Psychological and Physical Environmental Factors in the Development of Incontinence in Adults and Children: A Comprehensive Review.

Alexander von Gontard, Tom P V M de Jong, Jasmin Katrin Badawi, Kathleen A OʼConnell, Ann T Hanna-Mitchell, Anka Nieuwhof-Leppink, Linda Cardozo

Journal: Journal of wound, ostomy, and continence nursing : official publication of The Wound, Ostomy and Continence Nurses Society 2017;44(2):181-187

PMID: 28267126

Abstract

The aim of this review was to identify etiological environmental factors related to incontinence in children and adults. A variety of etiological environmental factors for the development of incontinence were identified. In children, these encompass stressful life events and trauma, family dysfunction, parental psychopathology, school-related stressors, toilet or "potty" training, fluid consumption habits, housing conditions, and the availability of toilets. In adults, physical exercise, obesity, working conditions, fluid intake, and the availability of toilets play a role. Intervening variables such as hormonal variations due to work shifts have also been identified as influencing the likelihood of incontinence. Current research suggests that environmental factors influence the development of incontinence in children and adults. The interactions between biological factors, the immediate environment, and intervening variables need to be explored in greater detail. Practical solutions to reduce barriers to adequate fluid intake and healthy toileting habits should be implemented in school and work settings.

Address: Alexander von Gontard, MD, Department of Child and Adolescent Psychiatry, Saarland University Hospital, Homburg, Germany. Tom P. V. M. de Jong, MD, PhD, Department of Pediatric Urology, University Children's Hospitals UMC Utrecht and AMC Amsterdam, Utrecht, the Netherlands. Jasmin Katrin Badawi, MD, PhD, Department of Urology, University Hospital Mannheim, Medical Faculty of the Ruprechts-Karls-University of Heidelberg, Mannheim, Germany. Kathleen A. O'Connell, PhD, RN, FAAN, Teachers College, Columbia University, New York City, New York. Ann T. Hanna-Mitchell, PhD, Department of Urology, Case Western Reserve University, Cleveland, Ohio. Anka Nieuwhof-Leppink, MSc, Pediatric Psychology and Social Work, University Medical Center Utrecht, Utrecht, the Netherlands. Linda Cardozo, OBE, MD, FRCOG, Department of Urogynaecology, King's College Hospital, London, United Kingdom.
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