Min Elissa E, Thomas Joseph
Department of Pharmacy Practice, College of Pharmacy, Purdue University, West Lafayette, Indiana.
J Family Med Prim Care. 2023 Aug;12(8):1555-1570. doi: 10.4103/jfmpc.jfmpc_1955_22. Epub 2023 Aug 29.
Patient perceptions of their doctors may influence talking to them about urinary incontinence (UI). We estimated prevalence of UI among Medicare beneficiaries and assessed association between beneficiaries' demographic and clinical characteristics and whether they spoke to their doctor about UI and association between beneficiaries' perceptions of their doctor and whether they spoke to their doctor about UI.
This study was approved by the Purdue University Institutional Review Board (IRB) and determined exempt, category 4 (protocol number 1907022503, approval on August 5th, 2019). Medicare Current Beneficiary Survey (MCBS) 2016 data were analyzed. Beneficiaries who indicated that they lost urine control 2-3 times a month or above were classified as experiencing UI. An 11-item patient perception of their physician scale was created based on MCBS items. Perceptions were categorized as favorable or unfavorable. SAS version 9.4 for Unix was used for all analyses. PROC LOGISTIC was used to assess multi-variable association between beneficiaries' perceptions of their doctors and talking to their doctor about UI.
Among 7466 persons meeting inclusion criteria, 1856 (24.9%) had UI. The perception of doctor scale scores ranged from 15 to 44, with mean score = 36.57 (standard deviation = 5.29). The scale Cronbach alpha reliability was 0.93. Using sensitivity and receiver operating characteristic analysis, a cutoff of 30 or higher was identified as a favorable perception. Beneficiaries with favorable perceptions of their doctor were more likely to speak to their doctor about experiencing UI than beneficiaries with unfavorable perceptions (odds ratio = 1.55, 95% confidence interval = 1.03 to 2.35, value = 0.038).
Overall, the more favorable the perception of their physicians, the more likely beneficiaries were to speak to them about their UI.
患者对医生的看法可能会影响他们与医生谈论尿失禁（UI）的情况。我们估计了医疗保险受益人中尿失禁的患病率，并评估了受益人的人口统计学和临床特征与他们是否与医生谈论尿失禁之间的关联，以及受益人对医生的看法与他们是否与医生谈论尿失禁之间的关联。
本研究经普渡大学机构审查委员会（IRB）批准，并确定为豁免类别4（方案编号1907022503，2019年8月5日批准）。对2016年医疗保险当前受益人调查（MCBS）数据进行了分析。表示每月有2 - 3次或以上尿液控制丧失的受益人被归类为患有尿失禁。基于MCBS项目创建了一个包含11个项目的患者对其医生的看法量表。看法被分类为有利或不利。所有分析均使用适用于Unix的SAS 9.4版本。使用PROC LOGISTIC评估受益人对医生的看法与与医生谈论尿失禁之间的多变量关联。
在7466名符合纳入标准的人中，1856人（24.9%）患有尿失禁。医生看法量表得分范围为15至44，平均得分 = 36.57（标准差 = 5.29）。量表的Cronbach alpha信度为0.93。通过敏感性和接受者操作特征分析，确定得分30及以上为有利看法。对医生有有利看法的受益人比有不利看法的受益人更有可能与医生谈论经历尿失禁的情况（优势比 = 1.55，95%置信区间 = 1.03至2.35，P值 = 0.038）。
总体而言，受益人对医生的看法越有利，就越有可能与医生谈论他们的尿失禁情况。
