Wang Cuili, Li Jingjing, Wan Xiaojuan, Wang Xiaojuan, Kane Robert L, Wang Kefang
School of Nursing, Shandong University, Jinan, China.
J Clin Nurs. 2015 Apr;24(7-8):1112-21. doi: 10.1111/jocn.12729. Epub 2014 Nov 24.
To examine whether and how stigma influences attitudes towards seeking treatment for urinary incontinence, and whether its effect varies by symptom severity.
Urinary incontinence is prevalent among women, but few seek treatment. Negative attitudes towards urinary incontinence treatment inhibit from seeking care. Urinary incontinence is a stigmatised attribute. However, the relationship between stigma and attitudes towards seeking treatment for urinary incontinence has not been well understood.
This was a cross-sectional community-based study.
We enrolled a sample of 305 women aged 40-65 years with stress urinary incontinence from three communities in a Chinese city between May-October in 2011. Data were collected on socio-demographic characteristics, urinary incontinence symptoms, stigma and attitudes towards seeking treatment for urinary incontinence using a self-reported questionnaire. Effects of stigma were analysed using path analysis.
Attitudes towards seeking treatment for urinary incontinence were generally negative. For the total sample, all the stigma domains of social rejection, social isolation and internalised shame had direct negative effects on treatment-seeking attitudes. The public stigma domain of social rejection also indirectly affected treatment-seeking attitudes through increasing social isolation, as well as through increasing social isolation and then internalised shame. The final model accounted for 28% of the variance of treatment-seeking attitudes. Symptom severity influenced the strength of paths: the effect of internalised shame was higher in women with more severe urinary incontinence.
Stigma enhances the formation of negative attitudes towards seeking treatment for urinary incontinence; public stigma affects treatment-seeking attitudes through internalisation of social messages.
Stigma reduction may help incontinent women to form positive treatment-seeking attitudes and engage them in treatment. Interventions should specifically target the self-stigma domains of social isolation and internalised shame in women with urinary incontinence to most efficiently increase their use of health care.
探讨耻辱感是否以及如何影响对尿失禁治疗的态度，以及其影响是否因症状严重程度而异。
尿失禁在女性中很常见，但很少有人寻求治疗。对尿失禁治疗的消极态度阻碍了她们寻求医疗护理。尿失禁是一种受污名化的特征。然而，耻辱感与对尿失禁治疗态度之间的关系尚未得到充分理解。
这是一项基于社区的横断面研究。
2011年5月至10月期间，我们从中国一个城市的三个社区招募了305名年龄在40 - 65岁之间患有压力性尿失禁的女性样本。使用自我报告问卷收集了社会人口学特征、尿失禁症状、耻辱感以及对尿失禁治疗态度的数据。使用路径分析来分析耻辱感的影响。
对尿失禁治疗的态度总体上是消极的。对于整个样本，社会排斥、社会隔离和内化羞耻感等所有耻辱感领域对寻求治疗的态度都有直接的负面影响。社会排斥的公众耻辱感领域还通过增加社会隔离，以及通过增加社会隔离然后导致内化羞耻感，间接影响寻求治疗的态度。最终模型解释了寻求治疗态度变异的28%。症状严重程度影响路径的强度：内化羞耻感在尿失禁更严重的女性中影响更大。
耻辱感加剧了对尿失禁治疗寻求的消极态度的形成；公众耻辱感通过社会信息的内化影响寻求治疗的态度。
减少耻辱感可能有助于尿失禁女性形成积极的寻求治疗态度并促使她们接受治疗。干预措施应特别针对尿失禁女性的社会隔离和内化羞耻感等自我耻辱感领域，以最有效地增加她们对医疗保健的利用。
