Mitteness L S
Medical Anthropology Program, University of California, San Francisco 94143-0850.
J Am Geriatr Soc. 1990 Mar;38(3):374-8. doi: 10.1111/j.1532-5415.1990.tb03525.x.
Public knowledge and beliefs about urinary incontinence in adulthood are potentially significant contributors to the success or lack of success of intervention strategies. This is especially true given the repeated finding that significant proportions of incontinent people (at least half) do not report their incontinence to a physician. Although there is little literature on this topic, at least three salient features need to be recognized. First, there is an indication that laypeople have vague understandings of the causes and parameters of incontinence. The functioning of the human body is a mystery to many adult Americans. This lack of information is fostered by cultural beliefs that the body is something off-limits, that its functions are the appropriate domain of specialists. Of course, educational factors and possibly ethnic affiliations modify this lack of information. Lack of information is compounded by lack of an appropriate vocabulary. Clinicians must be aware that a patient's understanding of the body or terminology for bodily functions may not fit their own framework. Second, there is consistent evidence that elderly people often consider urinary incontinence to be an inevitable and irremediable part of the normal aging process. This linkage of incontinence and normal aging is probably protective of self-esteem but does little to foster amelioration of incontinence. The belief that incontinence signals oncoming incompetence is a cultural construction that is apparent in popular culture, such as literature and movies and reflected in the secrecy attendant on much incontinence in later life.(ABSTRACT TRUNCATED AT 250 WORDS)
公众对成人尿失禁的认知和观念可能是干预策略成败的重要因素。鉴于反复发现相当大比例(至少一半)的失禁患者未向医生报告其失禁情况,这一点尤其正确。尽管关于该主题的文献较少,但至少有三个显著特征需要被认识到。首先,有迹象表明外行人对失禁的原因和参数理解模糊。人体的运作对许多成年美国人来说是个谜。这种信息缺失因文化观念而加剧,即身体是禁区,其功能是专家的专属领域。当然,教育因素以及可能的种族归属会改变这种信息缺失状况。信息缺失又因缺乏恰当的词汇而雪上加霜。临床医生必须意识到患者对身体或身体功能术语的理解可能与他们自己的框架不符。其次,有一致的证据表明老年人常常认为尿失禁是正常衰老过程中不可避免且无法补救的一部分。这种失禁与正常衰老的联系可能保护了自尊,但对改善失禁作用不大。认为失禁预示着即将出现能力不足的观念是一种文化建构,在大众文化如文学和电影中很明显,并反映在晚年许多失禁情况所伴随的隐秘性上。(摘要截选至250字)