【摘要】：研究背景膀胱過度活動癥(overactive bladder,OAB)是一種以尿急為特征的癥候群,伴或不伴急迫性尿失禁,常合并尿頻、夜尿,且排除泌尿系感染和其他確切病變。膀胱過度活動癥(OAB)在成人當中是一個常見疾病,對一部分患者來說,該病是一個沉重的負擔,嚴重影響了他們的生活質(zhì)量。膀胱過度活動癥(OAB)的診斷完全基于泌尿系統(tǒng)的癥狀,對它的全面評估需要依賴心理學特性良好的生活質(zhì)量問卷。尿失禁(Urinary Incontinence, UI)指尿液不自主流出,按照癥狀可以分為：壓力性尿失禁(Stress Urinary Incontinence, SUI),患者可在咳嗽、打噴嚏、持重物時,因腹壓的增高而漏尿；急迫性尿失禁(Urge Urinary Incontinence, UUI),指尿急時的不自主漏尿,常伴尿頻、夜尿；混合性尿失禁(Mixed Urinary Incontinence, MUI),指壓力性尿失禁和急迫性尿失禁并存的狀況。急迫性尿失禁影響問卷(Urge-Incontinence Impact Questionnaire, U-IIQ)和急迫性尿失禁量表(Urge-Urinary Distress Inventory, U-UDI)是用于評估膀胱過度活動癥和混合性尿失禁生活質(zhì)量的問卷,原版英文問卷已經(jīng)被證明有很好的信度和效度,其中急迫性尿失禁影響問卷(U-HQ)已經(jīng)成為國際尿控協(xié)會(International Continence Society, ICS)推薦的A級問卷。目的本研究引進急迫性尿失禁影響問卷(U-IIQ)口急迫性尿失禁量表(U-UDI),對其進行中文版本的研制,并評價其在盆底疾病患者中應用的信度和效度。方法1、分別對急迫性尿失禁影響問卷(U-IIQ)和急迫性尿失禁量表(U-UDI)進行中文版本的研制。2、對研制的簡體中文版急迫性尿失禁影響問卷(U-IIQ)和急迫性尿失禁量表(U-UDI)進行中國人群的信度、效度檢驗。結(jié)果124例符合標準的膀胱過度活動癥(OAB)和急迫性尿失禁(MUI)患者參與了急迫性尿失禁影響問卷(U-IIQ)和急迫性尿失禁量表(U-UDI)的驗證。急迫性尿失禁影響問卷(U-IIQ)和急迫性尿失禁量表(U-UDI)的內(nèi)部一致性極好,Cronbach's α系數(shù)分別為0.946和0.865。兩款問卷的重測信度都較好,急迫性尿失禁影響問卷(U-IIQ)和急迫性尿失禁量表(U-UDI)的兩次調(diào)查結(jié)果各題目得分之間組內(nèi)相關(guān)系數(shù)(ICC)值分別為0.575～0.966,0.575～0.966(P0.05)。因子分析結(jié)果顯示急迫性尿失禁影響問卷(U-IIQ)和急迫性尿失禁量表(U-UDI)提取出的因子成分與問卷理論結(jié)構(gòu)基本相符。簡體中文版急迫性尿失禁影響問卷(U-IIQ),急迫性尿失禁量表(U-UDI)與急迫性尿失禁簡版(IIQ-7)得分在0.01水平(雙側(cè))顯著相關(guān),Spearman相關(guān)系數(shù)分別為0.745和0.601,說明患者得分越高,受尿失禁／膀胱困擾越大。獨立樣本t檢驗顯示,簡體中文版急迫性尿失禁影響問卷(U-IIQ),急迫性尿失禁量表(U-UDI)能區(qū)分出膀胱過度活動癥狀評分(OABSS)輕度、中度和重度患者,有很好的判別效度。結(jié)論研究結(jié)果表明,我們研制出的簡體中文版急迫性尿失禁影響問卷(U-IIQ)和急迫性尿失禁量表(U-UDI)在中國人群中具有較高的信度和效度,可以作為評價相關(guān)疾病生活質(zhì)量的專用量表。
[Abstract]:Background bladder hyperactivity (OAB) is a syndrome characterized by urgency, with or without urgent urinary incontinence, often combined with urinary tract infection and night urine, and excludes urinary tract infections and other definite lesions. Bladder hyperactive disease (OAB) is a chronic disease among adults. For some patients, the disease is a heavy burden, which seriously affects their quality of life. The diagnosis of bladder hyperactive disease (OAB) is completely based on the symptoms of urinary system, and the comprehensive assessment of bladder needs to rely on a life quality questionnaire with good psychological characteristics. Urinary incontinence (UI) refers to involuntary outflow of urine, which can be divided into stress urinary incontinence (SUI) according to symptoms, and the patient can leak urine due to the increase of abdominal pressure during cough, sneeze and weight-holding, and urge urinary incontinence (UUI). It refers to the condition of the coexistence of stress urinary incontinence and urge urinary incontinence, which is usually accompanied with urinary incontinence, night urine, mixed urinary incontinence (MUI). The Urge-Incontinuity Impact Questonnaire, U-IIQ and Urge-Urinal District Inventory (U-UDI) were used to assess the quality of bladder hyperactive and mixed urinary incontinence, and the original English questionnaire has been proven to have good reliability and efficacy. The acute urinary incontinence impact questionnaire (U-HQ) has become a Class A questionnaire recommended by the International Communications Society (ICS). Objective This study was to introduce the U-IIQ questionnaire (U-UDI) for the development of the Chinese version and evaluate its reliability and efficacy in patients with Parkinson's disease. Methods 1. The Chinese version was developed by U-IIQ and U-UDI, respectively, and the reliability of Chinese population was evaluated by U-IIQ and U-UDI. Test of effectiveness. Results 124 patients with bladder hyperactive disorder (OAB) and urge urinary incontinence (MUI) in accordance with the standard participated in the verification of acute urinary incontinence impact questionnaire (U-IIQ) and urgency urinary incontinence gauge (U-UDI). The internal consistency of the urgency urinary incontinence impact questionnaire (U-IIQ) and the urgency urinary incontinence gauge (U-UDI) was excellent, and the Cron's relaxation coefficients were 0. 946 and 0. 865, respectively. The correlation coefficient (ICC) values were 0.575 ~ 0.966, 0.5575 ~ 0.966 (P0.05). The factor analysis showed that the factor components extracted by U-IIQ and U-UDI were basically consistent with the theoretical structure of questionnaire. Simplified Chinese version of urgency urinary incontinence effect questionnaire (U-IIQ), urgency urinary incontinence gauge (U-UDI) and urge urinary incontinence Jan (IIQ-7) score were significantly correlated with the 0. 01 level (double side), Spearman correlation coefficient was 0. 745 and 0. 601 respectively, indicating the higher the patient's score and the greater the urinary incontinence/ bladder disturbance. The independent sample t test showed that the questionnaire (U-IIQ) and urgency urinary incontinence gauge (U-UDI) in Chinese version were able to distinguish between mild, moderate and severe cases of over-activity symptom score (OABSS). Conclusion The results of the study indicate that the U-IIQ and U-UDI have higher reliability and efficacy in Chinese population, and can be used as a special scale to evaluate the quality of related diseases.
【學位授予單位】：北京協(xié)和醫(yī)學院
【學位級別】：博士
【學位授予年份】：2015
【分類號】：R694.54

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