The Meanings of Silence in Brazilian Women With Urinary Incontinence

PURPOSE: We explored the meanings of silence for Brazilian women with urinary incontinence (UI). SUBJECTS AND SETTING: The sample consisted of 8 women, aged 30 to 45 years. Respondents worked as housekeepers or cleaning staff and were from lower social, economic, and educational strata. Their years of formal education varied from 0 to 8 years and they earned up to 4.5 times the Brazilian minimum wage, which is equivalent to US$900. METHODS: A qualitative method using semistructured interviews was employed to gather data. Individual semistructured interviews were recorded and subsequently transcribed, including researchers' observations of subjects' nonverbal behaviors. The interviews began with the question: Can you tell me about your experience with urinary incontinence? Data were analyzed using a content analysis technique. RESULTS: Respondents avoided discussing UI and initially resisted labeling themselves as incontinent, but their nonverbal behaviors provided clues to the psychosocial distress caused by urinary leakage. Results suggest that respondents' underprivileged social, economic, and cultural situation may aggravate their limitations when expressing their feelings. We found that the women employed silence as a means to contain the psychosocial distress created by their UI, and that the silence itself should be interpreted as an expression of distress associated with UI. CONCLUSION: The silence of Brazilian women with UI is an essential element of communication about incontinence. We believe that the silence used by these women expresses the pain and anxiety they experienced, and it acts as an adaptive psychosocial mechanism.