The Truly Healthy Bladder: Understanding Normal As A Pathway To Prevention Of Lower Urinary Tract Symptoms In Women

 描述（由申请人提供）：许多妇女患有改变生活的下尿路症状（LUTS）。然而，由于缺乏对真正膀胱健康的理解和定义，LUTS的预防受到阻碍。健康膀胱的现有范例被过于狭隘地定义为没有LUTS，忽视了世界卫生组织的警告，即健康不仅仅是没有疾病。为了成为一个拥有健康膀胱的妇女的国家，并降低高昂的公共和私人医疗保健成本，我们必须在如何发展膀胱健康知识以及随后的LUTS预防方面进行巨大的转变。我们知道LUTS看起来像什么（尿失禁，尿路感染等）。但很少有文献可用于指导健康膀胱的表征。在这项提案中，密歇根大学一个具有护理，流行病学，预防科学，行为科学和初级保健医学背景的广泛跨学科研究团队将利用我们在健康促进和降低风险方面的专业知识来解决这一知识差距。我们将使用理解生物学和生理学生命阶段（青春期、成年期、生育期、围绝经期/绝经期、老年人）的关键交叉点的过程，以及对女性青少年、女性、父母和初级卫生保健医生所经历的膀胱健康社会信息的心理社会和行为反应，来表征整个生命周期的膀胱健康。我们的目标是开发一个证据库的健康女性青少年和妇女的膀胱健康的经验，使用新的混合方法的方法，为下尿路症状的预防策略。研究目的是：1.从专家意见和概念分析方法构建健康膀胱的可操作定义，2。进一步开发/改进/试验能够捕获健康膀胱状态内的变化的简单但概念新颖的调查仪器。 3.试点低成本发展项目，将丰富生产力和跨学科合作的预防LUTS财团，包括发展所需的基础知识，以确保资金的调查LUTS预防。超过三分之一的美国女性患有令人痛苦，尴尬和经常未报告的LUTS问题。这项工作通过为每个生命阶段具有健康膀胱的女性建立正常范围和相关协变量的证据基础，为制定合理，有效的预防策略奠定基础，以减轻女性和社会面临的LUTS的沉重疾病负担，从而显着解决了这些挑战。

 DESCRIPTION (provided by applicant): Many women suffer from life altering lower urinary tract symptoms (LUTS). However, prevention of LUTS is hampered by lack of understanding and definition of true bladder health. The existing paradigm of healthy bladder is too narrowly defined as absence of LUTS, ignoring the World Health admonition that health is NOT JUST absence of disease. To become a nation of women with healthy bladders and reduce high public and private medical care costs, a seismic shift is necessary in how we approach knowledge development about bladder health and subsequently LUTS prevention. We know what LUTS look like (incontinence, urinary tract infection, etc.) but scant literature is availableto guide characterization of the healthy bladder. In this proposal, a broadly interdisciplinary research team with backgrounds in nursing, epidemiology, prevention science, behavioral science, and primary care medicine at the University of Michigan will use our expertise in health promotion and risk reduction to address this knowledge gap. We will characterize bladder health across the lifespan using a process of understanding key intersections of biological and physiological life stages (adolescence, adulthood, childbearing, peri-menopause/menopause, elderly) with psychosocial and behavioral responses to societal messaging about bladder health as experienced by female adolescents, women, parents and primary health care clinicians. The goal is to develop an evidence base about healthy female adolescent's and women's experience of bladder health using novel mixed methods approaches to inform prevention strategies for LUTS. Study aims are: 1. Construct an operational definition of the healthy bladder drawing from expert opinion and concept analysis methods, 2. Further develop/refine/pilot a simple but conceptually novel survey instrument capable of capturing variance within the healthy bladder state. 3. Pilot low-cost developmental projects that will enrich productivity and interdisciplinary collaborations of the Preventing LUTS consortium, including developing fundamental knowledge required for securing funding on investigation of LUTS prevention. More than 1 in 3 US women suffer from the distressing, embarrassing, and often unreported problems of LUTS. This work significantly addresses these challenges by establishing an evidence base of normal ranges and associated covariates for women with healthy bladders across each life stage to lay the foundation for developing rational, effective prevention strategies to reduce the heavy disease burden of LUTS faced by women and society.