Miner Philip B
Oklahoma Foundation for Digestive Research, Oklahoma City 73104, USA.
Gastroenterology. 2004 Jan;126(1 Suppl 1):S8-13. doi: 10.1053/j.gastro.2003.10.056.
Failure to control the elimination of urine or stool causes psychological stress, complicates medical illnesses and management, and has major economic consequences. Patients often describe the impact of both fecal and urinary incontinence in terms of shame and embarrassment and report that it causes them to isolate themselves from friends and family. Incontinence frequently results in an early decision to institutionalize elderly relatives because families have difficulty coping with incontinence at home. Not surprisingly, there is an increase in symptoms of depression and anxiety in patients with incontinence as well as degradation in quality of life that has been documented by standardized assessment instruments. The direct health care costs for urinary incontinence are estimated to be 16.3 billion dollars per year (1995 costs). Separate cost estimates for fecal incontinence are not available. There is an acute need for methodologically sound studies to document the economic and personal impact of incontinence to develop guidelines for the allocation of health care resources and research funding to this major public health problem. This need is especially great for fecal incontinence, for which there is much less health care economic data than for urinary incontinence.
无法控制排尿或排便会导致心理压力，使医疗疾病和治疗变得复杂，并产生重大经济后果。患者经常用羞耻和尴尬来描述大便失禁和尿失禁的影响，并报告说这使他们与朋友和家人隔绝。失禁常常导致人们过早地决定将老年亲属送进养老院，因为家庭难以在家中应对失禁问题。毫不奇怪，失禁患者的抑郁和焦虑症状会增加，而且标准化评估工具已证明其生活质量会下降。据估计，尿失禁每年的直接医疗费用为163亿美元（1995年的费用）。目前尚无大便失禁的单独费用估计。迫切需要进行方法合理的研究，以记录失禁对经济和个人的影响，从而制定针对这一重大公共卫生问题的医疗资源分配和研究资金指南。对于大便失禁来说，这一需求尤为迫切，因为与尿失禁相比，关于大便失禁的医疗经济数据要少得多。
