Margie Polden Memorial Lecture: The psychology of incontinence – why successful treatments fail

Author(s): P. Toozs-Hobson & K. Loane - Pages: 4–7

Abstract

Over the past 20 years, treatments for incontinence have undergone a revolution. However, the results for some patients remain disappointing. There are two possible explanations for this: first, whilst a treatment may address a symptom, it does not always treat the impact of that symptom; and secondly, there can be a mismatch between physicians’ and patients’ expectations of what a treatment will achieve. The present authors discuss some of the issues surrounding patient perceptions of the impact of incontinence, and also recent research undertaken to investigate the differences in perception between doctors and their patients. George Kelly outlined the theory of personal constructs, which highlighted how individual expectations can be based on experience. The present authors’ research utilized repertory grids to identify themes that may be important in decisionmaking. The results highlight the diversity of options required to meet all expectations. A further study in the present authors’ unit demonstrated the potential impact of urodynamics on patients’ subsequent compliance with therapy. It is interesting that, at a time when there is an increasing focus on treating the whole patient, the Government has highlighted behavioural therapy as an important area to develop in managing patients with anxiety and depression.

Keywords: incontinence, psychology, treatment.