Waetjen L Elaine, Xing Guibo, Johnson Wesley O, Melnikow Joy, Gold Ellen B
Departments of Obstetrics and Gynecology and Public Health Sciences and the Center for Health Policy and Research, University of California Davis School of Medicine, Davis, and the Department of Statistics, University of California, Irvine, Irvine, California.
Obstet Gynecol. 2015 May;125(5):1071-1079. doi: 10.1097/AOG.0000000000000808.
To examine whether longitudinal urinary incontinence (UI) characteristics, race or ethnicity, socioeconomic status, and education were associated with UI treatment-seeking in a prospective cohort of community-dwelling midlife women.
We analyzed data from 9 years of the Study of Women's Health Across the Nation. The study asked participants reporting at least monthly UI about seeking treatment for their UI at baseline and in visit years 7, 8, and 9. Our main covariates included self-reported race or ethnicity, income, level of difficulty paying for basics, and education level. We used multiple logistic regression to examine associations between demographic, psychosocial, and longitudinal UI characteristics and whether women sought UI treatment. We explored interactions by race or ethnicity, socioeconomic status measures, and education level.
A total of 1,550 women (68% of women with UI) reported seeking treatment for UI over the 9 years of this study. In multivariable analyses, women had higher odds of seeking treatment when UI in the year before seeking treatment was more frequent (adjusted odds ratio [OR] 3.16, 95% confidence interval [CI] 1.15-8.67) and more bothersome (adjusted OR 1.09, 95% CI 1.01-1.18), with longer symptom duration, and with worsening UI symptoms (adjusted OR 1.75, 95% CI 1.01-3.04). Women who saw physicians regularly, had more preventive women's health visits, or both were more likely to seek UI treatment (adjusted OR 1.18, 95% CI 1.07, 1.30). Race or ethnicity, socioeconomic measures, and education were not significantly related to seeking treatment for UI.
We found no evidence of racial or ethnic, socioeconomic, or education level disparities in UI treatment-seeking. Rather, longitudinal UI characteristics were most strongly associated with treatment-seeking behavior in midlife women.
II.
在一个社区居住的中年女性前瞻性队列中,研究纵向尿失禁(UI)特征、种族或族裔、社会经济地位和教育程度是否与寻求UI治疗相关。
我们分析了来自全国妇女健康研究9年的数据。该研究询问了至少每月报告一次UI的参与者在基线以及第7、8和9年访视时是否寻求UI治疗。我们的主要协变量包括自我报告的种族或族裔、收入、支付基本生活费用的困难程度以及教育水平。我们使用多因素逻辑回归来研究人口统计学、心理社会因素和纵向UI特征与女性是否寻求UI治疗之间的关联。我们按种族或族裔、社会经济地位指标和教育水平探讨了交互作用。
在本研究的9年中,共有1550名女性(占UI女性的68%)报告寻求UI治疗。在多变量分析中,寻求治疗前一年UI更频繁(调整后的优势比[OR] 3.16,95%置信区间[CI] 1.15 - 8.67)、更困扰(调整后的OR 1.09,95% CI 1.01 - 1.18)、症状持续时间更长以及UI症状恶化(调整后的OR 1.75,95% CI 1.01 - 3.04)的女性寻求治疗的几率更高。经常看医生、进行更多预防性妇女健康检查或两者兼有的女性更有可能寻求UI治疗(调整后的OR 1.18,95% CI 1.07,1.30)。种族或族裔、社会经济指标和教育程度与寻求UI治疗没有显著关系。
我们没有发现寻求UI治疗方面存在种族或族裔、社会经济或教育水平差异的证据。相反,纵向UI特征与中年女性寻求治疗行为的关联最为密切。
II级