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BMC Urology
Published in: BMC Urology 1/2020

01-12-2020 | Urinary Incontinence | Research article

A meta-ethnography to understand the experience of living with urinary incontinence: ‘is it just part and parcel of life?’

Authors: Francine Toye, Karen L. Barker

Published in: BMC Urology | Issue 1/2020

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Abstract

Background

Urinary incontinence (UI) is highly prevalent and affects the lives of many men and women. We aimed to conduct a qualitative evidence synthesis (QES) to explore the experience of living with UI and to develop a conceptual model that can help us to understand this experience, and the potential barriers to appropriate healthcare.

Methods

We used the methods of meta-ethnography developed by Noblit and Hare and recently refined for larger studies. Meta-ethnography involves identifying concepts from the studies and abstracting these concepts into a line of argument. We searched for studies that explored the experience of adults with UI. We used the GRADE-CERQual framework to assess confidence in review findings.

Results

We screened 2307 titles, 429 abstracts, 107 full texts and included 41 studies (36 unique samples) in the synthesis. We organised the concepts into 26 conceptual categories, which we further abstracted into 6 themes: (1) Am I ill or is this normal? (2) It effects who I am and how I feel; (3) I feel stigmatised, ashamed and guilty; (4) talking can be difficult but it can help; (5) keeping incontinence under control; (6) have I got to the point that I need help? Our model conceptualises living with UI as navigating antagonists: Is UI normal or am I ill? Do I need help or am I managing? Do I keep UI to myself (and manage alone) or do I tell other people (and get the support that I need)? Do I use control strategies that focus on concealing (avoid risky situations, wear pads) versus, I use strategies that focus on improving the bodily function to improve continence. Our model highlights the experience of stigma, shame and guilt which exert a pull towards concealment.

Conclusions

The culture of secrecy and profound sense of shame is barrier to seeking help. An environment which reduces the shame and stigma of UI may help people to switch the focus to strategies that will improve continence, rather than conceal incontinence.
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Metadata
Title
A meta-ethnography to understand the experience of living with urinary incontinence: ‘is it just part and parcel of life?’
Authors
Francine Toye
Karen L. Barker
Publication date
01-12-2020
Publisher
BioMed Central
Published in
BMC Urology / Issue 1/2020
Electronic ISSN: 1471-2490
DOI
https://doi.org/10.1186/s12894-019-0555-4

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