The meaning of incontinence: a qualitative study of non-geriatric urinary incontinence sufferers

The meaning of the problem for incontinence suffers is known to be a very significant influence on coping. The present study was based on in-depth qualitative interviews with 28 young or middle-aged women who suffered urinary incontinence. Analysis, aimed at discovering the meaning of their condition for the sufferers themselves, led to the following conclusions. Incontinence is taboo, meaning not only that it is a socially unacceptable topic of conversation (inhibiting the approach of suffers to health professionals), but also that it is difficult for suffers themselves to focus on and think about clearly. Sufferers can react with apathy, or may perpetually teeter on the edge of taking ameliorative action: rational ways of tackling the problem are often not followed. The problem is seen as one of personal control: incontinence is lack of a grip on bodily propriety. Sufferers may feel horribly unique, and also worry that the incontinence is their own fault. They fear a guilty association with despised groups. It is noteworthy that the maintenance of 'normality'--allowing the sufferer to claim that there is no problem and that she is not incontinent--may involve a great deal of work. Although there are indications of defensive denial in sufferers' reactions to the problem, an additional interpretation is that they are fighting to subordinate the problem in favour of other priorities. Implications for practice of each of these features of the meaning of incontinence are drawn out.