Horrocks Sue, Somerset Maggie, Stoddart Helen, Peters Tim J
Faculty of Health and Social Care, University of the West of England, Bath, UK.
Fam Pract. 2004 Dec;21(6):689-96. doi: 10.1093/fampra/cmh622. Epub 2004 Nov 4.
Urinary incontinence is a significant health problem for older people. Many people with incontinence do not seek services. Simple and effective treatments exist in primary care.
Our aim was to explore reasons why older people living in the community do not present for help with problems of urinary incontinence and to identify ways in which they may be assisted to access continence services.
In-depth interviews lasting an average of 1 h were conducted with 20 people aged over 65 years living in the community, purposively selected from a sample of patients who volunteered to be interviewed.
Older people described ageing as a natural, degenerative process and had reduced health expectations. Urinary incontinence was commonly viewed as an inevitable aspect of ageing and, as such, something to be accepted and managed independently. Shame and embarrassment combined with generational differences in attitudes to disclosure about personal matters also prevented people from seeking advice. Relatively successful strategies to manage incontinence enabled people to contain their symptoms, although this was at a social, psychological and, in some cases, health cost. Older people in this sample had considerable co-morbidity, in many cases resulting in mobility problems. Despite regular contact with primary care professionals, they had seldom disclosed their urinary incontinence.
A combination of personal attitudes and practical barriers prevent older people from seeking help for urinary incontinence. It is possible that older people would be more likely to seek help if asked specifically about urinary leakage by primary health care professionals.
尿失禁是老年人面临的一个重大健康问题。许多尿失禁患者并未寻求相关服务。基层医疗中存在简单有效的治疗方法。
我们的目的是探究社区中老年人不就尿失禁问题寻求帮助的原因，并确定可以帮助他们获得控尿服务的方法。
对20名年龄在65岁以上的社区居民进行了平均时长为1小时的深入访谈，这些人是从自愿接受访谈的患者样本中有目的地挑选出来的。
老年人将衰老视为一个自然的退化过程，对健康的期望降低。尿失禁通常被视为衰老不可避免的一个方面，因此是需要接受并自行应对的事情。羞耻和尴尬，以及不同代人在个人事务披露态度上的差异，也阻碍了人们寻求建议。相对成功的尿失禁应对策略使人们能够控制症状，尽管这在社交、心理方面，以及在某些情况下，在健康方面都付出了代价。该样本中的老年人有相当多的合并症，在很多情况下导致了行动不便。尽管他们经常与基层医疗专业人员接触，但很少透露自己的尿失禁情况。
个人态度和实际障碍共同阻碍了老年人就尿失禁问题寻求帮助。如果初级卫生保健专业人员专门询问尿液泄漏情况，老年人可能更有可能寻求帮助。
