Social Isolation Among Individuals with Incontinence: A Scoping Review.

Introduction

Urinary and fecal incontinence, as well as the presence of an ostomy, are globally prevalent conditions with substantial implications for individuals' daily lives. Among the psychological consequences, social isolation is a frequently reported experience but remains poorly explored in the existing literature. The aim of this scoping review is to explore how social isolation has been conceptualized and operationalized in research on individuals with incontinence and to synthesize evidence on its antecedents and outcomes.

Methods

This review was conducted in accordance with the Joanna Briggs Institute guidelines and reported following the PRISMA-ScR checklist. Data were thematically synthesized and interpreted according to the Middle Range Theory of Social Isolation in Chronic Illness.

Results

Twenty-three studies met the inclusion criteria. Findings indicate that social isolation among individuals with incontinence is a complex, multifactorial phenomenon. Predisposing factors included individual needs for social interaction and desire for approval, psychological resilience, toilet accessibility, education, income, gender, and age. Precipitating factors were related to illness trajectory and adaptation processes, including ostomy acceptance, time since ostomy creation or oncological treatment, sense of belonging, perceived social support, stigma, self-esteem, clinical severity, illness-related conditions, and loss of autonomy. Reported outcomes were consistently adverse, encompassing depression, anxiety, and reduced quality of life.

Conclusions

Social isolation represents a core dimension of the lived experience of incontinence and should be recognized as a key clinical outcome. Systematic screening and targeted interventions should be integrated into continence care pathways. Future research should adopt longitudinal and interventional designs to clarify causal mechanisms and evaluate strategies to prevent and mitigate isolation.