Women seeking treatment for advanced pelvic organ protapse have decreased body image and quality of life
Women seeking treatment for advanced pelvic organ protapse have decreased body image and quality of life
复制标题
DOI：
10.1016/j.ajog.2006.01.060
复制
发表时间：
2006-05-01
影响因子：
9.8
通讯作者：
Barber, MD
中科院分区：
文献类型：
--
作者：
Jelovsek, JE;Barber, MD
目的：寻求盆腔器官脱垂治疗的女性争取改善生活质量。身体形象已被证明是生活质量差异的重要组成部分。到目前为止，还没有晚期盆腔器官脱垂患者的身体影像数据。我们的目标是比较晚期盆腔器官脱垂妇女和正常对照妇女的身体形象和生活质量。研究设计：我们采用病例对照研究设计。病例被定义为在三级妇科门诊就诊的晚期盆腔器官脱垂(3期或4期)的受试者。对照组被定义为每年到三级护理妇科或妇女保健诊所就诊，盆底支持正常(0期或1期)且无尿失禁的受试者。所有患者都完成了有效和可靠的身体形象量表和一般(简明健康调查)和具体情况(盆底窘迫问卷-20)生活质量量表。采用线性和Logistic回归分析调整可能的混杂变量。结果：纳入47例病例和51例对照。在控制了年龄、种族、产次、既往子宫切除和内科合并症后，患有晚期盆腔器官脱垂的受试者更有可能感觉到自我意识(调整后的优势比4.7；95%可信区间1.4至18，P=0.02)，不太可能感觉到身体上的吸引力(调整后的优势比11；95%可信区间2.9至5.1 P<；.001)，不太可能感觉到女性气质(调整后的优势比4.0；95%的可信区间1.2至15，P=0.03)，以及不太可能感觉到性吸引力(调整后的优势比4.6；95%可信区间1.4~17，P=0.02)。这两组人的相似之处在于，他们对着装时的外表不满意，很难看清自己裸体，因为外表而躲避别人，以及总体上对自己的身体不满意。晚期盆腔器官脱垂患者在SF-12生理评分上的生活质量显著降低(平均值42；95%可信区间39-45对平均值50；95%可信区间47-53，P<；0.009)。然而，在SF-12的心理量表上，两组之间没有发现差异(平均数51；95%可信区间50到54对平均数50；95%可信区间47到52，P=.56)。此外，晚期盆腔器官脱垂的患者在脱垂、尿路和结直肠量表以及盆底窘迫问卷的总分-20分上的得分显著低于正常对照组(平均总分104分；95%可信区间90到118对平均29分；95%可信区间16到43分，P
Objective: Women who seek treatment for pelvic organ prolapse strive for an improvement in quality of life. Body image has been shown to be an important component of differences in quality of life. To date, there are no data on body image in patients with advanced pelvic organ prolapse. Our objective was to compare body image and quality of life in women with advanced pelvic organ prolapse with normal controls.Study design: We used a case-control study design. Cases were defined as subjects who presented to a tertiary urogynecology clinic with advanced pelvic organ prolapse (stage 3 or 4). Controls were defined as subjects who presented to a tertiary care gynecology or women's health clinic for an annual visit with normal pelvic floor support (stage 0 or 1) and without urinary incontinence. All patients completed a valid and reliable body image scale and a generalized (Short Form Health Survey) and condition-specific (Pelvic Floor Distress Inventory-20) quality-of-life scale. Linear and logistic regression analyses were performed to adjust for possible confounding variables.Results: Forty-seven case and 51 control subjects were enrolled. After controlling for age, race, parity, previous hysterectomy, and medical comorbiditics, subjects with advanced pelvic organ prolapse were more likely to feel self-conscious (adjusted odds ratio 4.7; 95% confidence interval 1.4 to 18, P =.02), less likely to feel physically attractive (adjusted odds ratio 11; 95% confidence interval 2.9 to 5 1 P < .001), less likely to feel feminine (adjusted odds ratio 4.0; 95% confidence interval 1.2 to 15, P =.03), and less likely to feel sexually attractive (adjusted odds ratio 4.6; 95% confidence interval 1.4 to 17, P =.02) than normal controls. The groups were similar in their feeling of dissatisfaction with appearance when dressed, difficulty looking at themselves naked, avoiding people because of appearance, and overall dissatisfaction with their body. Subjects with advanced pelvic organ prolapse suffered significantly lower quality of life on the physical scale of the SF-12 (mean 42; 95% confidence interval 39 to 45 versus mean 50; 95% confidence interval 47 to 53, P < .009). However, no differences between groups were noted on the mental scale of the SF-12 (mean 51; 95% confidence interval 50 to 54 versus mean 50; 95% confidence interval 47 to 52, P =.56). Additionally, subjects with advanced pelvic organ prolapse scored significantly worse on the prolapse, urinary, and colorectal scales and overall Summary score of Pelvic Floor Distress Inventory-20 than normal controls (mean summary score 104; 95% confidence interval 90 to 118 versus mean 29; 95% confidence interval 16 to 43, P