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

 描述(由申请者提供)：许多女性患有生活改变的下尿路症状(LUTS)。然而，由于缺乏对真正的膀胱健康的理解和定义，LUTS的预防受到了阻碍。现有的健康膀胱范例过于狭隘地定义为没有LUT，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女性国家，并降低高昂的公共和私人医疗成本，我们有必要在如何处理有关膀胱健康的知识发展以及随后的LUTS预防方面进行巨大转变。我们知道LUT是什么样子的(尿失禁、尿路感染等)但很少有文献可用于指导对健康膀胱的描述。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弥补这一知识差距。我们将通过了解生物和生理生命阶段(青春期、成年期、生育期、围绝经期/绝经期、老年)的关键交叉点以及女性青少年、女性、父母和初级卫生保健临床医生对有关膀胱健康的社会信息的心理和行为反应，来表征整个生命周期的膀胱健康。其目的是利用新的混合方法建立一个关于健康的青春期女性和女性的膀胱健康经验的证据基础，为LUTS的预防策略提供信息。研究的目的是：1.借鉴专家意见和概念分析方法，构建一个可操作的健康膀胱定义；2.进一步开发/提炼/试行一种简单但概念新颖的调查工具，能够捕捉健康膀胱状态的变化。3.试验性低成本发展项目，将丰富预防LUTS联盟的生产力和跨学科合作，包括发展获得LUTS预防调查资金所需的基本知识。超过三分之一的美国女性遭受着LUTS的痛苦、尴尬和经常未被报道的问题。这项工作显著地解决了这些挑战，为每个生命阶段拥有健康膀胱的妇女建立了正常范围和相关协变量的证据基础，为制定合理、有效的预防战略奠定了基础，以减轻妇女和社会面临的LUT的沉重疾病负担。

 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.