Lalchandani Pooja, Lisha Nadra, Gibson Carolyn, Huang Alison J
University of California, San Francisco, 1545 Divisadero Street, Box 0320, San Francisco, CA, 94143-0320, USA.
San Francisco Veterans Affairs Health Care System, San Francisco, CA, USA.
J Gen Intern Med. 2020 Nov;35(11):3210-3217. doi: 10.1007/s11606-020-06118-0. Epub 2020 Sep 1.
Past research has examined the health outcomes of early sexual trauma in reproductive age women, but little is known about potential long-term effects in older age.
To examine associations between early life sexual trauma and later life sexual/genitourinary dysfunction and general functional disability in women.
Cross-sectional analysis of nationally representative observational data from the National Social Life, Health, and Aging Project (2010-2011) PARTICIPANTS: One thousand seven hundred forty-five US women aged ≥ 50 years MAIN MEASURES: Two forms of early life sexual trauma (childhood sexual abuse and unwanted first sexual experience), sexual/genitourinary dysfunction (pain during sex, lack of pleasure during sex, urinary incontinence, other urinary symptoms), and general functional disability (difficulty performing 7 activities of daily living (ADLs) or 8 instrumental activities of daily living (IADLs)), assessed by interview and questionnaire.
Of 1745 women, 11% reported a history of childhood sexual abuse and 39% an unwanted first sexual experience. Childhood sexual abuse was associated with later life sexual/genitourinary dysfunction (pain during sex [OR 1.9, 95% CI 1.1-3.3], other urinary problems [OR 1.9, 95% CI 1.2-3.1]), and difficulty with multiple ADLs/IADLs (walking across the room [OR 1.9, 95% CI 1.2-3.1], getting in or out of bed [OR 2.0, 95% CI 1.2-3.3], bathing [OR 2.0, 95% CI 1.2-3.5], prepping meals [OR 2.4, 95% CI 1.5-3.8], shopping for food [OR 1.6, 95% CI 1.0-2.4], and completing light work [OR 1.6, 95% CI 1.0-2.4]), after adjusting for age, race, and education. Unwanted first sexual experience was associated with later life lack of pleasure with sex (OR 1.7, 95% CI 1.1-2.5) and difficulty with ADLs/IADLs (walking one block [OR 1.5, 95% CI 1.1-2.1], completing light work [OR 1.6, 95% CI 1.1-2.1]) in adjusted analyses.
Early sexual trauma may be an under-recognized marker of risk of aging-related functional decline in women. Findings underline the importance of providing trauma-informed care for women across the aging spectrum.
过去的研究调查了育龄期女性早期性创伤的健康后果，但对于其在老年时期的潜在长期影响知之甚少。
研究女性早年性创伤与晚年性/泌尿生殖系统功能障碍及一般功能残疾之间的关联。
对来自国家社会生活、健康与老龄化项目（2010 - 2011年）具有全国代表性的观察性数据进行横断面分析
1745名年龄≥50岁的美国女性
两种早年性创伤形式（童年期性虐待和初次性经历不愉快）、性/泌尿生殖系统功能障碍（性交疼痛、性交缺乏快感、尿失禁、其他泌尿症状）以及一般功能残疾（在7项日常生活活动（ADL）或8项工具性日常生活活动（IADL）中存在困难），通过访谈和问卷进行评估。
在1745名女性中，11%报告有童年期性虐待史，39%报告初次性经历不愉快。在调整年龄、种族和教育程度后，童年期性虐待与晚年性/泌尿生殖系统功能障碍（性交疼痛[比值比（OR）1.9，95%置信区间（CI）1.1 - 3.3]，其他泌尿问题[OR 1.9，95% CI 1.2 - 3.1]）以及多项ADL/IADL困难（穿过房间[OR 1.9，95% CI 1.2 - 3.1]，上下床[OR 2.0，95% CI 1.2 - 3.3]，洗澡[OR 2.0，95% CI 1.2 - 3.5]，准备饭菜[OR 2.4，95% CI 1.5 - 3.8]，购买食品[OR 1.6，95% CI 1.0 - 2.4]，完成轻度工作[OR 1.6，95% CI 1.0 - 2.4]）相关。在调整分析中，初次性经历不愉快与晚年性交缺乏快感（OR 1.7，95% CI 1.1 - 2.5）以及ADL/IADL困难（步行一个街区[OR 1.5，95% CI 1.1 - 2.1]，完成轻度工作[OR 1.6，95% CI 1.1 - 2.1]）相关。
早期性创伤可能是女性衰老相关功能衰退风险中一个未被充分认识的标志。研究结果强调了为不同年龄段女性提供创伤知情护理的重要性。
