Porto Marta, Pimenta Filipa, Mascarenhas Teresa, Marôco João
William James Center for Research, Lisbon, Portugal.
Faculdade de Medicina da Universidade do Porto, Porto, Portugal.
Front Psychol. 2023 Nov 30;14:1252471. doi: 10.3389/fpsyg.2023.1252471. eCollection 2023.
Urinary Incontinence (UI) has numerous repercussions in women's lives, and it is underreported/underdiagnosed.
The present study aimed to understand: (1) the differences between women with and without urine loss regarding Quality of Life (QoL) and Sexual Function (SF); (2) the possible moderation role of UI-related beliefs and strategies on the relationship between UI-symptom severity and SF and QoL, in women with UI.
Cross-sectional Design. Participants: Primary aim: Overall, 2,578 women aged 40-65 ( = 49.94, = 6.76) were collected online. Secondary aim: 1,538 women who self-reported having urine loss occasionally/frequently ( = 50.19, = 6.58). All data analyses were done with IBM SPSS Statistics and R statistical system 4.0 through RStudio. Statistical Path analysis was performed with the lavaan package to study the hypothetical association and moderating effects between the variables.
Primary aim: women without UI had a better SF [(2576) = 3.13, = 0.002; 95% C.I., 0.18 to 0.80] and QoL [(2576) = 7.71, < 0.001; 95% C.I., 3.14 to 5.28] than their counterparts with UI. Secondary aim: UI-related coping strategies attenuated the impact of UI-symptom severity on SF( = -0.07; = 0.041); the more dysfunctional the UI-related beliefs were, the poorer QoL was ( = -0.06; = 0.031); the more frequent the UI-related hiding/defensive strategies were, the poorer QoL was ( = -0.26; < 0.001).
Limitations: online data collection, which thwarted the clarification of participants, if needed; absence of a UI medical diagnosis (only self-reported measures were used). Strengths and practical implications: (i) the crucial role of UI-related beliefs and strategies in the QoL of women with UI; (ii) the impact that UI-concealing/defensive strategies have in attenuating the impact of UI-symptom severity on SF, which might be perceived as a short-term benefit and hence contribute to maintaining the UI condition and constitute a barrier to help-seeking, (iii) impact of UI-symptom severity on QoL and SF (including a comparison group entailing women without UI, which is scarcely used); and (iv) the use of gold-standard and psychometrically robust instruments.
Changing dysfunctional UI-related beliefs and strategies in clinical settings may improve the QoL; UI-concealing strategies may reinforce themselves by immediate effects on SF, but are not functional in the long term.
尿失禁（UI）对女性生活有诸多影响，且报告不足/诊断不足。
本研究旨在了解：（1）有和没有尿失禁的女性在生活质量（QoL）和性功能（SF）方面的差异；（2）在患有尿失禁的女性中，与UI相关的信念和策略对UI症状严重程度与SF和QoL之间关系的可能调节作用。
横断面设计。参与者：主要目标：总体而言，通过网络收集了2578名年龄在40 - 65岁（平均年龄 = 49.94，标准差 = 6.76）的女性。次要目标：1538名自我报告偶尔/频繁有尿失禁的女性（平均年龄 = 50.19，标准差 = 6.58）。所有数据分析均使用IBM SPSS Statistics和通过RStudio的R统计系统4.0完成。使用lavaan软件包进行统计路径分析，以研究变量之间的假设关联和调节效应。
主要目标：没有尿失禁的女性在性功能方面更好[（2576）= 3.13，p = 0.002；95%置信区间，0.18至0.80]，在生活质量方面也更好[（2576）= 7.71，p < 0.001；95%置信区间，3.14至5.28]，优于有尿失禁的女性。次要目标：与UI相关的应对策略减弱了UI症状严重程度对性功能的影响（β = -0.07；p = 0.041）；与UI相关的信念功能失调越严重，生活质量越差（β = -0.06；p = 0.031）；与UI相关的隐藏/防御策略越频繁，生活质量越差（β = -0.26；p < 0.001）。
局限性：在线数据收集，这妨碍了在必要时对参与者进行澄清；缺乏UI医学诊断（仅使用自我报告的测量方法）。优点和实际意义：（i）与UI相关的信念和策略在患有UI的女性生活质量中的关键作用；（ii）UI隐藏/防御策略在减弱UI症状严重程度对性功能影响方面的作用，这可能被视为短期益处，从而有助于维持UI状况并构成寻求帮助的障碍；（iii）UI症状严重程度对生活质量和性功能的影响（包括一个有未患尿失禁女性的对照组，这很少被使用）；以及（iv）使用了金标准且心理测量稳健的工具。
在临床环境中改变与UI相关功能失调的信念和策略可能会改善生活质量；UI隐藏策略可能因其对性功能的即时影响而自我强化，但从长远来看并无益处。
