Diokno Ananias C, Sand Peter K, Macdiarmid Scott, Shah Rajul, Armstrong Robert B
Department of Urology, William Beaumont Hospital, Royal Oak, MI 48073-6710, USA.
Fam Pract. 2006 Oct;23(5):568-77. doi: 10.1093/fampra/cml018. Epub 2006 May 26.
To evaluate women's perceptions about bladder control problems.
757 Women with one or more bladder control symptoms (frequency, urgency, stress or urge urinary incontinence and nocturia) participated in an Internet-based survey. A separate study involved 12 focus groups including a total of 180 women with bladder control problems.
Respondents in the survey reported multiple symptoms, e.g. stress urinary incontinence (72%), frequency (56%), nocturia (45%), urge urinary incontinence (43%) and urgency (33%). Women in both the survey and the focus groups revealed extensive use of coping mechanisms to manage their symptoms. The focus groups revealed that many women were not aware that overactive bladder (OAB) is a pathophysiological condition. Approximately 30% of respondents in the survey felt uncomfortable talking to their doctor about their condition. Among women who did speak with their doctor, stress-related symptoms were described more readily than urge-related symptoms. In the survey, only about half (56%) of the women felt their OAB medication was effective, and half (50%) stopped taking their medication at some point. Information from the focus groups suggested that some women may have unrealistic expectations of onset of efficacy or extent of benefit and may be unprepared for managing side effects.
Feelings of embarrassment and limited understanding of the pathophysiology of OAB can contribute to miscommunication between a woman and her doctor. Patient education regarding reasonable expectations coupled with suggestions for coping with unwanted side effects will likely result in better management.
评估女性对膀胱控制问题的认知。
757名有一项或多项膀胱控制症状(尿频、尿急、压力性或急迫性尿失禁以及夜尿症)的女性参与了一项基于互联网的调查。另一项单独研究涉及12个焦点小组,共有180名有膀胱控制问题的女性。
调查中的受访者报告了多种症状,如压力性尿失禁(72%)、尿频(56%)、夜尿症(45%)、急迫性尿失禁(43%)和尿急(33%)。调查和焦点小组中的女性都表明广泛使用应对机制来管理她们的症状。焦点小组显示,许多女性不知道膀胱过度活动症(OAB)是一种病理生理状况。调查中约30%的受访者表示与医生谈论自己的病情时感到不舒服。在与医生交谈的女性中,与压力相关的症状比与急迫相关的症状更容易被描述。在调查中,只有约一半(56%)的女性觉得她们的OAB药物有效,并且一半(50%)的女性在某个时候停止了服药。焦点小组的信息表明,一些女性可能对疗效的开始或益处的程度有不切实际的期望,并且可能对管理副作用没有准备。
尴尬的感觉以及对OAB病理生理学的有限理解可能导致女性与医生之间的沟通不畅。对患者进行关于合理期望的教育以及应对不良副作用的建议可能会带来更好的管理。