女性医务人员尿失禁及其对生活质量影响的现况调查

doi:10.19723/j.issn.1671-167X.2019.04.019

摘要/Abstract

摘要：

目的:探索北京市女性医务人员尿失禁的发病情况相关因素及其对生活质量的影响。方法:在北京大学第一医院采用方便取样的方法进行抽样调查,对抽取的146名女性医务人员采用问卷调查的形式,了解其一般信息、排尿习惯、尿失禁患病率、尿失禁严重程度、尿失禁对生活质量的影响,排除处于妊娠期、处于尿路感染期、合并神经原性膀胱或尿道狭窄的调查对象。采用SPSS 21.0统计软件处理数据。结果:共纳入146名女性医务人员,有63(43.2%)名患有压力性尿失禁。全部研究对象的平均年龄为(39.4±9.9)岁,平均体重指数为(22.3±3.4) kg/m ²,中位分娩次数为1次(范围:0~3次),有自然分娩史的人数为50例,有32例(21.9%)患有慢性便秘。多因素分析结果提示,有便秘史和自然分娩史是尿失禁发生的独立相关因素。非尿失禁组的研究对象在总生活质量、行为维度、心理维度、社会维度方面均显著优于尿失禁组(P<0.001)。尿失禁在行为维度(r=-0.449, P<0.001)、心理维度(r=-0.538, P<0.001)、社会维度(r=-0.454, P<0.001)几个方面均明显影响研究对象的生活质量。结论:尿失禁在女性医务工作人员中有一定的发病率,并在行为、心理、社会各方面影响其生活质量,便秘史与自然分娩次数是女性医务人员发生尿失禁的独立相关因素。

关键词: 尿失禁, 女性, 相关因素, 生活质量

Abstract:

Objective: To explore risk factors of urinary incontinence (UI) and influences of UI on quality of life in female medical staff from Beijing.Methods: One hundred and forty-six female medical personnel were included in the present study through the convenient sampling method in Peking University First Hospital. The questionnaires contained the following information: demographic information, daily urination condition, the severity of UI [international consultation on incontinence questionnaire short form (ICI-Q-SF)], and the influences of UI on quality of life (QOL). We excluded the subjects who were in pregnancy or had urinary infection, neurogenic bladder, or urethral stricture. We used SPSS 21.0 software (IBM Corp, Armonk, NY) for statistical analysis. The Kolmogorov-Smirnov test determined the normality of the continuous variables. Means and standard deviation presented continuous variables in normality. Median and range presented continuous variables without normality. Frequency and percentile were used to present categorical or ranked variables.Results: There were 63 out of 146 (43.2%) female medical staff suffering from UI. The mean age and body mass index of the whole study cohort were (39.4±9.9) years and (22.3±3.4) kg/m ². The median delivery times of all the subjects were 1 time (range: 0-3 times). Fifty out of 146 (34.2%) subjects had transvaginal delivery history. Chronic constipation was diagnosed in 32 subjects (21.9%). No significant difference in daytime micturition and nocturia times were found between the UI and non-UI subjects. According to the multivariate analysis, chronic constipation (OR=4.95, 95%CI=1.81-13.53, P=0.002) and transvaginal delivery history (OR=3.50, 95%CI=1.49-8.21, P=0.004) were independent risk factors for UI. The non-UI subjects had superior quality of life than the UI subjects in terms of incontinence quality of life (I-QOL) total scores and all sub-scores of avoidance and limiting behaviors, psychosocial impacts, and social embarrassment (P<0.001). In addition, avoidance and limiting behaviors (r=-0.449, P<0.001), psychosocial impacts (r=-0.538, P<0.001), and social embarrassment (r=-0.454, P<0.001) of the 63 UI subjects were equally influenced by the incontinence symptom.Conclusion: UI is not uncommon in female medical staff. The quality of life of medical faculty is influenced by UI in terms of avoi-dance and limiting behaviors, psychosocial impacts, and social embarrassment. Chronic constipation and transvaginal delivery history were independent risk factors for UI.

Key words: Urinary incontinence, Female, Risk factor, Quality of life

中图分类号:

R694.54

车新艳,吴士良,陈宇珂,黄燕波,杨洋. 女性医务人员尿失禁及其对生活质量影响的现况调查[J]. 北京大学学报（医学版）, 2019, 51(4): 706-710.

Xin-yan CHE,Shi-liang WU,Yu-ke CHEN,Yan-bo HUANG,Yang YANG. A survey of risk factors and quality of life in female medical staff with urinary incontinence[J]. Journal of Peking University(Health Sciences), 2019, 51(4): 706-710.

图/表 4

表1

研究对象的一般资料"

Items	Totoal (n=146)	Urinary incontinence (n=63)	Non-urinary incontinence (n=83)
Age/years, $x ?$ ±s	39.4±9.9	42.0±8.7	37.3±10.3
Marital status, n (%)	118 (80.9)	59 (93.7)	59 (71.1)
Bachelor degree, n (%)	142 (97.3)	61 (96.8)	81 (97.6)
BMI/(kg/m²), $x ?$ ±s	22.3±3.4	22.9±2.8	21.8±3.8
Chronic disease histoy^*, n (%)	42 (28.8)	20 (31.7)	22 (26.5)
Constipation, n (%)	32 (21.9)	22 (34.9)	10 (12.0)
Pregnancy times, median (range)	1 (0-3)	1 (0-2)	1 (0-3)
Natural delivery, n (%)	50 (34.2)	34 (54.0)	16 (19.3)
Menopause, n (%)	9 (6.2)	6 (9.5)	3 (3.6)
Pelvic surgery history, n (%)	28 (19.2)	15 (23.8)	13 (15.7)
Daytime micturition times, n (%)
1-5	102 (69.9)	40 (63.5)	62 (74.7)
6-9	41 (28.1)	21 (33.3)	20 (24.1)
10-13	3 (2.1)	2 (3.2)	1 (1.2)
>13	0	0	0
Nocturia time, n (%)
0	59 (40.4)	28 (44.4)	31 (37.3)
1	68 (46.6)	29 (46.0)	39 (47.0)
2	16 (11.0)	6 (9.5)	10 (12.0)
>2	3 (2.1)	0	3 (3.6)
ICI-Q-SF, median (range)	0 (0-12)	5 (1-12)	0
QOL, median (range)
Total	109 (24-110)	103 (31-110)	110 (24-110)
Behavioral	39 (10-40)	37 (12-40)	40 (10-40)
Psychosocial	45 (9-45)	42 (10-45)	45 (9-45)
Social	25 (5-25)	24 (9-25)	25 (5-25)

表1

表2

表3

表4

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Variables	Univariate		Multivariate^*
Variables	OR (95%CI)	P	OR (95%CI)	P
Age	1.05 (1.02-1.09)	0.005	1.03 (0.98-1.07)	0.288
Marital status (yes vs. no)	4.81 (1.76-13.19)	0.002	2.10 (0.54-8.14)	0.282
Bachelor degree (yes vs. no)	0.75 (0.10-5.50)	0.780
BMI	1.11 (0.99-1.25)	0.075	1.08 (0.96-1.22)	0.199
Chronic disease history (yes vs. no)	1.29 (0.63-2.65)	0.489
Constipation (yes vs. no)	3.92 (1.69-9.07)	0.001	4.95 (1.81-13.53)	0.002
Pregnancy times	2.43 (1.26-4.69)	0.008	1.37 (0.58-3.23)	0.475
Natural delivery (yes vs. no)	4.91 (2.35-10.26)	<0.001	3.50 (1.49-8.21)	0.004
Perimenopause (yes vs. no)	2.81 (0.67-11.69)	0.156
Pelvic surgery history (yes vs. no)	1.68 (0.74-3.85)	0.218
Daytime micturition (times)	1.66 (0.87-3.17)	0.125
Nocturia (times)	0.72 (0.45-1.15)	0.170