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Aging Ment Health. 2016 Nov;20(11):1167-1173. Epub 2015 Jul 15.

Psychological resilience and active social participation among older adults with incontinence: a qualitative study.

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a Department of Community and Global Health, Graduate School of Medicine , The University of Tokyo , Tokyo , Japan.
b Department of Social Rehabilitation, Research Institute , National Rehabilitation Center for Persons with Disabilities , Saitama , Japan.
c Japan Toilet Labo , Tokyo , Japan.
d Sodegaura Satsukidai Hospital , Chiba , Japan.



Incontinence restricts participation in social activities among older adults. However, some older adults participate in social activities despite this condition. This study aimed to describe how older adults with incontinence could be resilient and actively participate in social activities.


We conducted semi-structured interviews with 11 socially active older adults with incontinence (age 70-90; nine women and two men) at their homes or in private areas of day-service centres in Chiba, Japan. We coded salient narratives by using thematic analysis and extracted themes. Finally, we developed a conceptual model and illustrated the interactions among themes.


We identified seven themes that affected active social participation; five of these pertained to psychological characteristics ('motivation to be socially active', 'psychological stress of incontinence', 'desire to interact with others', 'willingness to perform physical exercise', and 'confidence in managing incontinence') and the remaining two pertained to supporting environmental factors ('assistive devices' and 'accessible toilet'). Three psychological themes ('desire to interact with others', 'willingness to perform physical exercise', and 'confidence in managing incontinence') were intertwined with supporting environmental factors and increased the participants' 'motivation to be socially active'.


Older adults with incontinence can actively participate in the society when they have desire to interact with others, willingness to perform physical exercise, and confidence in managing incontinence. These psychological characteristics are important for being resilient in the face of incontinence and for active social participation.


frail elderly; incontinence; psychological resilience; qualitative research; social participation

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