Title Čimbenici koji utječu na prepoznavanje simptoma, težinu kliničke slike i kvalitetu života u osoba sa sindromom donjih mokraćnih puteva Title (english) Factors affecting symptom recognition, clinical severity, and quality of life in people with lower urinary tract syndrome Author Ana Lesac Brizić Mentor Vladimir Mozetič (mentor)Committee member Vladimir Mićović (predsjednik povjerenstva)Committee member Nataša Antoljak (član povjerenstva)Committee member Ivana Gobin (član povjerenstva)Granter University of Rijeka Defense date and country 2022-08-29, Croatia Scientific / art field, BIOMEDICINE AND HEALTHCARE Scientific / art field, BIOMEDICINE AND HEALTHCARE Universal decimal classificationUDC ) 61 - Medical sciences ThesaurusMESH - Medical Subject Headings )
Lower Urinary Tract Symptoms
Quality of Life
Abstract Ciljevi ovog istraživanja bili su procijeniti utjecaj edukacijske ankete (EA) s liječnikom
obiteljske medicine (LOM) na sposobnost prepoznavanja simptoma donjeg mokraćnog sustava
(LUTS), otkriti čimbenike koji utječu na prepoznavanje LUTS-a, odrediti učestalost pojedinih
LUTS-eva u ovisnosti o spolu i dobi, te istražit utjecaj LUTS-a na kvalitetu života.
Ispitanici i metode. Ovo presječno istraživanje provedeno je u ordinacijama obiteljske
medicine PGŽ, na dobrovoljnim ispitanicima koju su tražili pomoć LOM-a, neovisno o razlogu. U
prvom dijelu istraživanja, EA, ispitanici su samoprocjenom odredili imaju li LUTS. Nakon toga im
je objašnjena klinička slika LUTS-a, te ponuđeno prijaviti prepoznaju li nakon EA neke od
simptoma. Za svaki simptom određen je stupanj ometanja svakodnevnice (SOS). U drugom dijelu,
proširenom istraživanju (PI), ispitanicima su ponuđeni standardizirani upitnici za procjenu težine
LUTS-a (IPSS, ICIQ) i kvalitete života (SF12v2), određeni komorbiditeti, razina osobne edukacije,
te u slučaju učestalih mokraćnih infekcija, njihovi uzročnici. U EA je sudjelovalo 499 ispitanika, a
u PI 444 ispitanika.
Rezultati. U prosjeku, ispitanici imaju već 4 LUTS-a prije nego postanu svjesni problema
(p<0.0001, srednja vrijednost >4) i visok SOS (p<0.0001, medijan >8). Sposobnost prepoznavanja
LUTS-a povezana je s EA (χ2(1, N=241)=92.01, p<0.0001 i χ2(1, N=258 =119.01, p<0.0001 za
muškarce i žene). Viša razina osobnog obrazovanja nije utjecala na prepoznavanje LUTS-a, iako
su obrazovaniji ispitanici nakon EA prepoznali LUTS u prisutnosti manje simptoma (p<0.01).
Prevalencija i broj LUTS-eva povećavaju se s dobi, u žena iznad 41. godine, u muškaraca iznad
61. godine. Prevalencija LUTS-eva po spolu razlikuje se samo za slab mlaz (muškarci, p<0.0001),
inkontinenciju i bolno mokrenje (žene, p<0.0001 i p=0.028). IPSS vrijednosti ne se razlikuju među
muškarcima i ženama, kao ni ICIQ vrijednosti. Osobe s LUTS-om imaju lošiju kvalitetu života od
drugih ispitanika (p<0.0001), što se odnosi i na fizičku komponentu zdravlja (p=0.0002), kao i na
mentalnu (p<0.0001), no nemaju veći broj komorbiditeta (p>0.05). Najčešći uzročnik ponavljajućih
urinarnih infekcija je Escherichia coli.
Zaključak. Istraživanje je pokazalo da ispitanici imaju nisku razinu osviještenosti o
postojanju LUTS-a, neovisno o osobnoj razini edukacije. Edukativni razgovor s liječnikom
obiteljske medicine znatno doprinosi prepoznavanju LUTS-a, a time i poboljšanju kvalitete života
koju LUTS značajno narušava. Ovo je prvo istraživanje koje je odredilo prevalenciju LUTS-a
aktivnim traženjem i educiranjem ispitanika o prepoznavanju znakova i simptoma LUTS-a. Također, rezultati ukazuju na mogućnost korištenja IPSS upitnika u procjeni LUTS-a kod
opstruktivnih smetnja u žena.
Abstract (english) Objective. The objective of this study was to determine the prevalency of LUTS in both
men and women in Primorsko-goranska county, to determine the factors that shape one's ability
to recognase LUTS, as well as to determine the role of education on one's ability to recognize
LUTS. Factors that shape one's personal and subjective experience and perception of the clinical
manifestation of LUTS were also studied, as well as the impact of LUTS on health-related quality
of life (HRQoL).
Patients and Methods. This study was conducted on 157 people that voluntarily joined
educational survey, out of which 102 people continued to the second, more comprehensive phase
of the study. In the second part of the study, one's medical records were explored, and
standardized questionnaires for assessment of LUTS were used (IPSS, ICIQ), as well as the
questionnaire for assesment of HRQoL (SF12v2), and the visual analogue scale (VAS). This is
the first research in Croatia that was conducted on both genders and in all age groups over 18.
Results. Most of the subjects were not able to recognise LUTS, especially if the clinical
manifestation was not severe. Education about LUTS largely improved its recognition among the
subject. Most common symptoms are weak urinary stream in men and incontinence in women, as
well as nocturia and feeling of incomplete bladder voiding, in both sexes. The latter symptom is
especially interesting, due to its high prevalence in community and under-representation in
research. Interestingly, women had worse scores when tested for severity of voiding symptoms,
and men had same resultas as women when tested for severity of storage symptoms. LUTS
severely impacts HRQoL in both sexes, especially in the domene of mental health and emotional
and social functioning. These results are of special importance and significance, given the fact
that population of interest was not compared to a healthy population, but to a population affected
with various other medical conditions.
Conclusion. This study points out the important role of education in recognition of LUTS,
but also the impact of a general mind-set of the population on the perception of a personal health
and well-being. Results also point out the inaccuracy of so-called gender discrimination of the LUT
symptoms. Given that, and the fact that LUTS can severely disturb HRQoL, clearly LUTS should
be further investigated, as well as be educated about in the population.
Keywords
Edukacija pacijenata
Kvaliteta života
Odnos liječnik-pacijent
Primarna zdravstvena zaštita
Promicanje zdravlja
Simptomi donjeg mokraćnog sustava
Keywords (english)
LUTS
lower urinary tract symptoms
voiding simptoms
storage simptoms
health-related quality of life
Language croatian URN:NBN urn:nbn:hr:184:975469 Promotion 2022 Study programme Title: Biomedicine Postgraduate (doctoral) study programme Type of resource Text File origin Born digital Access conditions Access restricted to students and staff of home institution Terms of use Created on 2022-10-21 12:36:45
