Anto-Ocrah Martina, Oktapodas Feiler Marina, Pukall Caroline, Pacos-Martinez Amy
Department of Emergency Medicine, School of Medicine and Dentistry, University of Rochester, Rochester, NY; Department of Obstetrics and Gynecology, School of Medicine and Dentistry, University of Rochester, Rochester, NY; Department of Neurology, School of Medicine and Dentistry, University of Rochester, Rochester, NY.
Department of Environmental Medicine, School of Medicine and Dentistry, University of Rochester, Rochester, NY.
Sex Med. 2021 Feb;9(1):100297. doi: 10.1016/j.esxm.2020.100297. Epub 2021 Jan 20.
Previous findings from our group show that in the acute (ie, 6-10 weeks) post-injury period, women with concussions have a 70% greater risk of sexual dysfunction than those with extremity injuries. There are currently limited treatment options for the clinical management of concussions. Resilience is a protective, modifiable psychological construct that has been shown to improve concussion-related sequelae. To date, however, no research has evaluated how resilience impacts sexuality outcomes after concussion in women.
Evaluate if resilience offers protection against negative sexuality outcomes in a cohort of reproductive, aged women with a concussion, seeking care in the Emergency Department of a Level-1 Trauma Center. We hypothesized that women with low resilience will be more likely to experience negative impacts on sexuality and that increasing levels of resilience will be associated with more positive sexuality outcomes.
Secondary data analyses.
Resilience was evaluated with the Resilience Scale (RS), and the Brain Injury Questionnaire for Sexuality (BIQS) was used for sexuality.
Of the 299 participants recruited for the parent study, 80 with concussion had complete follow-up data and were included in these secondary analyses. Less than half (42.5%; n = 34) had low resilience (score≤130 on the RS), and the remaining 46 (57.5%) had high resilience (score>130 on the RS). In crude linear regression models, 1-unit increase in resilience was associated with a 4% increase in sexuality outcomes (β = 0.04, 95% CI:0.01, 0.05; P = .008). The effect estimate remained similar in post-concussion-symptom-adjusted models (β = 0.03, 95% CI:0.002, 0.06; P = .03). Mood-adjusted models showed a statistically significant interaction term (P < .0001). After stratifying by mood, findings showed that unit increases in resilience were associated with a 6% increase in sexuality outcomes for women in the high risk mood group (HADS score ≥11; PCS-adjusted β = 0.06, 95% CI:0.02, 0.11; P = .009).
Longitudinal studies are needed to evaluate how these improvements in resilience translate to patient recovery measures following concussion. Anto-Ocrah M, Oktapodas Feiler M, Pukall C, et al. Resilience and Sexuality After Concussion in Women. Sex Med 2021;9:100297.
我们团队之前的研究结果表明，在受伤后的急性期（即6 - 10周），脑震荡女性出现性功能障碍的风险比肢体受伤女性高70%。目前，脑震荡临床管理的治疗选择有限。心理弹性是一种具有保护作用且可改变的心理结构，已被证明能改善与脑震荡相关的后遗症。然而，迄今为止，尚无研究评估心理弹性如何影响女性脑震荡后的性健康结果。
评估心理弹性是否能保护一组在一级创伤中心急诊科就诊的患有脑震荡的育龄女性免受负面性健康结果的影响。我们假设心理弹性低的女性更有可能在性方面受到负面影响，而心理弹性水平的提高将与更积极的性健康结果相关。
二次数据分析。
使用心理弹性量表（RS）评估心理弹性，使用脑损伤性健康问卷（BIQS）评估性健康。
在为母研究招募的299名参与者中，80名患有脑震荡的参与者有完整的随访数据，并被纳入这些二次分析。不到一半（42.5%；n = 34）的参与者心理弹性低（RS评分≤130），其余46名（57.5%）心理弹性高（RS评分>130）。在简单线性回归模型中，心理弹性每增加1个单位，性健康结果增加4%（β = 0.04，95%置信区间：0.01，0.05；P = 0.008）。在调整脑震荡症状后的模型中，效应估计值保持相似（β = 0.03，95%置信区间：0.002，0.06；P = 0.03）。调整情绪后的模型显示出具有统计学意义的交互项（P < 0.0001）。按情绪分层后，研究结果表明，对于高风险情绪组（医院焦虑抑郁量表评分≥11；调整后的PCSβ = 0.06，95%置信区间：0.02，0.11；P = 0.009）的女性，心理弹性每增加1个单位，性健康结果增加6%。
需要进行纵向研究来评估心理弹性的这些改善如何转化为脑震荡后患者的恢复指标。安托 - 奥克拉赫M、奥克塔波达斯·费勒M、普卡尔C等。女性脑震荡后的心理弹性与性健康。性医学2021；9：100297。
