Psychosocial Factors Related to the Use of InterStim® for the Treatment of Refractory Overactive Bladder
Psychosocial Factors Related to the Use of InterStim® for the Treatment of Refractory Overactive Bladder
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DOI：
10.1097/spv.0000000000000062
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发表时间：
2014-09-01
影响因子：
1.6
通讯作者：
Amundsen, Cindy Louise
中科院分区：
文献类型：
--
作者：
Levin, Pamela June;Siddiqui, Nazema Yusuf;Amundsen, Cindy Louise
目的：骶神经调整术是治疗顽固性膀胱过度活动症(OAB)的有效方法。尽管有关于其他植入医疗设备的心理社会影响的文献，但没有关于InterStim(R)治疗的数据。我们旨在评估难治性OAB间歇治疗的女性患者的乐观情绪与治疗满意度之间的关系以及OAB症状的变化。方法：接受间歇治疗难治性OAB的成年女性在测试刺激前完成一系列有效问卷，评估乐观情绪、泌尿症状严重程度、抑郁和身体形象。调查问卷包括生活定向测验修订版、OAB问卷简表、严重抑郁量表和身体形象量表。三个月后，参与者重复问卷以评估尿路症状、抑郁和身体形象，并完成OAB治疗满意度问卷(OAB-SAT-Q)。相关分析评估生活定向量表修订分数与OAB-SAT-Q分量表分数和OAB问卷分量表变化分数之间的关系。受试者还完成了针对患者在手术前和手术后对植入装置的担忧的未经验证的问题。结果：纳入28名女性。在所有OAB-SAT-Q分量表上，乐观程度与受试者满意度的相关性都很弱(满意度、认可、不良影响和便利性的r值分别为-0.11、-0.21、-0.42和-0.20)。乐观情绪与OAB症状的变化在症状严重程度和健康相关生活质量分量表中的相关性较弱。比较手术前和术后的问卷显示，在抑郁、身体形象、症状严重程度和与健康相关的生活质量方面，有统计学上的显著改善。结论：乐观程度与患者对InterSTim治疗的满意度、OAB症状的改变或OAB相关的生活质量无关。与健康相关的生活质量、OAB症状、抑郁和身体形象在InterSTim治疗后有所改善。
Objectives: Sacral neuromodulation is a well-established treatment of refractory overactive bladder (OAB). Although literature exists on the psychosocial impact of other implanted medical devices, data do not exist for InterStim (R) therapy. We aim to evaluate the relationship between optimism and treatment satisfaction in women undergoing InterStim for refractory OAB and change in OAB symptoms.Methods: Adult women undergoing InterStim therapy for refractory OAB completed a series of validated questionnaires before test stimulation assessing optimism, urinary symptom severity, depression, and body image. Questionnaires included the Life Orientation Test-Revised, OAB Questionnaire-Short Form, Major Depression Inventory, and a body image scale. Three months postoperatively, participants repeated the questionnaires to assess urinary symptoms, depression, and body image and completed the OAB Satisfaction with Treatment Questionnaire (OAB-SAT-q). Correlations assessed the relationship between the Life Orientation Test-Revised score and OAB-SAT-q subscale scores, and the OAB questionnaire subscale change scores. Subjects also completed the nonvalidated questions aimed at patients concerns regarding the implanted devices pre-operatively and postoperatively.Results: Twenty-eight women were included. Level of optimism was weakly correlated with subject satisfaction across all OAB-SAT-q subscales (r value of -0.11, -0.21, -0.42, and -0.20 for satisfaction, endorsement, adverse effects, and convenience, respectively). Optimism had a weak correlation with change in OAB symptoms in symptom severity and health-related quality of life subscales. Comparison of pre-operative and postoperative questionnaires demonstrated statistically significant improvements in depression, body image, symptom severity, and health-related quality of life. Patients concerns regarding implanted devices changed only marginally.Conclusions: The level of optimism did not correlate with satisfaction with InterStim treatment, change in OAB symptoms, or OAB-related quality of life. Health-related quality of life, OAB symptoms, depression, and body image improved after InterStim treatment.