Mitteness L S, Barker J C
Medical Anthropology Program, University of California, San Francisco, USA.
Med Anthropol Q. 1995 Jun;9(2):188-210. doi: 10.1525/maq.1995.9.2.02a00050.
The geriatric medical literature presents a perspective on urinary incontinence in the elderly that is sharply divergent from the realities of medical and lay responses to incontinence. This contrast raises questions about the cultural significance of urinary incontinence. The geriatric literature reveals a consensus that urinary incontinence, a major health problem among the elderly, is treatable and frequently reversible. The elderly and their health care providers, however, not only see incontinence as an inevitable, irreversible, and normal part of growing old but also consider it a sign of incompetence. This linkage of incontinence with incompetence forces elderly people to adopt several strategies for managing their incontinence so as not to compromise their competence in the eyes of others. Incontinence is a cultural symbol for the increasing dependencies of old age, dependencies that are much feared and resented in U.S. society, where tremendous emphasis is placed on independence even into advanced old age.
老年医学文献中关于老年人尿失禁的观点,与医学和普通民众对尿失禁的实际反应截然不同。这种差异引发了关于尿失禁文化意义的问题。老年医学文献显示出一种共识,即尿失禁作为老年人的一个主要健康问题,是可治疗的,而且常常是可逆的。然而,老年人及其医疗保健提供者不仅将尿失禁视为衰老过程中不可避免、不可逆转且正常的一部分,还将其视为能力不足的标志。尿失禁与能力不足的这种关联迫使老年人采取多种策略来应对尿失禁,以免在他人眼中损害自己的能力。在美国社会,即使到了高龄也非常强调独立性,尿失禁是老年期日益增加的依赖性的文化象征,这种依赖性令人十分恐惧和反感。