間質性膀胱炎病人臨床症狀、膀胱功能狀況與主觀感受之關係

Relationships among Clinical Symptoms, Bladder Condition, and Subjective Perceptions in Patients with Interstitial Cystitis/Painful Bladder Syndrome

背景：間質性膀胱炎在臨床被病人視為一種「無聲的考驗」，其症狀的多元與無特定性，常導致病人身體與心理承受折磨與苦痛。目的：本文目的為探討病人的臨床症狀、膀胱功能狀況與主觀感受的相關性。方法：以橫斷式及病歷回溯研究設計，針對東部一家醫學中心107位間質性膀胱炎門診病人，採用結構式問卷收集資料。結果：症狀問題指數得分愈高，表示與低膀胱適應性、腎絲球狀出血嚴重度及疼痛等有關（p < .05），Hunner’s潰瘍的存在與疼痛程度呈顯著正相關，而下尿路症狀、低膀胱容量與腎絲球狀出血愈明顯者，病人主觀感受則愈差（p < .05）。結論／實務應用本研究除了突顯間質性膀胱炎病人的臨床症狀、膀胱功能與病理表現等，的確會影響病人的不適感受之外，重點在於強調臨床護理人員應加以瞭解此疾病症狀間的複雜相關性，才能進一步瞭解病人的不適感程度，進而關懷與陪伴，提供合適的護理介入與衛教，增加病人的生活品質。

Background: Interstitial cystitis (IC) is a silent challenge for patients. Various symptoms related to IC are causes of physical disability and mental distress.Purpose: This study investigated the relationships between clinical symptoms, bladder condition and patient perceptions.Methods: This study enrolled 107 patients diagnosed with interstitial cystitis at a medical center in eastern Taiwan and employed a cross-sectional design. Patient medical charts were reviewed. Structural questionnaires were used to collect data.Results: Participants with a high symptom problem index had poor bladder compliance, severe glomerulation and high visual analog scale (VAS) scores. There was a positive correlation between Hunner's ulcer and a high VAS score. Patients with severe lower urinary symptoms, low competency and severe glomerulation earned significantly higher patient perception of bladder condition scores.Conclusions/Implications for Practice: This study found significant correlations between clinical symptoms, bladder condition and patient perceptions. This study may help enhance nursing staff knowledge of IC clinical symptoms so that they may provide appropriate interventions and education to improve patient self-care abilities and life quality.