoms: An update. Advances in Nursing Science 19(3) 14\u201317. https:\/\/doi.org\/10.1097\/00012272-199703000-00003.","DOI":"10.1097\/00012272-199703000-00003"},{"key":"e_1_3_2_10_1","doi-asserted-by":"crossref","unstructured":"Matthews C. A. Whitehead W. E. Townsend M. K. Grodstein F. (2013). Risk factors for urinary fecal or dual incontinence in the Nurses' Health Study. Obstetetrics & Gynecology 122(3) 539\u2013545. https:\/\/doi.org\/10.1097\/AOG.0b013e31829efbff","DOI":"10.1097\/AOG.0b013e31829efbff"},{"key":"e_1_3_2_11_1","doi-asserted-by":"crossref","unstructured":"Melville J. L. Delaney K. Newton K. Katon W. (2005). Incontinence severity and major depression in incontinent women. Obstetetrics & Gynecology 106(3) 585\u2013592. https:\/\/doi.org\/10.1097\/01.AOG.0000173985.39533.37","DOI":"10.1097\/01.AOG.0000173985.39533.37"},{"key":"e_1_3_2_12_1","unstructured":"Merriam-Webster. (n.d.). Merriam-Webster.com dictionary. \u201cSymptom.\u201d \u201cBurden.\u201d Retrieved June 8 2023 from https:\/\/www.merriam-webster.com\/"},{"key":"e_1_3_2_13_1","unstructured":"National Association for Continence. (n.d.a) The true impact of incontinence. Retrieved November 1 2022 from https:\/\/nafc.org\/urinary-incontinence\/the-true-impact-of-incontinence\/"},{"key":"e_1_3_2_14_1","unstructured":"National Association for Continence. (n.d.b). Talking to your doctor about incontinence. Retrieved November 1 2022 from https:\/\/nafc.org\/talking-to-your-doctor\/"},{"key":"e_1_3_2_15_1","first-page":"77","volume-title":"Concept Development in Nursing: Foundations, techniques, and application","author":"Rodgers B.","year":"2000","unstructured":"Rodgers B. (2000). Concept analysis: An evolutionary view. In Rodgers B., Knafl K. (Eds.), In Concept Development in Nursing: Foundations, techniques, and application (pp. 77\u2013101). Saunders."},{"key":"e_1_3_2_16_1","unstructured":"Saiki L. S. (2015). Midlife female urinary incontinence and the intimate dyad. [Doctoral dissertation University of New Mexico]. ProQuest Dissertations and Theses Global. Retrieved from https:\/\/go.openathens.net\/redirector\/mssm.edu?url=https:\/\/www.proquest.com\/dissertations-theses\/midlife-female-urinary-incontinence-intimate-dyad\/docview\/1723932465\/se-2"},{"key":"e_1_3_2_17_1","doi-asserted-by":"crossref","unstructured":"Stange K. C. Nutting P. A. Miller W. L. Ja\u00e9n C. R. Crabtree B. F. Flocke S. A. Gill J. M. (2010). Defining and measuring the patient-centered medical home. Journal of General Internal Medicine 25(6) 601\u2013612. https:\/\/doi.org\/10.1007\/s11606-010-1291-3","DOI":"10.1007\/s11606-010-1291-3"},{"key":"e_1_3_2_18_1","doi-asserted-by":"crossref","unstructured":"Stockdill M. L. Patrician P. A. Bakitas M. (2019). Understanding and measuring symptom burden in heart failure: A concept analysis. Western Journal of Nursing Research 41(10) 1423\u20131447. https:\/\/doi.org\/10.1177\/0193945919833710","DOI":"10.1177\/0193945919833710"},{"key":"e_1_3_2_19_1","doi-asserted-by":"crossref","unstructured":"Strickland R. (2014). Reasons for not seeking care for urinary incontinence in older community-dwelling women: A contemporary review. Urologic Nursing 34(2) 63\u201368 94. https:\/\/doi.org\/10.7257\/1053-816X.2014.34.2.63","DOI":"10.7257\/1053-816X.2014.34.2.63"},{"key":"e_1_3_2_20_1","doi-asserted-by":"crossref","unstructured":"Tenfelde S. Janusek L. W. (2014). Yoga: A biobehavioral approach to reduce symptom distress in women with urge urinary incontinence. Journal of Alternative and Complementary Medicine 20(10) 737\u2013742. https:\/\/doi.org\/10.1089\/acm.2013.0308","DOI":"10.1089\/acm.2013.0308"},{"key":"e_1_3_2_21_1","doi-asserted-by":"crossref","unstructured":"Tenfelde S. Tell D. Garfield L. Mathews H. Janusek L. (2021). Yoga for women with urgency urinary incontinence: A pilot study. Female Pelvic Medicine & Reconstructive Surgery \u200927(1) 57\u201362. http:\/\/doi.org\/10.1097\/SPV.0000000000000723","DOI":"10.1097\/SPV.0000000000000723"},{"key":"e_1_3_2_22_1","doi-asserted-by":"crossref","unstructured":"Washington B. B. Raker C. A. Sung V. W. (2011). Barriers to pelvic floor physical therapy utilization for treatment of female urinary incontinence. American Journal of Obstetrics & Gynecology 205(2) 152.e1\u2013152.e9. https:\/\/doi.org\/10.1016\/j.ajog.2011.03.029","DOI":"10.1016\/j.ajog.2011.03.029"}],"container-title":["Nursing Science Quarterly"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/08943184241311908","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/full-xml\/10.1177\/08943184241311908","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/08943184241311908","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,5,1]],"date-time":"2026-05-01T21:28:46Z","timestamp":1777670926000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.sagepub.com\/doi\/10.1177\/08943184241311908"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,3,20]]},"references-count":21,"journal-issue":{"issue":"2","published-print":{"date-parts":[[2025,4]]}},"alternative-id":["10.1177\/08943184241311908"],"URL":"https:\/\/doi.org\/10.1177\/08943184241311908","relation":{},"ISSN":["0894-3184","1552-7409"],"issn-type":[{"value":"0894-3184","type":"print"},{"value":"1552-7409","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,3,20]]}}}