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1. Faecal

1.1. Neural

1.1.1. Parasympathetic Nervous system Vagus and sacral nerve

1.1.2. Sympathetic Nervous system T12-L2 - rectum and anal canal relaxation

1.2. Disease

1.2.1. Pain

1.2.2. Surgery

1.3. Psychological

1.3.1. Sexual and physical abuse Stool withholding

2. Age

2.1. younger individuals- incontinence is one of the most common paediatric health problems

2.1.1. reluctant to disclose to peers

2.1.2. environments such as school can have inadequate toilet facilities, the client is unable to adhere to structured toilet regime and fluid intake.

2.2. Elderly

2.2.1. seen as the normal part of the ageing process

2.2.2. Fear of the treatment, underlying medical reasons

2.2.3. loss of independence

2.2.4. Generation not used to discussing such private bodily function

2.2.5. co morbities such as stroke, surgery, medications such as diurectics

3. Gender

3.1. Female

3.1.1. Menopause decrease in oestrogen leading to thinning of vaginal and urethral walls change in hormones

3.1.2. Pregnancy/Post partum reluctant to disclose as incontinece can be perceived as normal Pelvic floor damage change in hormones

3.1.3. Anatomy shorter urethra therefore higher risk of UTIS

3.2. Stress incontinence (more common in women) but can occur in men who had had a radical prostatectomy

3.2.1. sphincter muscles are unable to maintain urethra closure

4. Society

4.1. Taboo subject amongst peers

4.2. Socially unacceptable

4.2.1. Natural aversion

4.2.2. Shame/embarrassment

4.3. Gossip and hostility

5. Health Professional Perspective

5.1. Lack of knowledge and awareness related to the specific problem

5.1.1. Unable to educate and empower the client

5.2. the client is unable to acceess primary care

5.3. simplified response to incontinece "normal ageing" process

6. Culture

6.1. shame

6.2. rituals such as ablution 5 times a day

6.3. decrease quality of life

6.4. beliefs behind what causes incontinece

7. Mental Health

7.1. Cycle of incontinence

7.1.1. Anxiety

7.2. Reactions to incontinence

7.3. clinical depresssion

7.3.1. neurotransmitters are depleted ie norephineprine. This can result in lack of sphincter control

7.4. Delirium

7.4.1. unable to recognise bladder flilling, recognise an appropriate place for voiding.