title: Sense of coherence as a key to improve homebound status among older adults with urinary incontinence.
abstract: OBJECTIVE
  Being homebound is regarded as a negative condition for social participation in Japan. However, little is known about the possibility of psychological resilience to prevent being homebound among older adults with urinary incontinence. The present study aimed to examine the association between sense of coherence as a measure of psychological resilience and being homebound among older adults with urinary incontinence.
  
  
  METHODS
  A cross-sectional study was carried out in Chiba, Japan. We trained 95 care managers as interviewers, and they collected the data from 411 community-dwelling frail older adults using a pretested structured questionnaire. Logistic regression analysis was run to identify factors associated with being homebound among the participants with urinary incontinence.
  
  
  RESULTS
  Of the participants, 158 (38.4%) had urinary incontinence. Among the participants with urinary incontinence, 52 (32.9%) were homebound. As a result of logistic regression analysis adjusting for age, sex, living status, hobby, types of prevalent diseases, walking ability, perceived social support and subjective social capital, lower meaningfulness in their lives, which is a component of a sense of coherence, remained positively associated with being homebound (adjusted odds ratio 0.79, 95% confidence interval 0.65-0.96).
  
  
  CONCLUSIONS
  Being homebound is less prevalent among those who feel challenges, or worthy of investment or engagement in daily life. By improving a sense of meaningfulness, homebound status might be improved among older adults with urinary incontinence. To encourage active social participation of the target population, their psychological resilience (particularly meaningfulness) should be addressed more.
authors.affiliation: Department of Community and Global Health, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan.|Department of Social Rehabilitation, Research Institute, National Rehabilitation Center for Persons with Disabilities, Saitama, Japan.
authors.forename: Kyo
authors.initials: K
authors.lastname: Takahashi
authors.affiliation: Japan Toilet Labo, Tokyo, Japan.
authors.forename: Atsushi
authors.initials: A
authors.lastname: Kato
authors.affiliation: Sodegaura Satsukidai Hospital, Chiba, Japan.
authors.forename: Tomoyuki
authors.initials: T
authors.lastname: Igari
authors.affiliation: Department of Community and Global Health, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan.
authors.forename: Eriko
authors.initials: E
authors.lastname: Sase
authors.affiliation: Department of Community and Global Health, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan.
authors.forename: Akira
authors.initials: A
authors.lastname: Shibanuma
authors.affiliation: Department of Community and Global Health, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan.
authors.forename: Kimiyo
authors.initials: K
authors.lastname: Kikuchi
authors.affiliation: Department of Community and Global Health, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan.
authors.forename: Keiko
authors.initials: K
authors.lastname: Nanishi
authors.affiliation: Department of Community and Global Health, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan.
authors.forename: Masamine
authors.initials: M
authors.lastname: Jimba
authors.affiliation: Department of Community and Global Health, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan.
authors.forename: Junko
authors.initials: J
authors.lastname: Yasuoka
mesh_terms: D000203:Activities of Daily Living; D000368:Aged; D000369:Aged, 80 and over; D001521:Behavior Therapy / Q000379:methods*; D003430:Cross-Sectional Studies; D005260:Female; D015577:Geriatric Assessment; D018577:Homebound Persons / Q000523:psychology / Q000534:rehabilitation*; D006801:Humans; D015994:Incidence; D007564:Japan / Q000453:epidemiology; D008297:Male; D012189:Retrospective Studies; D060685:Sense of Coherence; D014549:Urinary Incontinence / Q000453:epidemiology / Q000523:psychology / Q000534:rehabilitation*
keywords: frail elderly; homebound persons; psychological resilience; sense of coherence; urinary incontinence