{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,12]],"date-time":"2026-06-12T18:10:31Z","timestamp":1781287831704,"version":"3.54.1"},"reference-count":25,"publisher":"Wiley","issue":"6","license":[{"start":{"date-parts":[[2025,5,19]],"date-time":"2025-05-19T00:00:00Z","timestamp":1747612800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Neurourology and Urodynamics"],"published-print":{"date-parts":[[2025,8]]},"abstract":"<jats:title>ABSTRACT<\/jats:title><jats:sec><jats:title>Objective<\/jats:title><jats:p>Female urinary incontinence (UI) can lead to social isolation (SI). To reduce UI's probable impact, women tend to self\u2010manage their symptoms and employ coping strategies which can sometimes be dysfunctional and exacerbate SI. UI dysfunctional coping strategies are primarily employed as a means of self\u2010management, with women failing to engage in efforts to seek treatment. Literature regarding the mediating role of dysfunctional UI strategies in the relationship between UI severity and SI is scarce. Therefore, this study investigated the mediating role of dysfunctional UI hiding and defensive coping strategies in explaining the relationship between UI severity and SI, among middle\u2010aged women experiencing stress, urgency, and mixed UI.<\/jats:p><\/jats:sec><jats:sec><jats:title>Study Design<\/jats:title><jats:p>The study adopted a cross\u2010sectional, observational, descriptive, and correlational design, and recruited 1090 women online (social media) aged 40\u201365 years, who reported occasional or frequent urine loss and were not receiving any treatment for UI.<\/jats:p><\/jats:sec><jats:sec><jats:title>Main Outcome Measures<\/jats:title><jats:p>The predictor was symptom severity; the mediator outcome was dysfunctional UI strategies, and the main outcome measure was SI.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Mediation analysis with structural equation modeling indicated that dysfunctional coping strategies significantly mediated the relationship between UI severity and SI, explaining a variability of 0.45 in SI. The direct effect between UI severity and SI was nonsignificant when indirect paths were included. Multigroup analysis indicated that the mediation model was consistent across different UI types, showing that the influence of dysfunctional strategies on SI was similar, regardless of the UI type.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>UI severity influences social isolation through coping behaviors focused on defensive and hiding behaviors in women who have not sought treatment for UI and across the different UI types, highlighting the importance of addressing these strategies in healthcare interventions. Tailoring interventions to modify maladaptive coping strategies is crucial for reducing SI, and enhancing the quality of life of women experiencing UI.<\/jats:p><\/jats:sec>","DOI":"10.1002\/nau.70079","type":"journal-article","created":{"date-parts":[[2025,5,19]],"date-time":"2025-05-19T05:56:00Z","timestamp":1747634160000},"page":"1361-1369","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["Dysfunctional Urinary Incontinence Strategies: A Mediation Model to Explain Why Urinary Incontinence Symptoms Are Associated With Social Isolation Among Women"],"prefix":"10.1002","volume":"44","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-7557-3685","authenticated-orcid":false,"given":"Marta G.","family":"Porto","sequence":"first","affiliation":[{"name":"William James Center for Research Ispa \u2010 Instituto Universit\u00e1rio Lisbon Portugal"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9214-5378","authenticated-orcid":false,"given":"Jo\u00e3o","family":"Mar\u00f4co","sequence":"additional","affiliation":[{"name":"INTREPID LAB ECEO \u2013 Universidade Lus\u00f3fona &amp; CETRAD Lisbon Portugal"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0979-4842","authenticated-orcid":false,"given":"Teresa","family":"Mascarenhas","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology, CHSJEPE\/Faculty of Medicine University of Porto Porto Portugal"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8659-4393","authenticated-orcid":false,"given":"Filipa","family":"Pimenta","sequence":"additional","affiliation":[{"name":"William James Center for Research Ispa \u2010 Instituto Universit\u00e1rio Lisbon Portugal"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2025,5,19]]},"reference":[{"key":"e_1_2_12_2_1","doi-asserted-by":"publisher","DOI":"10.1111\/bju.12852"},{"key":"e_1_2_12_3_1","doi-asserted-by":"publisher","DOI":"10.1080\/13697137.2018.1543263"},{"key":"e_1_2_12_4_1","doi-asserted-by":"publisher","DOI":"10.1038\/s41443-019-0219-7"},{"key":"e_1_2_12_5_1","first-page":"85","volume-title":"Chronic Illness: Impact and Intervention","author":"Biordi D.","year":"2013"},{"key":"e_1_2_12_6_1","doi-asserted-by":"publisher","DOI":"10.1186\/s13063-015-1099-x"},{"key":"e_1_2_12_7_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0149-2918(01)80104-1"},{"key":"e_1_2_12_8_1","doi-asserted-by":"publisher","DOI":"10.1097\/GME.0000000000000943"},{"issue":"2","key":"e_1_2_12_9_1","first-page":"69","article-title":"Medical and Self\u2010Care Practices Reported by Women With Urinary Incontinence","volume":"10","author":"Diokno A. 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