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寻求下尿路症状临床治疗的原因:一项混合方法研究。

Reasons for Seeking Clinical Care for Lower Urinary Tract Symptoms: A Mixed Methods Study.

机构信息

Department of Medical Social Sciences, Northwestern University Feinberg School of Medicine, Chicago, Illinois.

Arbor Research Collaborative for Health, Ann Arbor, Michigan.

出版信息

J Urol. 2018 Feb;199(2):528-535. doi: 10.1016/j.juro.2017.07.067. Epub 2017 Jul 20.

Abstract

PURPOSE

The primary objective of this study was to evaluate reasons for seeking care among men and women with lower urinary tract symptoms.

MATERIALS AND METHODS

Participants were recruited from urology and urogynecology clinics, and the community. The sample was enriched with persons expected to have abnormal or diminished bladder sensations (eg participants with lower back surgery and participants 65 years old or older). Interviews were performed in person beginning with an open-ended assessment of urinary symptoms and associated bother followed by more directed questions, including reasons for seeking or not seeking treatment. We also examined the relationship between symptom frequency and bother using the LUTS (Lower Urinary Tract Symptoms) Tool.

RESULTS

A total of 88 participants, including 38 men and 50 women, with a mean ± SD age of 52.2 ± 14.3 years provided information about urinary symptoms, including a range of quality of life consequences and coping behaviors. They sought treatment mostly because of new, continuing or bothersome symptoms. Factors associated with not seeking treatment included low symptom severity and concerns about the costs vs the benefits of treatment (eg side effects of medication). Symptom frequency and bother were associated with each other across symptoms assessed by the LUTS Tool.

CONCLUSIONS

In this large qualitative study we obtained useful insights into the impact of lower urinary tract symptoms from the perspective of the person with the symptoms. Removing barriers and misconceptions about the treatment of lower urinary tract symptoms may increase the number of people who seek clinical care and improve the clinical course of men and women who experience lower urinary tract symptoms.

摘要

目的

本研究的主要目的是评估下尿路症状患者寻求治疗的原因。

材料和方法

参与者从泌尿科和泌尿妇科诊所和社区招募。该样本通过预期有异常或减弱膀胱感觉的人(例如接受过下背部手术的参与者和 65 岁或以上的参与者)进行了丰富。访谈是亲自进行的,首先对尿症状和相关困扰进行开放式评估,然后进行更有针对性的问题,包括寻求或不寻求治疗的原因。我们还使用 LUTS(下尿路症状)工具检查了症状频率与困扰之间的关系。

结果

共有 88 名参与者,包括 38 名男性和 50 名女性,平均年龄 ± SD 为 52.2 ± 14.3 岁,提供了有关尿症状的信息,包括一系列生活质量后果和应对行为。他们主要因为新的、持续的或困扰的症状而寻求治疗。不寻求治疗的因素包括症状严重程度低和对治疗成本与效益的担忧(例如药物的副作用)。通过 LUTS 工具评估的症状中,症状频率和困扰相互关联。

结论

在这项大型定性研究中,我们从有症状的人的角度获得了有关下尿路症状影响的有用见解。消除对下尿路症状治疗的障碍和误解可能会增加寻求临床护理的人数,并改善经历下尿路症状的男性和女性的临床病程。

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