Academic journal article Health Sociology Review

'It's Our Lot': How Resilience Influences the Experience of Depression in Women with Urinary Incontinence

Academic journal article Health Sociology Review

'It's Our Lot': How Resilience Influences the Experience of Depression in Women with Urinary Incontinence

Article excerpt


Urinary incontinence is not often considered without mentioning associated effects, such as depression (Heymen, 2004). The International Continence Society's (ICS) definition of incontinence associates it with psychological and psychosocial factors (Abrams et al., 2002). However, examinations of mental health in combination with psychosocial aspects of incontinence have been neglected (Fultz & Herzog, 2001; Gallagher, 1998; Lagro-Janssen, Smits & Van Weel, 1992; Shaw, 2001; Valerius, 1997).

The empirical literature demonstrates a relationship between incontinence and mental illness (Avery et al., 2013b; Heymen, 2004), and that mental health is associated with a reduction in help-seeking (Hahm & Segal, 2005; Jorm, Blewitt, Griffiths, Kitchener & Parslow, 2005; Mojtabai, Olfson & Mechanic, 2002). However, research which explicitly focuses on the psychological implications of incontinence has been minimal, mostly concentrating on older people, women and/or samples of convenience (Black, Griffiths, Pope, Bowling & Abel, 1997; Chiarelli & Cockburn, 2002; Heidrich & Wells, 2004). There have been no studies concerning the interaction of incontinence, depression and help seeking, although we might expect this to occur. Few investigations have concentrated on the impact of mental health on psychosocial issues relating to incontinence such as quality of life, management and coping behaviours, social connectedness, and beliefs and knowledge of the condition, focussing more upon risk factors such as gender, age, cognitive impairment and physical health (Heymen, 2004; Miner, 2004; Valerius, 1997). This study investigates these interactions.

Many psychosocial factors associated with incontinence may be adversely affected by depression (Andersson, Johansson, Sahlberg-Blom, Pettersson & Nilsson, 2005; Broome, 2003; Fultz & Herzog, 2001; Vigod & Stewart, 2006) and interactions such as these are important. When an opportunity to reduce the burden of incontinence is presented, treating depression may be as successful as treating incontinence (Dugan et al., 1998; Fultz & Herzog, 2001; Stach-Lempinen et al., 2003; Zorn, Montgomery, Pieper, Gray & Steers, 1999), increasing overall quality of life (Avery et al., 2013b).

One concept which stands out when describing this relationship is resilience, particularly in relation to psychosocial aspects such as support structures, self-esteem, physical and mental health, coping style, resourcefulness, and self-discipline, which are all constructs of this concept. There has been much discussion about what actually defines resilience; this makes measuring resilience difficult because it has been described both as a continuum and an aggregate of a number of different resources (Polk, 1997).

Resilience has been defined as the mechanisms that protect people against the psychological risks associated with adversity (Rutter, 1987). It has also been seen as the outcome of the successful adaptation and swift recovery after experiencing severe adversity (Davydov, Stewart, Ritchie & Chaudieu, 2010). There have been many studies looking at the associations between resilience and depression (Beardslee & Podorefsky, 1988; Bisschop, Kriegsman, Beekman & Deeg, 2004; Davydov et al., 2010; Diehl & Hay, 2013; Min, Jung et al., 2013; Rutten et al., 2013; Southwick & Charney, 2012). The main way resilience is thought to interact with psychological factors is that it can reduce depression and anxiety (Burton, Pakenham & Brown, 2009; Hjemdal, Vogel, Solem, Hagen & Stiles, 2011), and researchers have proposed that patients with psychological problems such as depression may benefit from interventions that enhance resilience (Fava & Tomba, 2009).

Resilience has rarely been studied in the context of incontinence and depression. One study interviewed women aged 25 to 74 years about chronic conditions, including incontinence, physical functioning and psychological health. …

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