Pakistani women's perceptions and experiences of incontinence.

Aim: To investigate the perceptions and experience of Pakistani women who have urinary incontinence problems.
Method: Data were collected from a sample group of six Pakistani women with incontinence problems. A female Miripuri Punjabi speaker conducted and recorded semi-structured interviews with the women. The interviewer interpreted these recordings onto another tape. Data were then analysed and categorised.
Results: The women had low self-esteem and also felt sinful because of their incontinence. Muslim women are obliged to perform ritual cleansing and prayer five times a day. If they pass urine or faeces, or experience incontinence, they become unclean and prayer is denied until the act of ritual cleansing is repeated. The women used prayer to relieve stress caused by incontinence, but being unclean denied them this comfort, thus increasing stress. Some participants had become secretive and isolated. The women had developed three strategies to help them live with incontinence: risk reduction to reduce the number of incidents; management, which focused on coping with incontinent episodes; and problem-sharing with other women. Their inhibitions and language limitations prevented them from disclosing their problems clearly to health professionals and fully understanding advice they received. These inhibitions were reduced when they were treated by a female health professional. Having an interpreter present also increased satisfaction with treatment.
Conclusion: To provide an effective continence service to Pakistani women with incontinence, it is necessary for healthcare professionals to understand their cultural and religious identities.