Department of Surgery (Urology), University of Utah, Salt Lake City, UT, USA.
Department of Urology, University of Michigan, Ann Arbor, MI, USA.
Spinal Cord. 2021 Sep;59(9):987-996. doi: 10.1038/s41393-020-00609-x. Epub 2021 Jan 25.
Prospective, multi-centered, observational.
To characterize the relationship between psychosocial aspects of health-related quality of life (HRQoL) and patient-reported bladder outcomes.
Multi-institutional sites in the United States, cohort drawn from North America.
We performed a cross-sectional analysis of data collected as part of the multicenter, prospective Neurogenic Bladder Research Group Spinal Cord Injury (SCI) Registry. Outcomes were: Neurogenic Bladder Symptom Score (NBSS), Neurogenic Bladder Symptom Score Satisfaction (NBSS-Satisfaction), and SCI-QoL Bladder Management Difficulties (SCI-QoL Difficulties). Adjusted multiple linear regression models were used with variables including demographic, injury characteristics, and the following psychosocial HRQoL measures; SCI-QoL Pain Interference (Pain), SCI-QoL Independence, and SCI-QoL Positive Affect and Well-being (Positive Affect). Psychosocial variables were sub-divided by tertiles for the analysis.
There were 1479 participants, 57% had paraplegia, 60% were men, and 51% managed their bladder with clean intermittent catheterization. On multivariate analysis, higher tertiles of SCI-QoL Pain were associated with worse bladder symptoms, satisfaction, and bladder management difficulties; upper tertile SCI-QoL Pain (NBSS 3.8, p < 0.001; NBSS-satisfaction 0.6, p < 0.001; SCI-QoL Difficulties 2.4, p < 0.001). In contrast, upper tertiles of SCI-QoL Independence and SCI-QoL Positive Affect were associated with improved bladder-related outcomes; upper tertile SCI-QoL Independence (NBSS -2.3, p = 0.03; NBSS-satisfaction -0.4, p < 0.001) and upper tertile SCI-QoL Positive Affect (NBSS -2.8, p < 0.001; NBSS-satisfaction -0.7, p < 0.001; SCI-QoL Difficulties -0.7, p < 0.001).
In individuals with SCI, there is an association between psychosocial HRQoL and bladder-related QoL outcomes. Clinician awareness of this relationship can provide insight into optimizing long-term management after SCI.
前瞻性、多中心、观察性研究。
描述健康相关生活质量（HRQoL）的社会心理方面与患者报告的膀胱结局之间的关系。
美国多机构地点，队列来自北美。
我们对多中心前瞻性神经源性膀胱研究组脊髓损伤（SCI）登记处收集的数据进行了横断面分析。结果包括：神经源性膀胱症状评分（NBSS）、神经源性膀胱症状评分满意度（NBSS-Satisfaction）和 SCI-QoL 膀胱管理困难（SCI-QoL Difficulties）。使用调整后的多元线性回归模型，包括人口统计学、损伤特征以及以下社会心理 HRQoL 测量变量；SCI-QoL 疼痛干扰（Pain）、SCI-QoL 独立性和 SCI-QoL 积极影响和幸福感（Positive Affect）。社会心理变量按三分位数进行分析。
共有 1479 名参与者，57%为截瘫，60%为男性，51%通过间歇性清洁导尿管理膀胱。在多变量分析中，SCI-QoL 疼痛的较高三分位数与更差的膀胱症状、满意度和膀胱管理困难相关；上三分位数 SCI-QoL 疼痛（NBSS 3.8，p<0.001；NBSS 满意度 0.6，p<0.001；SCI-QoL 困难 2.4，p<0.001）。相比之下，SCI-QoL 独立性和 SCI-QoL 积极影响的上三分位数与改善的膀胱相关结局相关；SCI-QoL 独立性上三分位数（NBSS-2.3，p=0.03；NBSS 满意度-0.4，p<0.001）和 SCI-QoL 积极影响上三分位数（NBSS-2.8，p<0.001；NBSS 满意度-0.7，p<0.001；SCI-QoL 困难-0.7，p<0.001）。
在 SCI 患者中，社会心理 HRQoL 与膀胱相关的 QoL 结局之间存在关联。临床医生对这种关系的认识可以深入了解 SCI 后的长期管理。
