Burgio Kathryn L, Goode Patricia S, Locher Julie L, Richter Holly E, Roth David L, Wright Kate Clark, Varner R Edward
Birmingham/Atlanta Geriatric Research, Education, and Clinical Center, Department of Veterans Affairs Medical Center, Birmingham, Alabama 35233, USA.
Obstet Gynecol. 2003 Nov;102(5 Pt 1):940-7. doi: 10.1016/s0029-7844(03)00770-1.
To identify predictors of outcome of a multicomponent behavioral training program for urge and stress incontinence in women.
This report is a secondary analysis of data from three prospective, randomized, clinical trials testing behavioral interventions for urinary incontinence. Participants were a volunteer sample of 258 ambulatory, nondemented, community-dwelling women, aged 40-92 years, with stress, urge, or mixed urinary incontinence. Participants received 8 weeks (four visits) of multicomponent behavioral training in each study. The relationship between a number of variables and treatment success were explored by univariate and multivariable logistic regression analyses.
Successful treatment of predominantly urge incontinence (75% reduction of incontinent episodes as recorded on bladder diary) was associated with not wearing any form of protection for incontinence (P = .045; 95% confidence interval [CI] .282, .987). Achieving total continence (100% reduction) was associated with fewer incontinent episodes at baseline (P < .001; 95% CI .138, .557), previous surgery for incontinence (P = .021; 95% CI 1.169, 6.543), and lower education level (P = .022; 95% CI .175, .871). Successful treatment of predominantly stress incontinence (75% reduction) was related to not having previous evaluation or treatment for incontinence (P = .001; 95% CI .026, .415), and fewer incontinent episodes on baseline bladder diary (P = .026; 95% CI .210, .907). Outcomes were not associated with age, race, type of incontinence, or a number of other variables reflecting medical history, obstetric history, medications, pelvic examination, body mass index, urodynamic parameters, or psychological distress.
Aside from indicators of severity and previous treatment, there were few associations between baseline clinical variables and outcome of behavioral treatment.
确定针对女性急迫性和压力性尿失禁的多成分行为训练项目结局的预测因素。
本报告是对三项前瞻性、随机临床试验数据的二次分析，这些试验测试了针对尿失禁的行为干预措施。参与者是258名年龄在40 - 92岁、能自主活动、无痴呆、居住在社区的女性志愿者样本，她们患有压力性、急迫性或混合性尿失禁。在每项研究中，参与者接受为期8周（四次就诊）的多成分行为训练。通过单变量和多变量逻辑回归分析探讨了多个变量与治疗成功之间的关系。
以急迫性尿失禁为主的成功治疗（膀胱日记记录的失禁发作次数减少75%）与未使用任何形式的尿失禁防护用品有关（P = .045；95%置信区间[CI] .282，.987）。实现完全控尿（减少100%）与基线时失禁发作次数较少（P < .001；95% CI .138，.557）、既往有尿失禁手术史（P = .021；95% CI 1.169，6.543）以及较低的教育水平有关（P = .022；95% CI .175，.871）。以压力性尿失禁为主的成功治疗（减少75%）与既往未进行过尿失禁评估或治疗有关（P = .001；95% CI .026，.415），且基线膀胱日记中的失禁发作次数较少（P = .026；95% CI .210，.907）。结局与年龄、种族、尿失禁类型或反映病史、产科病史、药物治疗、盆腔检查、体重指数、尿动力学参数或心理困扰的其他多个变量无关。
除了严重程度指标和既往治疗情况外，基线临床变量与行为治疗结局之间几乎没有关联。
