Brigham and Women's Hospital, Harvard Medical School, Boston, USA.
Am J Nurs. 2011 Apr;111(4):26-33; quiz 34-5. doi: 10.1097/01.NAJ.0000396551.56254.8f.
Evidence suggests that race affects the prevalence and incidence of urinary incontinence (UI) in women. But little is known about racial differences in the rates of remission, improvement, and progression of UI in women.
We sought to compare changes in UI frequency over two years among Asian, black, and white women with UI.
Participants in the Nurses' Health Study and the Nurses' Health Study II responded to mailed questionnaires (in 2000 and 2002, and 2001 and 2003, respectively), giving information on race and the frequency of UI. Prospective analyses were conducted over two years from data gathered on 57,900 women, ages 37 to 79, who had at least monthly UI at baseline.
Over the two two-year study periods, black women were significantly more likely than white women to report remission of UI (14% versus 9%, respectively), and Asian women were significantly more likely than white women to report less frequent UI (40% versus 31%, respectively). Improvement was more common in older black women than in older white women, but rates of improvement were comparable between younger black and younger white women. Black women were less likely than white women to report more frequent UI at follow-up (30% versus 34%, respectively), and, after adjusting for health and lifestyle factors, the difference was borderline statistically significant.
Changes in the frequency of UI appear to vary by race, even after adjustment for risk factors. These findings may account for some of the previously observed differences in UI prevalence across racial groups. Although UI is a common condition in women of all races, nurses and other clinicians should be aware that its presentation may vary according to race. Such an understanding could increase clinicians' confidence in discussing UI with patients, reducing the possibility that the condition goes unrecognized.
epidemiology, progression, race, remission, urinary incontinence.
有证据表明，种族会影响女性尿失禁（UI）的患病率和发病率。但对于女性 UI 缓解率、改善率和进展率的种族差异知之甚少。
我们旨在比较患有 UI 的亚洲、黑人和白人女性在两年内 UI 频率的变化。
参加护士健康研究和护士健康研究 II 的参与者通过邮寄问卷（分别在 2000 年和 2002 年，以及 2001 年和 2003 年）回答问题，提供种族和 UI 频率的信息。对 57900 名年龄在 37 至 79 岁之间、基线时有至少每月一次 UI 的女性进行了为期两年的前瞻性分析。
在两个为期两年的研究期间，黑人女性报告 UI 缓解的可能性明显高于白人女性（分别为 14%和 9%），而亚洲女性报告 UI 频率较低的可能性明显高于白人女性（分别为 40%和 31%）。在较年长的黑人女性中，改善更为常见，而在较年轻的黑人女性和较年轻的白人女性中，改善率相当。黑人女性报告在随访时 UI 更为频繁的可能性低于白人女性（分别为 30%和 34%），且在调整健康和生活方式因素后，差异具有统计学意义。
即使在调整了危险因素后，UI 频率的变化似乎也因种族而异。这些发现可能解释了先前观察到的不同种族群体之间 UI 患病率的差异。尽管 UI 是所有种族女性的常见疾病，但护士和其他临床医生应该意识到，其表现可能因种族而异。这种理解可以增强临床医生与患者讨论 UI 的信心，减少该疾病未被识别的可能性。
流行病学、进展、种族、缓解、尿失禁。
