Hunter D J, McKee C M, Black N A, Sanderson C F
Health Services Research Unit, London School of Hygiene and Tropical Medicine, UK.
Qual Life Res. 1995 Aug;4(4):335-41. doi: 10.1007/BF01593886.
Our objective was to determine the extent to which lower urinary tract symptoms affect the general health status of men and contribute to the decision to undergo surgery. A cross-sectional population survey using postal questionnaires was conducted in the North West Thames health region, followed by a prospective cohort study of men undergoing prostatectomy (North West Thames and Oxford regions). The subjects in the first survey were 221 men aged 55 and over with previously reported mild, moderate or severe urinary symptoms; subjects in the second study were 388 men undergoing prostatectomy. Main outcome measures were self-reported symptom severity, bothersomeness and general health status (Nottingham Health Profile, Part 1). The response rate among eligible responders in the population survey was 85.7%. Increasing symptom severity was associated with worsening NHP scores for energy, emotional reactions, sleep and physical mobility (p < 0.01). Increasing bothersomeness of symptoms was associated with emotional reactions, sleep and pain (p < 0.05). Men undergoing surgery reported worse health status than men in the population with the same severity of symptoms as regards emotional reactions, energy and pain. For a given level of symptom severity, the impact of those symptoms on aspects of a man's general health status may be the determinant of seeking and undergoing surgery. Greater understanding of the factors that affect a man's response to his symptoms is needed in interpreting the decision to seek and accept treatment.
我们的目标是确定下尿路症状在多大程度上影响男性的总体健康状况，并促使他们做出手术决定。我们在泰晤士河北部健康区域开展了一项使用邮政问卷的横断面人群调查，随后对接受前列腺切除术的男性进行了一项前瞻性队列研究（泰晤士河北部和牛津地区）。第一次调查的对象是221名55岁及以上且此前报告有轻度、中度或重度尿路症状的男性；第二项研究的对象是388名接受前列腺切除术的男性。主要结局指标为自我报告的症状严重程度、困扰程度和总体健康状况（《诺丁汉健康状况问卷》第1部分）。人群调查中符合条件的应答者的应答率为85.7%。症状严重程度增加与能量、情绪反应、睡眠和身体活动能力方面的《诺丁汉健康状况问卷》得分恶化相关（p < 0.01）。症状困扰程度增加与情绪反应、睡眠和疼痛相关（p < 0.05）。在情绪反应、能量和疼痛方面，接受手术的男性报告的健康状况比症状严重程度相同的人群中的男性更差。对于给定的症状严重程度水平，这些症状对男性总体健康状况各方面的影响可能是寻求和接受手术的决定因素。在解释寻求和接受治疗的决定时，需要更深入地了解影响男性对其症状反应的因素。
