An Evolutionary Concept Analysis of Urinary Incontinence

Nicole Zhang


Urol Nurs. 2018;38(6):289-295. 

In This Article

Naming the Concept of Interest

Dating back to the 14th century, the word continence originated from an old French word for self-restraint and the Latin contiencia, meaning to hold back or be repressed (Online Etymology Dictionary, n.d.). From these roots in repression and in control, to be incontinent implies something not proper, a person who is not re strained in their actions. Conversely, if an individual is continent, they are in control. Even today, the definition of incontinence has the same meaning as seen in the definition from the Merriam-Webster Dictionary (n.d.), which is lacking self-restraint or not being under control.

Akrasia is a Greek word meaning weakness of will or acting in a way contrary to one's sincerely held moral values (Oxford Dictionary, n.d.). This word is often used synonymously with incontinence, especially in philosophy and in relation to the concept of moral incontinence. While Aristotle and Socrates addressed this concept in ancient times, current philosophers and psychologists still discuss akrasia.

The concept of moral incontinence was first discussed by Aristotle in Aristotle's Nicomachean Ethics Book VII (Russell, 2011). In this piece of work, moral incontinence is conceptually discussed as an excessive and involuntary pursuit of pleasure and simultaneous avoidance of pain. Incontinence was thought to be one of the three things that should be avoided to maintain good character. Additionally, a morally incontinent person was thought to knowingly engage in bad behaviors due to their passions. This is considered in comparison to someone who is morally continent with passions and desires, but behaves appropriately (Russell, 2011). Therefore, when the label of incontinent is attached to patients, there is meaning that comes with the term. Further, some individuals still understand incontinence as the term they see in the dictionary, not as a medical condition.

These are some of the historic uses of the word incontinence. The word incontinence is the name of the concept chosen for this concept analysis because it is the term most widely used, especially with relevance to nursing practice. The term incontinence generally has meanings that preceded the use as a medical terminology. Therefore, when the term UI came to systemic use to define the condition, it came with a lot of history and numerous associations that have been neglected. Understanding where the word came from and what happens when the term is applied in medical terminology is important. In the case of use of the term incontinence, it is especially important because the history is rooted in morality and character. In examining the social situation around the term incontinence, this history is crucial. Morality and stigma have been linked to UI repeatedly in the literature, with UI being tied to lack of societal competence that is often assumed when an individual develops incontinence (Mitteness & Barker, 1995).