尿失禁與膀胱過動症的自然病史研究及健康促進計畫介入的成效

中山醫學大學機構典藏 CSMUIR > 醫學院 > 醫學研究所 > 研究計劃 > Item 310902500/10364

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Title:	尿失禁與膀胱過動症的自然病史研究及健康促進計畫介入的成效 Natural History of Stress Incontinence and Overactive Bladder and Outcomes of Health Promotion Program
Authors:	陳進典;陳順郎;黃淑君
Contributors:	醫學研究所
Keywords:	尿失禁;膀胱過動症;自然病史;健康促進計畫;盛行率;發生率 stress incontinence,overactive bladder,health promotion,prevalence,incidence
Date:	2014
Issue Date:	2015-02-25T09:19:24Z (UTC)
Abstract:	骨盆底功能障礙的問題隨著生活水準的提高，逐漸受到重視。調查的尿失禁與膀胱過動症的盛行率與自然病史，可以了解疾病的相關因子和致病因素；可以進一步的針對其相關因子或致病因素，擬定預防措施及推動衛生政策，以減少醫療成本的支出，並可改善罹病後的生活品質。過去的研究發現下泌尿道症狀（尤其是膀胱過動症）盛行率很高，是會隨時間的進展而變動的症候群（dynamic syndrome）；不管在東方或西方國家的流行病學調查都發現其盛行率（prevalence）、發生率（incidence）和緩解率（remission）會受到懷孕、生產、停經和老化的過程所影響。本研究計畫擬針對臺中市之社區（南區崇倫里、福順里、西區後龍里和中興里與太平區新坪里）民?(包含男性和女性)，以家戶(household) 為單位進行盛行率調查，以前瞻縱向 (prospective and longitudinal)的研究方式進行。配合社區營造活動，合併以增強策略導入團體衛生教育課程，並估團體衛教課程介入的成效。本研究計畫將使用下列量表：一般屬性的健康狀況問卷(SF-36)、國際攝護腺症狀評分表(IPSS)、膀胱過動症狀問卷(OABSS)、因應策略、兩種生活品質問卷：Urogenital distress Inventory (UDI-6 Short form)和Incontinence Impact Questionnaire (IIQ-7 short form)。以下是本研究計畫的目的： 1. 評估不同性別的罹患尿失禁及膀胱過動症的盛行率(prevalence)、相關因子和共病 (comobility)；進一步計算出每年症狀發生率(incidence)、每年緩解率(remission)和每年症狀進行率( symptoms progression)。 2. 評估男性與女性對於罹患尿失禁及膀胱過動症後的認知、因應策略與就醫行為有無不同？ 3. 評估社經地位、教育程度和家戶所得等，對於民?的當下自覺健康狀況以及對於罹患尿失禁及膀胱過動症後的認知程度、因應策略與就醫行為有無影響？ 4. 將社區分成實驗組和對照組，評估進行衛教介入（增強策略）後，民?對於尿失禁及膀胱過動症的認知程度、因應策略與就醫行為是否有改變？衛教介入（增強策略）後自覺健康狀況是否有改變？第一年評估尿失禁及膀胱過動症的盛行率急對生活品質的衝擊；進一步比較男女之間有無性別的差異？第二年評估尿失禁及膀胱過動症的自然病史及衛教成效；比較男女之間有無性別的差異？第三年評估尿失禁及膀胱過動症的自然病史及衛教成效；比較男女之間有無性別的差異？ Lower urinary tract symptoms (LUTS) and pelvic floor dysfunction is a disabling condition that affects health-related quality of life. The occurrence（prevalence and incidence）of stress incontinence and overactive bladder increased with age. The population survey has revealed that stress incontinence and overactive bladder have become a large economic burden on health services currently and will continue to be in the future. In this proposal, we try to conduct a community-based integrated epidemiology for surveying prevalence and nature history of stress incontinence and overactive bladder as well as their impact on quality of life in the Central Taiwan. Targeted population is aged 40 years or older residents in community by randomized sampling (matching with gender and age). Trained nurses or research assistants will be sent to interview the participants and assisted the residents who did not have an educational background or could not read through and understand the questionnaire, especially women over the age of 65. Following questionnaire will be used in this proposal: SF-36, IPSS, copy strategies, Urogenital distress Inventory (UDI-6 Short form), Incontinence Impact Questionnaire (IIQ-7 short form) and, Overactive Bladder Symptom Score (OABSS). This prospective longitudinal population-based survey will be conducted for three years to evaluate prevalence, incidence, remission and symptoms progression of stress incontinence and overactive bladder. Outcomes of health promotion program for teaching copying strategies of stress incontinence and overactive bladder will be evaluated too. The research schemes are as following: Year 1- Community residents (n=2,400; female: 1,200 and male: 1,200, matching with age) are randomly selected from the total population aged 40 years or older residing in the Central Taiwan. The residents are invited to participate in this project after signing the informed consent. Trained nurses or research assistants will be sent to interview the participants and assisted the residents who did not have an educational background or could not read through and understand the questionnaire. Aims of the Year 1 are to establish database and determine prevalence stress incontinence and overactive bladder. Impact of quality of life of the fore-mentioned diseases and their associated factors are also collected. Years 2- The participants in the Year 1 who are still available will be asked to complete the similar questionnaires to evaluate incidence, remission and symptoms progression of stress incontinence and overactive bladder. Impact of quality of life of the fore-mentioned diseases and their associated factors are also collected. Participants in communities will be allocated into study (re-enforced program for teaching copying strategies) and controlled groups (handout of health education). Outcomes of health promotion program for teaching copying strategies of stress incontinence and overactive bladder will be evaluated. Years 3- The participants in the Year 1 who are still available will be asked to complete the similar questionnaires to evaluate incidence, remission and symptoms progression of stress incontinence and overactive bladder. Aims of the Year 3 are to evaluate natural history such as prevalence, incidence, remission, progression of stress incontinence and overactive bladder. Impact of quality of life of the fore-mentioned diseases and their associated factors as well as outcomes of health promotion program are also analyzed.
URI:	https://ir.csmu.edu.tw:8080/ir/handle/310902500/10364
Appears in Collections:	[醫學研究所] 研究計劃

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