Impacto do tipo de incontinência urinária sobre a qualidade de vida de usuárias do Sistema Único de Saúde no Sudeste do Brasil

Abstract

ResumoOBJETIVO: Identificar o impacto da incontinência urinária (IU) sobre a qualidade de vida (QV), comparar os escores dos domínios de QV em mulheres com incontinência de esforço (IUE), bexiga hiperativa (BH) e incontinência mista (IUM) e estabelecer a associação entre o tipo clínico de IU e o impacto sobre a QV. MÉTODOS: Foram coletadas informações sobre idade, índice de massa corpórea (IMC) e comorbidades de 181 mulheres incontinentes atendidas em serviço público. O King's Health Questionnaire (KHQ) foi aplicado e as pacientes foram divididas, de acordo com a autoavaliação do impacto da incontinência, em dois grupos, cujos escores dos domínios do KHQ foram comparados pelo teste de Mann-Whitney. De acordo com os sintomas, as mulheres foram divididas nos grupos IUE, BH e IUM, e os escores do KHQ foram comparados pelos testes de Kruskal-Wallis e de Dunn. As razões de chances (OR) de a mulher reportar pior impacto da IU na QV foram estimadas por modelo logístico binário. As variáveis de controle foram faixa etária, IMC e número de comorbidades. RESULTADOS: Observou-se diferença significante entre os dois grupos de autoavaliação do impacto da IU para todos os domínios do KHQ. O grupo IUM apresentou piores escores que o grupo IUE para todos os domínios, e o grupo BH, para limitações de atividades diárias e físicas. Houve diferença significante entre as chances de as mulheres dos grupos IUE e IUM reportarem pior impacto de IU na QV (OR=2,9; p=0,02). CONCLUSÃO: Assim como em outras populações de serviços especializados, a IUM foi o subtipo mais comum, e a perda urinária comprometeu de forma moderada/grave a QV, afetando o domínio limitações das atividades diárias com maior intensidade. A análise ajustada mostrou que mulheres com IUM apresentam chance aproximadamente três vezes maior de reportarem pior impacto sobre a QV que aquelas com IUE. Abstract PURPOSE:To identify the impact of urinary incontinence (UI) on quality of life (QoL), to compare the scores of QoL domains in women with stress urinary incontinence (SUI), overactive bladder (OAB) and mixed incontinence (MUI) and to establish the association between the clinical type of UI and the impact on QoL. METHODS: Data of 181 incontinent women attended at a public hospital were collected regarding age, body mass index (BMI) and co-morbidities. King's Health Questionnaire (KHQ) was applied and patients were classified into two groups according to the self-assessment of incontinence impact. KHQ scores were compared by the Mann-Whitney test. Depending on their urinary symptoms, women were divided into SUI, OAB and MUI groups and their scores in the KHQ domains were compared by the Kruskal-Wallis and Dunn tests. The odds ratio (OR) of a woman reporting a worse effect of UI on QoL was estimated using the binary logistic model. The control variables were: age, BMI and number of co-morbidities. RESULTS: A significant difference was found between the two groups of self-assessment of UI impact for all KHQ domains. The MUI group showed worse scores than the SUI group for al...

Impacto dos tipos de incontinência urinária na qualidade de vida de mulheres

“…The sociodemographic and gynecological-obstetric characteristics of participants are similar to those found in other studies conducted in specialized services (9)(10) . In general, women with MUI tend to be slightly older than women with other types of UI (14) .…”

“…A large population study indicates Diabetes Mellitus (DM) as a risk factor and still suggests that women with this comorbidity have a reduced probability of UI remission (17) . Thus, studies evaluating UI risk factors point to DM and SAH (Systemic Arterial Hypertension) as important factors (10,(18)(19) . Regarding the type of UI, MUI was the most prevalent in some studies (10,16,(18)(19) .…”

“…Thus, studies evaluating UI risk factors point to DM and SAH (Systemic Arterial Hypertension) as important factors (10,(18)(19) . Regarding the type of UI, MUI was the most prevalent in some studies (10,16,(18)(19) . However, data from other studies were in disagreement, and found SUI was more prevalent (14,(20)(21) .…”

“…It has three subscales assessing behavioral and emotional factors (questions 1-4), physical factors (questions 5-9), and factors related to the partner (questions [10][11][12]. The Likert scale is used to rank the answers ranging from 'never' to 'always' with a 0-4 score.…”

“…The application of QoL assessment questionnaires has become frequent in the last decades with the emergence of generic and specific instruments for certain pathologies (8) . In Brazil, some recent publications address the impact of UI on QoL, but these are studies with reduced samples and/or using only one of the QoL assessment questionnaires (9)(10) . The objective of this study was to identify the most frequent UI type among women attended in specialized urogynecology services, considering a representative sample, and to compare the impact of different UI types on the general and specific QoL of these women using the main questionnaires validated for Brazilian Portuguese.…”