Gonzalez Chiappe Solange, Lasserre Andrea, Chartier Kastler Emmanuel, Falchi Alessandra, Blaizeau Fanette, Blanchon Thierry, Hanslik Thomas, Denys Pierre
INSERM, UMR_S 1136, Paris, France.
Sorbonne Universities, UPMC University Paris 06, Paris, France.
Neurourol Urodyn. 2016 Apr;35(4):528-34. doi: 10.1002/nau.22752. Epub 2015 Mar 8.
To estimate the prevalence of GP (general practitioner) patients performing ISC (intermittent self-catheterization), to describe GP and patient knowledge about ISC and to assess the patients' quality of life.
A cross-sectional study was conducted in metropolitan France between November 2012 and September 2013 with French Sentinelles GPs and their patients (≥18 years) performing ISC. Linear regression models assessed independent associations between quality of life scores (Qualiveen and SF-12 scores) and patients' characteristics.
The prevalence of ISC performers was estimated to be 61.7 (95% confidence interval [CI] = 61.0-62.4) of 100,000 inhabitants. Patients were males in 58.8% of cases and 53.8 years of age on average. They performed 4.84 catheterizations per day for 10.5 years. Over 1 year, there were 118 (55.1%) cases of patient-reported urinary incontinence (UI) and 158 (63.3%) cases of patient-reported urinary tract infection (UTI). Symptomatic UTIs were treated with antibiotics in 79.7% of cases. The average Qualiveen score was 1.38 (95%CI: 1.23-1.53). The average SF-12 Physical Component Score (PCS) and Mental Component Score (MCS) were 38.6 (95%CI: 36.8-40.4) and 46.4 (95%CI: 44.3-48.5), respectively. According to multivariate analysis, a poorer Qualiveen score and constipation reduced the PCS and a urinary medication prescription reduced the MCS. A poorer Qualiveen score was also associated with UI and UTI on bivariate analysis.
ISC seems to be significant in French general practice whereas practical skills remain heterogeneous. UI, UTI, and constipation are recurrent issues among ISC performers that significantly decrease their quality of life. Education and adapted guidelines for GP guidance could improve these patients' conditions. Neurourol. Urodynam. 35:528-534, 2016. © 2015 Wiley Periodicals, Inc.
评估进行间歇性自我导尿术(ISC)的全科医生(GP)患者的患病率,描述全科医生和患者对间歇性自我导尿术的了解情况,并评估患者的生活质量。
2012年11月至2013年9月在法国大都市对实施间歇性自我导尿术的法国哨兵计划全科医生及其患者(≥18岁)进行了一项横断面研究。线性回归模型评估了生活质量评分(Qualiveen和SF-12评分)与患者特征之间的独立关联。
估计每10万居民中间歇性自我导尿术实施者的患病率为61.7(95%置信区间[CI]=61.0-62.4)。58.8%的患者为男性,平均年龄53.8岁。他们在10.5年中每天进行4.84次导尿。在1年时间里,有118例(55.1%)患者报告有尿失禁(UI),158例(63.3%)患者报告有尿路感染(UTI)。79.7%的有症状尿路感染病例使用抗生素治疗。Qualiveen平均评分为1.38(95%CI:1.23-1.53)。SF-12身体成分评分(PCS)和精神成分评分(MCS)的平均值分别为38.6(95%CI:36.8-40.4)和46.4(95%CI:44.3-48.5)。根据多变量分析,Qualiveen评分较低和便秘会降低PCS,而开具泌尿系统药物处方会降低MCS。在双变量分析中,Qualiveen评分较低也与尿失禁和尿路感染有关。
间歇性自我导尿术在法国全科医疗中似乎很重要,但实际技能仍存在差异。尿失禁、尿路感染和便秘是间歇性自我导尿术实施者中反复出现的问题,会显著降低他们的生活质量。针对全科医生指导的教育和适应性指南可能会改善这些患者的状况。《神经泌尿学与尿动力学》35:528-534,2016年。©2015威利期刊公司。