BACKGROUND Urinary incontinence (UI) is highly prevalent and affects the lives of many men and women. We aimed to conduct a qualitative evidence synthesis (QES) to explore the experience of living with UI and to develop a conceptual model that can help us to understand this experience, and the potential barriers to appropriate healthcare. METHODS We used the methods of meta-ethnography developed by Noblit and Hare and recently refined for larger studies. Meta-ethnography involves identifying concepts from the studies and abstracting these concepts into a line of argument. We searched for studies that explored the experience of adults with UI. We used the GRADE-CERQual framework to assess confidence in review findings. RESULTS We screened 2307 titles, 429 abstracts, 107 full texts and included 41 studies (36 unique samples) in the synthesis. We organised the concepts into 26 conceptual categories, which we further abstracted into 6 themes: (1) Am I ill or is this normal? (2) It effects who I am and how I feel; (3) I feel stigmatised, ashamed and guilty; (4) talking can be difficult but it can help; (5) keeping incontinence under control; (6) have I got to the point that I need help? Our model conceptualises living with UI as navigating antagonists: Is UI normal or am I ill? Do I need help or am I managing? Do I keep UI to myself (and manage alone) or do I tell other people (and get the support that I need)? Do I use control strategies that focus on concealing (avoid risky situations, wear pads) versus, I use strategies that focus on improving the bodily function to improve continence. Our model highlights the experience of stigma, shame and guilt which exert a pull towards concealment. CONCLUSIONS The culture of secrecy and profound sense of shame is barrier to seeking help. An environment which reduces the shame and stigma of UI may help people to switch the focus to strategies that will improve continence, rather than conceal incontinence.

中文翻译：

---

元民族志旨在了解尿失禁的生活经历：“这只是生活的一部分吗？”

背景技术尿失禁(UI)非常普遍并且影响许多男性和女性的生活。我们的目的是进行定性证据综合 (QES)，以探索 UI 生活的体验，并开发一个概念模型，帮助我们了解这种体验以及适当医疗保健的潜在障碍。方法 我们使用了 Noblit 和 Hare 开发的元民族志方法，并且最近针对更大规模的研究进行了改进。元民族志涉及从研究中识别概念并将这些概念抽象为一系列论证。我们检索了探索患有 UI 的成年人的经历的研究。我们使用 GRADE-CERQual 框架来评估审查结果的可信度。结果 我们筛选了 2307 个标题、429 个摘要、107 个全文，并在综合中纳入了 41 项研究（36 个独特样本）。我们将这些概念分为 26 个概念类别，并进一步抽象为 6 个主题：(1) 我是生病了还是这是正常的？(2) 它影响我是谁以及我的感受；（3）我感到被侮辱、羞愧和内疚；(4) 交谈可能很困难，但会有所帮助；(5)控制失禁；(6) 我已经到了需要帮助的地步了吗？我们的模型将与 UI 一起生活的概念化为导航对手：UI 是正常的还是我生病了？我需要帮助还是我正在管理？我是否将 UI 保留给自己（并单独管理），还是告诉其他人（并获得我需要的支持）？我是否使用专注于隐藏的控制策略（避免危险情况、耐磨垫），还是使用专注于改善身体功能以改善失禁的策略。我们的模型强调了耻辱、羞耻和内疚的经历，这些经历对隐瞒产生了影响。结论 保密文化和深刻的羞耻感是寻求帮助的障碍。减少 UI 带来的耻辱和耻辱的环境可能会帮助人们将注意力转移到改善失禁的策略上，而不是掩盖失禁的情况。