Fear of humiliation inhibits women's care‐seeking behaviour for long‐term urinary incontinence

Abstract

Most women with urinary incontinence (UI) do not seek professional help. Women's experiences of their behaviour when seeking care for incontinence are important to improve understanding by nurses and encourage as well as enable women to seek help. The aim of this study was to illuminate the meaning of women's lived experiences of their behaviour when seeking care for long-term UI. Thirteen women were interviewed (range 37-52 years) who had not sought professional help for incontinence. A phenomenological hermeneutic method was used to analyse and interpret the interview texts. Three themes evolved from data: being in an affected situation, having personal beliefs about seeking care and having desired expectations about care. Being in an affected situation, means that the women were negatively affected by their long-term incontinence. Living with shame, altered sexual relationships and a need for distancing have negatively influenced their care-seeking behaviour (CSB). Having personal beliefs about seeking care means that the women had their own beliefs regarding morally acceptable behaviour for seeking care because of incontinence. This led to a toning down of their problem and a minimization of the problem associated with incontinence as it was considered to be a normal consequence of pregnancy and childbirth. Having desired expectations about care means that the women had opinions relevant to the care and felt being asked about incontinence and an understanding atmosphere should be included. The conclusion is that fear of humiliation inhibited women from seeking care for long-term UI. The findings suggest that nurses should be precise when asking about women's experiences of UI because otherwise they do not bring it up. Additionally, CSB can help nurses to explain the experience and enable women to seek help for this manageable condition.

Pelvic Floor Muscle Exercise after Delivery with or without the Biofeedback Method: An Intervention Study

“…Half of them (n = 7) did not report any problems with UI until their six month postpartum control. It is possible that these women felt embarrassed about their incontinence and avoided reporting this sensitive subject at baseline [14,18,19]. Shame and the fear of not being able to control urine leakage at all times can cause women a loss of confidence and lower self-esteem and even promote the feeling that they are unique in their discomfort [15,35,36].…”

“…The involuntary leakage of urine is not only a hygiene problem but also the cause of social and psychological suffering that negatively affects daily life, leisure time and sexual activity [14][15][16]. Many women suffer in silence and are reluctant to seek help as they are ashamed of the condition itself and find it difficult to seek professional help [17][18][19]. It is therefore very important to prevent SUI and to offer adequate treatment to reduce or cure the problem among women for both physical and psychological reasons.…”

Psychocultural meanings of urinary incontinence in women: a review

“…The interferences of UI in the restriction of younger women's everyday activities do not seem to have an expressive meaning in the search for selfcare to solve the problem (13) , with the psychological factors drawing attention when they react to urinary loss with apathy or when they abstain from rectifying actions (9) . Others experience urinary loss as a taboo, try to manipulate incontinence in different ways, recover the power over their uncontrolled body and continue living normally (17) .…”

“…For young women, this would point to an "early old age", which they normally tend to abhor, feeling shame in the face of clear evidence of loss of self-esteem, highlighted by the fear of rejection in sexual activity due to incontinence, guilt about not feeling desire or pleasure and about losing urine during the orgasm (5) . The impact of UI was felt in intimate relationships: sexual life was inhibited due to its lack of spontaneity, needing to be planned, interfering in the sexuality of the women and their partners (13) . …”

Capturing Volunteered Information for Inclusive Service Design: Potential Benefits and Challenges

“…Additionally, and as testament to the prevalence of this issue, 25 -28% of women between the ages of 20 and 59 are affected by continence issues (Samuelsson et al, 1997;Hägglund and Wadensten, 2007;Hannestad et al, 2000). As a result, people managing continence concerns may experience feelings of shame, social exclusion and reluctance to venture outside into unknown areas of the built environment (Verhoef et al, 2005;Hägglund and Wadensten, 2007). It is not enough to simply provide adequate and accessible toilet facilities, since their locations, adequacy and accessibility must also be effectively communicated (Knight and Bichard, 2011).…”