Department of Surgery and Epidemiology and Biostatistics, Western University, London, Ontario, Canada.
Division of Urology, Department of Surgery, University of Utah, Salt Lake City, Utah, USA.
Neurourol Urodyn. 2021 Aug;40(6):1643-1650. doi: 10.1002/nau.24730. Epub 2021 Jun 17.
To conduct a conjoint analysis experiment to better understand the psychosocial priorities related to bladder management in individuals after spinal cord injury (SCI).
We developed a conjoint analysis survey that included 11 psychosocial attributes phrased in the context of bladder management (including attributes for urinary infections, and incontinence). We then performed a multi-center prospective cross-sectional study of adults with existing SCI which consisted of a baseline interview, followed by the online conjoint analysis survey (delivered through Sawtooth software). Hierarchical Bayes random effects regression analysis was used to determine the relative importance of the attributes.
A total of 345 people complete the study. There was good representation of both men and women, and individuals with cervical and thoracic or lower lesions. The most important attribute was the frequency of urinary infections. Age, sex, and level of SCI were generally not related to the attributes measured in the study. In the subgroup of 256 patients who used a catheter for bladder management, significantly more importance was placed on urinary tract infections, time, fluid intake, and social life among indwelling catheter users compared to intermittent catheter users.
Most bladder-related psychosocial priorities are not impacted by a patient's age, sex or level of SCI. Differences in psychosocial priorities between indwelling and intermittent catheter users may represent factors that should be focused on to optimize bladder management after SCI.
通过联合分析实验,更好地了解脊髓损伤(SCI)后个体在膀胱管理方面的社会心理优先事项。
我们开发了一项联合分析调查,其中包括 11 项以膀胱管理为背景的社会心理属性(包括尿路感染和尿失禁属性)。然后,我们对现有的 SCI 成年人进行了一项多中心前瞻性横断面研究,该研究包括基线访谈,随后是在线联合分析调查(通过 Sawtooth 软件进行)。分层贝叶斯随机效应回归分析用于确定属性的相对重要性。
共有 345 人完成了这项研究。研究对象中男女比例均衡,且包括颈椎和胸椎或以下部位损伤的个体。最重要的属性是尿路感染的频率。年龄、性别和 SCI 水平与研究中测量的属性通常没有关系。在使用导管进行膀胱管理的 256 名患者亚组中,与间歇性导尿患者相比,留置导尿患者更重视尿路感染、时间、液体摄入和社会生活。
大多数与膀胱相关的社会心理优先事项不受患者年龄、性别或 SCI 水平的影响。留置导尿和间歇性导尿患者之间的社会心理优先事项差异可能代表应关注的因素,以优化 SCI 后的膀胱管理。