Blog text about female incontinence: presentation of self, disclosure, and social risk assessment

Female urinary incontinence is a significant health concern that often remains undisclosed to healthcare providers, often because of embarrassment and fear of a negative response.

The purpose of this study was to explore communication patterns found in blog text regarding self-presentation by women living with incontinence for clues to facilitate disclosure.

This is a descriptive, empirical study of publically archived blog text (years inclusive 2006-2011; N = 16,629 words from 19 bloggers) by women communicating about urinary incontinence, utilizing methods of content analysis.

Valence and word concordance analysis showed that words indicative of facilitating social connections were used more often in proximity with close contacts (Z = -2.68, p = .004) and words indicative of blocking social connections were used more often in proximity with community contacts (Z = -2.97, p = .002). Differences between descriptions of facilitative and blocking reactions from healthcare providers were not significant (Z = -0.28, p = .39). Cluster analysis indicated a decreasing level of negatively charged descriptors of incontinence-related communications as the context moved from the hidden self to close contacts and then to the public sphere. Word frequency analysis identified a pattern in the blog text about urinary incontinence of self-presenting as otherwise fit, healthy, and competent.

Study results suggest that any report of incontinence concerns, including joking or casual references, should be addressed because women may not disclose the degree to which symptoms affect their psychosocial health. Further research is needed to explore whether providers might facilitate disclosure of urinary incontinence by first acknowledging the woman's strengths, thereby creating a sense of safety and acceptance.