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转诊至盆底护理中心的男性患者首次接触盆底功能障碍主诉的患病率及分诊情况

Prevalence and triage of first contact pelvic floor dysfunction complaints in male patients referred to a Pelvic Care Centre.

作者信息

Berghmans Bary, Nieman Fred, Leue C, Weemhoff M, Breukink S, van Koeveringe G

机构信息

Pelvic Care Centre Maastricht, Maastricht University Medical Centre, Maastricht, The Netherlands.

Department of Clinical Epidemiology & Medical Technology Assessment, Maastricht University Medical Centre, Maastricht, The Netherlands.

出版信息

Neurourol Urodyn. 2016 Apr;35(4):487-91. doi: 10.1002/nau.22733. Epub 2015 Jan 25.

Abstract

AIMS

(i) To describe and analyse pelvic floor dysfunction symptoms in men referred to a Pelvic Care Centre (PCC). (ii) To describe the triage process of the same patients based on response to a first-contact interview.

METHODS

Triage started with a telephone interview using previously constructed questions, asking for six types of PF complaints during the preceding 6 months. If present, complaint severity was registered on a 0-10 scale. Next, these first-contact complaints were used to describe patient case mix profiles using cross-tabular analysis. Later on, at first PCC visit, an intake questionnaire regarding specific PF health problem(s) was filled out. This procedure contributed to a firm baseline characterization of the individual patient profile and a clinically valid allocation to structured, predefined assessment and treatment.

RESULTS

From 2005 to 2013 985 first-time patients (mean age 58.2 years (SD 15.3) have been referred to the PCC. Most frequently mentioned complaints: voiding dysfunctions (73.9%), urinary incontinence (29.5%), sexual problems (16.6%), faecal incontinence (13.9%), constipation (9.6%), and prolapse (0.3%). A first appointment to a single specialist was determined in 805 (81.7%) patients, in 137 (13.9%) consultation of >1 specialist. Data analysis revealed higher-order interactions between PF complaints, suggesting patient profile complexity and patient population heterogeneity.

CONCLUSIONS

One out of seven PCC patients showed multifactorial problems, needing >1 specialist. PF complaints either turned out to stand alone or cluster with others, or even to strengthen, weaken, nullify or inverse relationships. Neurourol. Urodynam. 35:487-491, 2016. © 2015 Wiley Periodicals, Inc.

摘要

目的

(i)描述并分析被转诊至盆底护理中心(PCC)的男性盆底功能障碍症状。(ii)根据首次接触访谈的回复描述同一批患者的分诊过程。

方法

分诊始于电话访谈,使用预先设计的问题,询问患者在过去6个月内的六种盆底功能障碍相关主诉。若有相关主诉,依据0至10分的量表记录严重程度。接下来,利用交叉表分析,根据这些首次接触时的主诉描述患者病例组合概况。随后,在首次到PCC就诊时,填写一份关于特定盆底健康问题的问诊问卷。这一流程有助于对个体患者概况进行稳固的基线特征描述,并在临床上有效地分配至结构化、预先定义的评估和治疗。

结果

2005年至2013年期间,985名首次就诊患者(平均年龄58.2岁(标准差15.3))被转诊至PCC。最常提及的主诉为:排尿功能障碍(73.9%)、尿失禁(29.5%)、性功能问题(16.6%)、大便失禁(13.9%)、便秘(9.6%)以及脱垂(0.3%)。805名(81.7%)患者确定预约了单一专科医生,137名(13.9%)患者咨询了不止一名专科医生。数据分析揭示了盆底功能障碍主诉之间的高阶相互作用,表明患者概况的复杂性和患者群体的异质性。

结论

七分之一的PCC患者存在多因素问题,需要不止一名专科医生。盆底功能障碍主诉要么单独出现,要么与其他主诉聚集,甚至会加强、削弱、抵消或反转相互关系。《神经泌尿学与尿动力学》35:487 - 491, 2016。© 2015威利期刊公司。

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