Dysfunctional Urinary Incontinence Strategies: A Mediation Model to Explain Why Urinary Incontinence Symptoms Are Associated With Social Isolation Among Women.

OBJECTIVE

Female urinary incontinence (UI) can lead to social isolation (SI). To reduce UI's probable impact, women tend to self-manage their symptoms and employ coping strategies which can sometimes be dysfunctional and exacerbate SI. UI dysfunctional coping strategies are primarily employed as a means of self-management, with women failing to engage in efforts to seek treatment. Literature regarding the mediating role of dysfunctional UI strategies in the relationship between UI severity and SI is scarce. Therefore, this study investigated the mediating role of dysfunctional UI hiding and defensive coping strategies in explaining the relationship between UI severity and SI, among middle-aged women experiencing stress, urgency, and mixed UI.

STUDY

DESIGN

The study adopted a cross-sectional, observational, descriptive, and correlational design, and recruited 1090 women online (social media) aged 40-65 years, who reported occasional or frequent urine loss and were not receiving any treatment for UI.

MAIN OUTCOME MEASURES: The predictor was symptom severity; the mediator outcome was dysfunctional UI strategies, and the main outcome measure was SI.

RESULTS

Mediation analysis with structural equation modeling indicated that dysfunctional coping strategies significantly mediated the relationship between UI severity and SI, explaining a variability of 0.45 in SI. The direct effect between UI severity and SI was nonsignificant when indirect paths were included. Multigroup analysis indicated that the mediation model was consistent across different UI types, showing that the influence of dysfunctional strategies on SI was similar, regardless of the UI type.

CONCLUSIONS

UI severity influences social isolation through coping behaviors focused on defensive and hiding behaviors in women who have not sought treatment for UI and across the different UI types, highlighting the importance of addressing these strategies in healthcare interventions. Tailoring interventions to modify maladaptive coping strategies is crucial for reducing SI, and enhancing the quality of life of women experiencing UI.