骨盆鬆弛症候群婦女接受骨盆重建術前的症狀困擾及生活衝擊

The Life Impacts and Symptom Distress in Women With Pelvic Organ Prolapse Syndrome Before Pelvic Reconstruction Surgery

背景：接受骨盆重建術是骨盆鬆弛症候群婦女很難做的抉擇，然而國內少有研究探討這些婦女在手術前之症狀困擾及生活衝擊。婦科護理人員有必要瞭解骨盆底肌無力造成骨盆腔承載的內臟器官脫垂，對她們身心健康及生活等造成的影響。目的：瞭解骨盆鬆弛症候群婦女接受骨盆重建術前的症狀困擾及生活衝擊情況與程度，並探討此二主題之相關性及預測因子。方法　本研究採橫斷式研究，以結構式問卷進行資料收集。研究對象為北區某醫學中心住院接受骨盆重建手術之婦女，共收集110份問卷。結果　本研究對象婦女之泌尿道症狀最嚴重的困擾為日間頻尿，骨盆症狀最嚴重的困擾為感覺陰道有突出物，生活衝擊最嚴重的情況為因相關症狀而感到焦慮、憂鬱或緊張。經統計分析顯示，泌尿道症狀困擾越高其骨盆症狀困擾程度越高。而泌尿道症狀困擾程度與骨盆症狀困擾程度越多，其生活衝擊亦越高。又樣本之教育程度與骨盆症狀，可預測其對生活衝擊之影響。結論／實務應用　骨盆鬆弛症候群的病人宜注意其日間頻尿與陰道突出物之症狀困擾，及需注意因症狀造成之情緒焦慮憂鬱困擾之情形。護理人員照護骨盆鬆弛症候群的病人，除了評估其於泌尿道與骨盆症狀困擾外，宜考量病人的教育程度及骨盆症狀兩項因素對其生活衝擊之影響。

Background: The decision whether or not to undergo pelvic reconstructive surgery is difficult for women suffering from pelvic organ prolapse. However, little research has examined the symptom distress and life impacts that these women face prior to this surgery. Thus, it is crucial that gynecology nurses learn about these life impacts and symptom distresses in order to help these women make the best decisions with regard to surgery. Purpose: To explore the life impacts and degree of symptom distress in pre-surgery women with pelvic organ prolapse; to explore the relationships between demographic data and the variables of life impact and degree of symptom distress; and to identify the factors that relate to the explainable variance in the life impacts of these women. Methods: A cross-sectional and correlational research design was used and a total of 110 women with pelvic organ prolapse who had not yet undergone pelvic reconstruction surgery were recruited in the gynecological clinics of one medical center in Taiwan. Results: Daytime urination frequency was the most prevalent urinary tract symptom noted by the participants; vaginal protrusion was the most prevalent pelvis-related symptom noted; and depression and anxiety were the most prevalent life impacts noted. Moreover, greater lower-urinary-tract symptom distress was associated with greater pelvic-symptom distress. Furthermore, greater lower urinary tract and pelvic symptom distresses were associated with a greater negative impact on life. Education background and pelvis-related symptoms were the explained variances in pre-surgery life impacts. Conclusions: Women with pelvic organ prolapse should pay particular attention to symptoms that include: daytime urinary frequency, vaginal protrusion, and emotional problems including depression and anxiety. Education background and level of symptom distress should be taken into consideration when caring for the life impacts of this vulnerable group of women.