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性功能、灾难化思维、抑郁和疼痛,作为间质性膀胱炎/膀胱疼痛综合征女性生活质量的预测因素。

Sexual functioning, catastrophizing, depression, and pain, as predictors of quality of life in women with interstitial cystitis/painful bladder syndrome.

作者信息

Tripp Dean A, Nickel J Curtis, Fitzgerald Mary P, Mayer Robert, Stechyson Natalie, Hsieh Annie

机构信息

Department of Psychology, Queen's University, Kingston, Ontario, Canada.

出版信息

Urology. 2009 May;73(5):987-92. doi: 10.1016/j.urology.2008.11.049.

Abstract

OBJECTIVES

To study the association of sexual dysfunction with quality of life (QOL) while simultaneously examining the shared influence of empirically supported variables that are also associated with diminished interstitial cystitis/painful bladder syndrome (IC/PBS) QOL (ie, pain, catastrophizing, depression). Previous research has indicated that sexual dysfunction is prevalent, bothersome, and an important predictor of diminished QOL in patients with IC/PBS. However, the deleterious association between sexual dysfunction and QOL has not been investigated in more inclusive models that use validated measures.

METHODS

Women were recruited from 3 North American centers who agreed to the study and completed measures of QOL, pain severity, IC/PBS symptoms and bother (IC Symptom Index, IC Problem Index), pain catastrophizing, depression, and sexual dysfunction. Hierarchical multivariate regression was executed to test both unique and combined effects.

RESULTS

A total of 115 women, with a mean age of 50 years, participated in this study. Regression modeling showed that diminished QOL physical composite scores were predicted by a longer symptom duration (P = .013), unemployment (P = .017), and greater pain severity (P = .004). In regard to the diminished QOL mental composite scores, the lone predictors included age (P = .029) and pain catastrophizing (P = .002).

CONCLUSIONS

In disagreement with previous research, sexual functioning was not associated with diminished physical or mental composites of patient QOL. Furthermore, these data suggest that demographic factors and pain might be predictive of poorer QOL outcomes, and that anxious worry about pain (ie, catastrophizing) is a target for future research and clinical intervention.

摘要

目的

研究性功能障碍与生活质量(QOL)之间的关联,同时检验那些也与间质性膀胱炎/膀胱疼痛综合征(IC/PBS)生活质量下降相关的经验证变量(即疼痛、灾难化思维、抑郁)的共同影响。既往研究表明,性功能障碍在IC/PBS患者中普遍存在、令人困扰,且是生活质量下降的重要预测因素。然而,性功能障碍与生活质量之间的有害关联尚未在使用经过验证的测量方法的更全面模型中进行研究。

方法

从3个北美中心招募同意参与研究的女性,她们完成了生活质量、疼痛严重程度、IC/PBS症状及困扰(IC症状指数、IC问题指数)、疼痛灾难化思维、抑郁和性功能障碍的测量。进行分层多元回归以检验独特效应和联合效应。

结果

共有115名平均年龄为50岁的女性参与了本研究。回归模型显示,症状持续时间较长(P = 0.013)、失业(P = 0.017)和疼痛严重程度较高(P = 0.004)可预测生活质量身体综合评分降低。关于生活质量心理综合评分降低,唯一的预测因素包括年龄(P = 0.029)和疼痛灾难化思维(P = 0.002)。

结论

与既往研究不同,性功能与患者生活质量的身体或心理综合评分降低无关。此外,这些数据表明人口统计学因素和疼痛可能是较差生活质量结果的预测因素,并且对疼痛的焦虑担忧(即灾难化思维)是未来研究和临床干预的目标。

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