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中国社区居住的脊髓损伤患者神经原性下尿路功能障碍管理模式及相关因素。

Patterns of neurogenic lower urinary tract dysfunction management and associated factors among Chinese community-dwelling individuals with spinal cord injury.

机构信息

Department of Rehabilitation, Tongji Hospital Affiliated to Tongji Medical College of Huazhong University of Science and Technology, Wuhan, 430030, Hubei, China.

Department of Nursing, Tongji Hospital Affiliated to Tongji Medical College of Huazhong University of Science and Technology, Wuhan, 430030, Hubei, China.

出版信息

Sci Rep. 2024 Jun 9;14(1):13224. doi: 10.1038/s41598-024-64081-w.

Abstract

To identify different patterns of neurogenic lower urinary tract dysfunction management among Chinese community-dwelling individuals with spinal cord injury and explore the factors associated with latent classes. This was a cross-sectional study conducted in communities throughout China Mainland. Participants were recruited through the China Association of Persons with Physical Disability and a total of 2582 participants was included in the analysis. The data were collected by a questionnaire consisting of socio-demographic factors, disease-related factors, and a list of 8 bladder management methods. Latent class analysis was used to identify different latent classes of neurogenic lower urinary tract dysfunction management. Then the multinomial logistic regression was applied to analyze the relationship between neurogenic lower urinary tract dysfunction management patterns and socio-demographic and disease-related factors. Neurogenic lower urinary tract dysfunction management pattern among community-dwelling individuals with spinal cord injury was divided into four latent classes: "urinal collecting apparatus dominated pattern" (40.3%), "bladder compression dominated pattern" (30.7%), "intermittent catheterization dominated pattern" (19.3%) and "urethral indwelling catheterization dominated pattern" (9.6%). Multinomial logistic regression analysis found that the employment status, residential region, nursing need, payment method for catheterization products, hand function, time since spinal cord injury, urinary incontinence and concerns about social interaction affected by urination problems were significantly associated with latent classes. Only 19.3% of people used the intermittent catheterization as their main neurogenic lower urinary tract dysfunction management method. More attention needs to be paid to the promotion of the standardization process of intermittent catheterization in community-dwelling individuals with spinal cord injury. The associated factors of the four classes can be used for tailored and targeted interventions to increase the use of intermittent catheterization.

摘要

为了识别中国社区居住的脊髓损伤患者神经原性下尿路功能障碍管理的不同模式,并探讨与潜在类别相关的因素。这是一项在中国内地社区进行的横断面研究。通过中国残疾人协会招募参与者,共有 2582 名参与者被纳入分析。数据由一份问卷收集,问卷包括社会人口统计学因素、疾病相关因素和 8 种膀胱管理方法列表。采用潜在类别分析识别神经原性下尿路功能障碍管理的不同潜在类别。然后应用多变量逻辑回归分析神经原性下尿路功能障碍管理模式与社会人口统计学和疾病相关因素之间的关系。社区居住的脊髓损伤患者的神经原性下尿路功能障碍管理模式分为四个潜在类别:“集尿器主导模式”(40.3%)、“膀胱压迫主导模式”(30.7%)、“间歇性导尿主导模式”(19.3%)和“留置导尿主导模式”(9.6%)。多变量逻辑回归分析发现,就业状况、居住地区、护理需求、导尿产品的支付方式、手功能、脊髓损伤后时间、尿失禁以及对排尿问题引起的社交互动的关注与潜在类别显著相关。只有 19.3%的人将间歇性导尿作为主要的神经原性下尿路功能障碍管理方法。需要更加关注社区居住的脊髓损伤患者中间歇性导尿规范化进程的推广。四个类别的相关因素可用于有针对性的干预措施,以增加间歇性导尿的使用。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a0df/11162410/9577d7d17b17/41598_2024_64081_Fig1_HTML.jpg

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