探討影響社區婦女尿失禁之相關因素及尿失禁對社區婦女身心社會之影響

A Survey ofFactors Influencing Community Women's Incontinence and the Physical, Psychosocial Impact Related to Incontinence

本研究之目的為探討社區婦女發生尿失禁的相關因素與嚴重度及其身心社會與生活滿意度所受到之影響，並瞭解社區婦女具備的尿失禁知識。本研究為橫斷式問卷調查法，採系統抽樣以信義區兩個里中年齡 35 歲以上之婦女 99 人為研究對象，使用郵寄問卷方式收集資料。研究工具為參照文獻自擬之結構式問卷，包括研究對象的人口學變項、尿失禁知識、生活滿意度及身心社會影響等量表；效度採專家鑑別效度，依專家意見計算內容效度指數（ CVI， the index of content validity ），凡 CVI 達 0.8 以上的項目均保留，信度採內在一致性，Alpha 值皆介於 0.7-0.9。研究對象中有 43.4% 婦女在最近一年內有不自主漏尿情形， 尿失禁嚴重度多屬於輕度（72.5% ），次為中度（ 25% ），而 95.2% 婦女的漏尿主要發生在腹壓增加時。曾接受泌尿道或婦科手術婦女易發生尿失禁（ p<0.05 ）；而生產兩胎及兩胎以上之婦女亦趨於易發生尿失禁（ p=0.06 ），於統計上呈臨界顯著差異。尿失禁婦女在身心社會方面均受到中度以上的影響，其生活滿意度比無尿失禁婦女低（ p=0.05 ），於統計上呈臨界顯著差異，生活滿意度中的日常活動及休閒娛樂活動的滿意度亦呈現顯著差異（ p<0.05 ）。社區婦女尿失禁知識平均分數為 6.74 分（滿分為 10 分）。藉本研究結果，建議應對高危險群婦女提供所需的預防措施，並對尿失禁婦女提供所需的照護策略及相關知識，以提升婦女的生活品質。The purpose of this study was to examined the risk factors ofincontinence, the degree of incontinence severity, the physical and psychosocialimpact of incontinence and the knowledge of incontinence among the women in acommunity. A cross-sectional survey was conducted. A questionnaire was mailed toeach of 1, 064 women aged over 35 who were recruited using systemic sampling fromHsinyi district, Taipei City. Contents of the questionnaire include: personalcharacteristics, life satisfaction, the physical and psychosocial impact ofincontinence and the knowledge of incontinence . The indices of content validity(CVI) of life satisfaction, the physical and psychosocial impact of incontinenceand the knowledge of incontinence were all above 0.8. The Cronbach Alpha ofthese parts were between 0.7 and 0.9.The results demonstrated that 43.4% of the 99 women suffered from incontinence, with a degree of incontinence severity was between mild and moderate. Most women(95.2%) experienced incontinence when their abdominal pressure increased. Thedelivery para (p=.06) and the urogenital surgeries (p=.00) were associated withincontinence. The physical and psychosocial impact of incontinence was mild tomoderate among these incontinent women. Lower satisfaction of life was alsoreported by these women compared to that in healthy women (p=.05). In addition, the knowledge of incontinence (mean=6.74, range 1-10) among women in thecommunity still needs to be improved.The findings of this study suggested that the prevention intervention should beoffered to those community women who have had any history of urogenitalsurgeries or who have given birth more than twice. In order to improve the lifesatisfaction of incontinent women and lower the impact of incontinence, suitableservices should be offered.