Understanding and Improving Treatment Decision-Making for Older Males with Stress Urinary Incontinence

了解并改善患有压力性尿失禁的老年男性的治疗决策

• 批准号: 9811955
• 负责人: Lindsay Ann Hampson
• 金额: $ 12.05万
• 依托单位: UNIVERSITY OF CALIFORNIA, SAN FRANCISCO
• 依托单位国家: 美国
• 财政年份: 2019
• 资助国家: 美国
• 起止时间: 2019-09-01 至 2021-05-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/9811955
• 关键词: Address; Adult; Aftercare; Age; Age-Years; Aging; Attitude; Automobile Driving; Belief; Benefits and Risks; Body Weight decreased; California; Caring; Clinical Research; Comorbidity; Computerized Medical Record; Consultations; Counseling; Data; Decision Aid; Decision Making; Devices; Disease; Dryness; Elderly; Ensure; Ethics; Etiology; Extravasation; Foundations; Frequencies; Goals; Gold; Health; Impaired cognition; Incontinence; Individual; Infection; Institution; Intervention; Interview; Kegel exercise; Knowledge; Life Expectancy; Liquid substance; Manuals; Measures; Medical center; Mental Depression; Methods; Mission; Motivation; Operative Surgical Procedures; Outcome; Patient-Focused Outcomes; Patients; Personal Satisfaction; Population; Postoperative Period; Public Health; Pump; Quality of life; Recommendation; Regrets; Repeat Surgery; Research; Research Personnel; Research Proposals; Risk; San Francisco; Scrotum; Social isolation; Sphincter; Stress Urinary Incontinence; Structure; Surgeon; Surveys; Telephone; Testing; Time; Training; Treatment Factor; United States National Institutes of Health; Universities; Urethra; Urinary Incontinence; Urination; Urologist; Urology; Veterans; age related; base; chronic pain; cognitive function; cohort; cost; demographics; functional status; health related quality of life; improved; innovation; male; men; men' s group; multiple chronic conditions; novel; older men; operation; patient oriented; patient population; personalized decision; prostate surgery; reconstruction; surgery outcome; treatment choice; urinary; urologic

PROJECT SUMMARY/ABSTRACT: Male stress urinary incontinence (SUI) is common, costly, and significantly impacts health-related quality of life among older men, yet little is known about patient-centered outcomes in this population. Moreover, current patient counseling for male SUI treatment is based upon surgical outcomes, lacking guidance from patient- centered factors and patients’ underlying attitudes and beliefs about the importance of these various factors on treatment decisions and outcomes. Data are needed to understand how multi-morbidity, cognitive function, functional limitations, and life expectancy impact quality of life and decisional regret among older men who have made SUI treatment decisions. The long-term goal is to broaden our understanding of patient-centered outcomes in this population and to ensure treatments are aligned with patients’ overall goals. The objective of this application is to gain an understanding of quality of life and decisional regret among older men who have made SUI treatment decisions, and to understand the beliefs and motivations that drive these decisions. The central hypothesis is that there are geriatric-specific factors that impact quality of life and decisional regret among older men who have made SUI treatment decisions which go beyond those that are usually considered by surgeons counseling patients about these decisions. This hypothesis will be tested by utilizing a cohort of men ≥ 65 who have made SUI treatment decisions at the University of California, San Francisco and the San Francisco Veterans Affairs Medical Center to pursue two specific aims: 1) To identify patient-, disease- and treatment-related factors associated with decisional regret and quality of life among older men who have made SUI treatment decisions; and 2) To understand the underlying beliefs and motivations driving treatment decisions among older men with SUI. This project is innovative because it is the first to focus on patient- centered outcomes in this patient population, goes beyond commonly measured surgical outcomes to bring geriatric principles to treatment decisions, and importantly, will be the first to identify what patient-identified treatment factors are important to older men considering SUI treatment. The proposed research is significant because it will improve patient counseling and informed decision-making among older adults facing treatment decisions for SUI, which is critical to patient-centered surgical care.

项目摘要/摘要： 男性压力性尿失禁(SUI)是常见的、昂贵的，并显著影响与健康相关的生活质量 在老年男性中，对这一人群中以患者为中心的结果知之甚少。此外，目前 男性SUI治疗的患者咨询是基于手术结果的，缺乏患者的指导- 中心因素和患者对这些不同因素的重要性的潜在态度和信念 治疗决定和结果。需要数据来理解多种疾病，认知功能， 功能限制和预期寿命影响老年男性的生活质量和决策后悔 已经做出了SUI治疗决定。我们的长期目标是扩大我们对以患者为中心的理解 以确保治疗与患者的总体目标保持一致。的目标是 这个应用程序是为了了解老年男性的生活质量和决策悔恨 做出SUI治疗决定，并了解驱动这些决定的信念和动机。这个 中心假设是老年人特有的因素会影响生活质量和决策后悔 在做出了SUI治疗决定的老年男性中，这些决定超出了通常认为的 通过外科医生就这些决定向患者提供咨询。这一假设将通过利用一组 在加州大学旧金山分校和旧金山分校做出过SUI治疗决定的男性≥65 旧金山退伍军人事务部医疗中心追求两个具体目标：1)识别患者、疾病和 治疗相关因素与已作出决定的老年男性的后悔和生活质量 Sui治疗决策；以及2)了解推动治疗的基本信念和动机 患有SUI的老年男性的决定。这个项目是创新的，因为它是第一个专注于患者的项目- 以患者群体为中心的结果，超出了通常测量的手术结果 老年治疗的原则决定了，重要的是，将首先确定哪些患者是确定的 治疗因素对考虑SUI治疗的老年男性很重要。这项拟议的研究具有重要意义 因为它将改善面临治疗的老年人的患者咨询和知情决策 SUI的决定，这对以患者为中心的外科护理至关重要。