Interpersonal Trauma as a Marker of Risk for Urinary Tract Dysfunction in Midlife and Older Women.
Interpersonal Trauma as a Marker of Risk for Urinary Tract Dysfunction in Midlife and Older Women.
复制标题
人际创伤是中年和老年女性尿路功能障碍的风险标志。
DOI：
10.1097/aog.0000000000003586
复制
发表时间：
2020
影响因子：
7.2
通讯作者：
Huang,AlisonJ
中科院分区：
文献类型：
--
作者：
Boyd,BrittniAJ;Gibson,CarolynJ;VanDenEeden,StephenK;McCaw,Brigid;Subak,LesleeL;Thom,David;Huang,AlisonJ
目的：研究社区居住的中年和老年女性的人际创伤暴露与泌尿系统症状之间的关系。方法：我们分析了参加加州综合医疗保健系统的 40-80 岁多种族女性队列的横断面数据。使用结构化项目问卷评估一生中亲密伴侣暴力（IPV）和性侵犯史、当前创伤后应激障碍（PTSD）症状和当前泌尿系统症状。多变量调整逻辑回归模型检查了创伤性暴露和 PTSD 症状与每周尿失禁、压力型尿失禁、急迫型尿失禁和每晚两次或两次以上夜尿之间的关联。 结果：在分析的 1,999 名参与者中，21.7% 的女性报告了终生情感 IPV，16.2% 报告了身体 IPV， 19.7% 的人报告了性侵犯，22.6% 的人报告了临床上显着的 PTSD 症状。总体而言，45% 的人报告每周尿失禁，23% 的人报告压力型尿失禁，23% 的人报告尿急型尿失禁，35% 的人报告夜尿症。接触情绪性 IPV 与任何每周尿失禁（比值比 [OR] 1.33，95% CI 1.04–1.70）、压力型尿失禁（OR 1.30，95% CI 1.00–1.65）、紧急型尿失禁（OR 1.30，95% CI 1.00–1.70）和夜尿有关（或 1.73，95% CI 1.36–2.19）。物理 IPV 暴露与夜尿症相关（OR 1.35，95% CI 1.04–1.77），但与失禁无关。性侵犯史与任何类型的每周失禁或夜尿症无关。 PTSD 的症状与评估的所有泌尿系统症状相关，包括任何每周失禁（OR 1.46，95% CI 1.15–1.85）、压力型失禁（OR 1.70，95% CI 1.32–2.20）、紧急型失禁（OR 1.60，95% CI 1.24–2.06）和夜尿症（或 1.95， 95% CI 1.55–2.45）。结论：在这个多种族、社区队列中，超过 20% 的女性报告有 IPV 病史、PTSD 症状或两者兼而有之，这些与症状性尿路功能障碍相关。研究结果强调需要为出现泌尿系统症状的中年和老年女性提供创伤知情护理。
OBJECTIVE:To examine relationships between interpersonal trauma exposures and urinary symptoms in community-dwelling midlife and older women.METHODS:We analyzed cross-sectional data from a multiethnic cohort of women aged 40–80 years enrolled in an integrated health care system in California. Lifetime history of intimate partner violence (IPV) and sexual assault, current posttraumatic stress disorder (PTSD) symptoms, and current urinary symptoms were assessed using structured-item questionnaires. Multivariable-adjusted logistic regression models examined associations between traumatic exposures and PTSD symptoms with any weekly urinary incontinence, stress-type incontinence, urgency-type incontinence, and nocturia two or more times per night.RESULTS:Of the 1,999 participants analyzed, 21.7% women reported lifetime emotional IPV, 16.2% physical IPV, 19.7% sexual assault, and 22.6% reported clinically significant PTSD symptoms. Overall, 45% reported any weekly incontinence, 23% stress-type incontinence, 23% urgency-type incontinence, and 35% nocturia. Exposure to emotional IPV was associated with any weekly incontinence (odds ratio [OR] 1.33, 95% CI 1.04–1.70), stress-type incontinence (OR 1.30, 95% CI 1.00–1.65), urgency-type incontinence (OR 1.30, 95% CI 1.00–1.70), and nocturia (OR 1.73, 95% CI 1.36–2.19). Physical IPV exposure was associated with nocturia (OR 1.35, 95% CI 1.04–1.77), but not incontinence. Sexual assault history was not associated with weekly incontinence of any type or nocturia. Symptoms of PTSD were associated with all urinary symptoms assessed, including any weekly incontinence (OR 1.46, 95% CI 1.15–1.85), stress-type incontinence (OR 1.70, 95% CI 1.32–2.20), urgency-type incontinence (OR 1.60, 95% CI 1.24–2.06), and nocturia (OR 1.95, 95% CI 1.55–2.45).CONCLUSION:More than 20% of women in this multiethnic, community-based cohort reported a history of IPV, PTSD symptoms, or both, which were associated with symptomatic urinary tract dysfunction. Findings highlight the need to provide trauma-informed care of midlife and older women presenting with urinary symptoms.