Smith T M, Menees S B, Xu X, Saad R J, Chey W D, Fenner D E
Female Pelvic Medicine and Reconstructive Surgery, Department of Obstetrics and Gynecology, L4000 Women's Hospital, University of Michigan, 1500 E. Medical Center Drive, SPC 5276, Ann Arbor, MI 48109, USA.
Int Urogynecol J. 2013 Mar;24(3):493-9. doi: 10.1007/s00192-012-1889-6. Epub 2012 Jul 18.
Fecal incontinence (FI) is a distressing, highly prevalent condition affecting quality of life (QOL). The aim of our study was to identify predictors of moderate/severe health-related QOL among women with FI.
Data were collected from women presenting to a multispecialty clinic from January 2005 to July 2009 with FI. All completed questionnaires on demographics and validated instruments including the Fecal Incontinence Quality of Life Instrument (FIQL), Patient Health Questionnaire (PHQ) for depression, and Fecal Incontinence Severity Index (FISI). Logistic regression was used to identify factors associated with moderate/severe FI.
The study included 226 women with an average age of 59.2 years (SD = 14.1); 92 % were Caucasian, 67 % were married, and the average body mass index was 30.0 (SD = 8.6). Their QOL was moderately/severely affected by FI in 35.6 %. Mean overall FIQL score was 2.5 (SD = 0.8). Median QOL subscale measures were: lifestyle = 2.7 (SD = 1.0), coping = 2.09 (SD = 0.9), depression = 2.8 (SD = 1.0), and embarrassment = 2.2 (SD = 0.9). Average FISI score was 31.6 (SD = 15.7) and average depression score on the PHQ was 8.93 (SD = 8.1). In univariate analyses, diabetes, irritable bowel symptoms, prior hysterectomy, history of previous medical care for FI, higher FISI and PHQ scores were associated with moderate/severe FIQL scores (p < 0.05). Higher PHQ scores and prior hysterectomy significantly predicted moderate/severe QOL in logistic regression analysis (p < 0.05).
We confirm that women with higher depression scores and prior hysterectomy have moderate/severe QOL impairment. When evaluating FI, screening for depression should be undertaken.
大便失禁（FI）是一种令人苦恼且极为常见的病症，会影响生活质量（QOL）。我们研究的目的是确定患有大便失禁的女性中与中度/重度健康相关生活质量相关的预测因素。
收集了2005年1月至2009年7月到一家多专科诊所就诊的患有大便失禁的女性的数据。所有患者均完成了关于人口统计学的问卷以及经过验证的量表，包括大便失禁生活质量量表（FIQL）、用于评估抑郁的患者健康问卷（PHQ）以及大便失禁严重程度指数（FISI）。采用逻辑回归分析来确定与中度/重度大便失禁相关的因素。
该研究纳入了226名女性，平均年龄为59.2岁（标准差=14.1）；92%为白种人，67%已婚，平均体重指数为30.0（标准差=8.6）。其中35.6%的女性生活质量受到中度/重度大便失禁的影响。FIQL总体平均得分为2.5（标准差=0.8）。生活质量子量表的中位数测量值分别为：生活方式=2.7（标准差=1.0），应对能力=2.09（标准差=0.9），抑郁=2.8（标准差=1.0），尴尬=2.2（标准差=0.9）。FISI平均得分为31.6（标准差=15.7），PHQ抑郁平均得分为8.93（标准差=8.1）。在单因素分析中，糖尿病、肠易激症状、既往子宫切除术、既往因大便失禁接受医疗护理的病史、较高的FISI和PHQ得分与中度/重度FIQL得分相关（p<0.05）。在逻辑回归分析中，较高的PHQ得分和既往子宫切除术显著预测了中度/重度生活质量（p<0.05）。
我们证实，抑郁得分较高且既往有子宫切除术的女性存在中度/重度生活质量受损情况。在评估大便失禁时，应进行抑郁筛查。
