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埃塞俄比亚西北阿姆哈拉地区三家医院慢性病门诊就诊的男性糖尿病患者的性功能障碍:患病率及相关因素。

Sexual dysfunction among men with diabetes mellitus attending chronic out-patient department at the three hospitals of Northwest Amhara region, Ethiopia: Prevalence and associated factors.

机构信息

Department of Reproductive and Child Health, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia.

出版信息

PLoS One. 2021 Aug 11;16(8):e0256015. doi: 10.1371/journal.pone.0256015. eCollection 2021.

Abstract

BACKGROUND

Sexual dysfunction is the commonest reproductive health problem observed among men with diabetes mellitus affecting their quality of life. Previous studies conducted in this area were concentrated on the specific domains of sexual dysfunction, and factors were not well-addressed. Therefore, this study was aimed to determine the prevalence of all forms of sexual dysfunction and to identify its associated factors among diabetic men patients attending at the three hospitals of the Amhara region, Ethiopia.

METHOD

An institutional-based cross-sectional study was conducted involving 462 men diabetic patients at the three hospitals of the northwest Amhara region. A systemic random sampling technique was employed. A face-to-face interviewer-administered change in the sexual functioning questionnaire was used to collect the required data from the 20th of February to the 15th of April 2020. The binary logistic regression was employed and a multivariable logistic regressions model was used to control the effect of confounders. Variables that had an independent correlation with the sexual dysfunction were identified based on a p-value≤ 0.05. Likewise, the direction and strength of association were interpreted using Adjusted Odds Ratio (AOR) with its corresponding 95% CI.

RESULTS

The prevalence of sexual dysfunction was found to be 69.5% (95%CI: (65.1-73.9)). The magnitude of sexual dysfunction was prevalently observed among participants who were older (> 50 years) (AOR = 8.7, 95%CI: (3.3-23.1)). Likewise, the odds of sexual dysfunction was significantly higher among men who have lived with diabetes for a longer duration (AOR = 10.8, 95%CI: (5.3-21.9)), with poor metabolic control (AOR = 3.57, 95%CI: (1.81-7.05)), with comorbid illnesses (AOR = 5.07, 95%CI: (2.16-11.9)), and diabetic-related complications (AOR = 3.01, 95%CI: 1.31-6.92). On the other hand, participants who were physically active (AOR = 0.41, 95%CI: (0.12-0.7)) and satisfied with their relationship (AOR = 0.15, 95%CI: (0.03-0.7)) showed a lesser risk of experiencing sexual dysfunction.

CONCLUSION

Well over two-thirds of men with diabetes mellitus have experienced sexual dysfunction, implying a public health pressing problem. Older age, lack of physical activity, living longer duration with diabetes, having diabetic complications, experiencing co-morbid illnesses, being unsatisfied with couple relationship, and poor metabolic control increased the risk of developing SD. Therefore, promoting physical exercise, preventing co-morbid illnesses, and couples counseling to build up a good couple relationship are recommended to promote the sexual and reproductive health of men with diabetes.

摘要

背景

性障碍是糖尿病男性最常见的生殖健康问题,影响其生活质量。之前在这一领域进行的研究集中在性功能障碍的特定领域,而且没有很好地解决相关因素。因此,本研究旨在确定在埃塞俄比亚阿姆哈拉地区三家医院就诊的糖尿病男性患者所有形式的性障碍的患病率,并确定其相关因素。

方法

本研究为基于机构的横断面研究,涉及阿姆哈拉地区西北部三家医院的 462 名糖尿病男性患者。采用系统随机抽样技术。从 2020 年 2 月 20 日至 4 月 15 日,采用性功能变化问卷对患者进行面对面访谈式调查,以收集所需数据。采用二项逻辑回归,并使用多变量逻辑回归模型来控制混杂因素的影响。根据 p 值≤0.05,确定与性障碍具有独立相关性的变量。同样,使用调整后的优势比(AOR)及其相应的 95%置信区间来解释方向和关联强度。

结果

性障碍的患病率为 69.5%(95%CI:(65.1-73.9))。在年龄较大(>50 岁)的参与者中,性障碍的严重程度明显更高(AOR=8.7,95%CI:(3.3-23.1))。同样,糖尿病病程较长(AOR=10.8,95%CI:(5.3-21.9))、代谢控制较差(AOR=3.57,95%CI:(1.81-7.05))、合并疾病(AOR=5.07,95%CI:(2.16-11.9))和糖尿病相关并发症(AOR=3.01,95%CI:1.31-6.92)的男性发生性障碍的可能性显著更高。另一方面,身体活跃(AOR=0.41,95%CI:(0.12-0.7))和对夫妻关系满意(AOR=0.15,95%CI:(0.03-0.7))的参与者发生性障碍的风险较低。

结论

超过三分之二的糖尿病男性患者经历过性障碍,这是一个紧迫的公共卫生问题。年龄较大、缺乏身体活动、糖尿病病程较长、患有糖尿病并发症、患有合并疾病、对夫妻关系不满意和代谢控制较差会增加发生 SD 的风险。因此,建议提倡身体锻炼、预防合并疾病和夫妻咨询,以建立良好的夫妻关系,促进糖尿病男性的性和生殖健康。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/acdc/8357135/06020a6bb561/pone.0256015.g001.jpg

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