北京市女性护士下尿路症状和膀胱过度活动症的患病率及其与职业紧张的关系

Prevalence of overactive bladder and other lower urinary tract symptoms in female nurses in Beijing and its association with occupational stress

目的调查北京女性护士下尿路症状（LUTS）和膀胱过度活动症（OAB）的患病情况及其职业紧张状况，探讨工作压力和职业紧张对LUTS和OAB的影响。方法2010年9月至2011年3月，对整群抽取的北京市三家综合性医院所有在岗≥1年的女性护士进行问卷调查。1135名受调查护士完整填写包括基本人口学信息、排尿相关个人习惯、下尿路相关症状的问卷和职业紧张量表（OSI—R）。计算女性护士中LUTS（包括尿急、尿频、夜尿、急迫性尿失禁等）和OAB的患病率和职业压力情况。应用独立样本t检验比较调查人群与中国职业女性常模的职业紧张得分，并比较患OAB与未患OAB护士的职业紧张得分。应用多元Logistic回归模型校正年龄、体质指数（BMI）、生育史和盆腔手术史的影响，评估OSI—R各分量表得分与各LUTS症状和OAB的关系。结果共收集有效问卷1070份，参与者年龄为（30＋8）岁，范围为19～58岁。OAB患病率为27．57％（295例，95％C1为24．89％一30．25％）。患至少一种LUTS者占89．63％（959例，95％c，为87．80％～91．45％），尿急为64．39％（689例，95％C1为61．52％～67．26％），尿频为27．10％（290例，95％c，为24．44％～29．77％），夜尿为17．85％（191例，95％C1为15．59％～20．18％），急迫性尿失禁为21．03％（225例，95％C1为18．59％～23．47％）。所调查人群OSI—R的职业紧张和精神压力各分量表得分均高于中国职业女性常模，相应的应对资源各分量表得分均低于中国职业女性常模。患OAB护士大多数职业紧张和精神压力分量表得分高于未患OAB者，应对资源方面得分与未患OAB护士比较差异无统计学意义。应用多元Logistic回归模型调整年龄、BMI、生育史和盆腔手术史的影响后，OSI—R分量表得分均显示与至少一项LUTS或OAB相关，但是仅能在10％以内增加或降低LUTS或OAB的风险。结论女性护士中OAB及其他LUTS患病率均高于普通女性人群。女性护理人员的职业压力高于普通职业女性。职业压力在一定程度上与OAB及其他LUTS患病情况呈正相关。

Objective To evaluate the prevalence of overactive bladder （OAB） and other lower urinary tract symptoms （LUTS） , and to study its association with occupational stress in female nurses in Bei- jing. Methods From September 2010 to March 2011, 1135 registered female nurses with one or more years of nursing experience were cluster-sampled. The participants completed questionnaires on LUTS-related symptoms and Occupational Stress Inventory-Revised （OSI-R） tests. Multiple Logistic regressions were per- formed to evaluate the independent impact of perceived occupational stress on OAB and other LUTS, adjus- ting for age, body mass index （BMI） , and history of childbearing and pelvic surgery. Results 1070 valid responses to questionnaires were obtained. The mean age of the respondents was （30-＋8） years, ranged from 19 to 58. The prevalence of OAB was 27.57% （295 cases, 95%CI： 24.89%-30.25%）. LUTS of any types occured in 89.63% of nurses （959, 95%C1： 87.80%- 91.45%）, with 64.39% reporting urgency （689, 95%CI： 61.52% - 67.26%） , 27.10% reporting increased daytime frequency （ 290, 95% CI： 24.44% - 29.77% ） , 17.85% reporting nocturia （191, 95%CI： 15.59%-20.18%） and 21.03% reporting urge incon- tinence （225, 95%CI： 18.59%-23.47% ）. The occupational stress and psychological strain levels of nurses were higher than those of normative populations, while their coping resources were lower. Most of the sub- scales of occupational stress and psychological strain showed higher results for nurses with OAB than for those with OAB-free, while coping resources were not found to make any significant differences. After adjus- ting age, BMI, and childbearing and pelvic surgery history, each sub-scale of OSI-R was found to be associ- ated with at least one type of LUTS. Coneluslons The prevalence of OAB and other LUTS is high among female nurses in Beijing, and occupational stress may be a contributing factor. Taking measures to decrease their occupational stress and psychological strain may improve urological health among female nurses.