DuBeau C E, Levy B, Mangione C M, Resnick N M
Brigham and Women's Hospital and Beth Israel Deaconess Medical Center, Division on Aging, Harvard Medical School, Boston, Massachusetts 02115, USA.
J Am Geriatr Soc. 1998 Jun;46(6):683-92. doi: 10.1111/j.1532-5415.1998.tb03801.x.
The impact of urinary incontinence (UI) on health-related quality of life (QoL) is significant yet variable, but little is known about patient-defined content areas regarding the influence of UI on QoL and whether patient-specific factors correlate with specific content areas of UI-related QoL. In order to identify the most valid content areas for a new UI-related QoL questionnaire, our primary goal was to determine the content areas of greatest concern regarding UI-related QoL among older persons with urge incontinence. The second goal was to examine the possible role of patients' explanatory style as a mediator of UI impact on health-related QoL. Data on the questionnaire will be presented elsewhere.
Focus groups comprising urge-incontinent persons were used to obtain verbatim descriptions of the impact of UI on QoL.
A university-affiliated tertiary hospital.
Community-dwelling women (n = 25) and men (n = 5) more than 60 years of age, with urge incontinence, recruited from newspaper, newsletter, and radio advertisements.
Qualitative content analysis of focus group transcripts was used to determine QoL items. These were compared with previously described UI-related QoL items obtained from the literature. Subjects' statements regarding causes of UI were evaluated for predominant explanatory style.
Thirty-two UI-related QoL items were identified, more than half of which were not described previously. Compared with expert-defined UI-related QoL items from the literature, patient-defined items focused more on coping with embarrassment and interference from UI than on prevention of actual activity performance. Explanatory statements were made frequently by patients talking about their UI. Although positive style explanatory statements were most common, they did not correlate with any QoL items. By contrast, there was a significant correlation between negative explanatory style and six specific UI-related QoL items.
Focus groups of older persons with urge incontinence suggest that experts and patients view the impact of urge UI on QoL differently. Whereas experts focus more on functional impact, patients more often cite the impact of UI on their emotional well-being and on the interruption of activities. In addition, the association between negative explanatory style and specific UI-related QoL items suggests that explanatory style may be an important mediator of patients' perceptions of UI-related QoL.
尿失禁（UI）对健康相关生活质量（QoL）的影响重大但存在差异，然而对于患者定义的关于UI对QoL影响的内容领域以及特定患者因素是否与UI相关QoL的特定内容领域相关，我们知之甚少。为了确定一种新的UI相关QoL问卷最有效的内容领域，我们的主要目标是确定老年急迫性尿失禁患者中与UI相关QoL最受关注的内容领域。第二个目标是研究患者的解释风格作为UI对健康相关QoL影响的中介可能发挥的作用。问卷数据将在其他地方呈现。
采用由急迫性尿失禁患者组成的焦点小组来获取UI对QoL影响的逐字描述。
一家大学附属医院。
从报纸、时事通讯和广播广告中招募的60岁以上社区居住的女性（n = 25）和男性（n = 5），患有急迫性尿失禁。
使用焦点小组记录的定性内容分析来确定QoL项目。将这些项目与先前从文献中获得的与UI相关的QoL项目进行比较。评估受试者关于UI原因的陈述的主要解释风格。
确定了32个与UI相关的QoL项目，其中一半以上以前未被描述过。与文献中专家定义的与UI相关的QoL项目相比，患者定义的项目更多地关注应对UI带来的尴尬和干扰，而不是预防实际活动表现。患者在谈论自己的UI时经常做出解释性陈述。虽然积极风格的解释性陈述最为常见，但它们与任何QoL项目均无关联。相比之下，消极解释风格与六个特定的与UI相关的QoL项目之间存在显著相关性。
老年急迫性尿失禁患者的焦点小组表明，专家和患者对急迫性UI对QoL的影响看法不同。专家更多地关注功能影响，而患者更常提及UI对其情绪健康和活动中断的影响。此外，消极解释风格与特定的与UI相关的QoL项目之间的关联表明，解释风格可能是患者对UI相关QoL认知的重要中介因素。
