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      Overactive bladder symptom severity, bother, help-seeking behavior, and quality of life in patients with type 2 diabetes: a path analysis

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          Abstract

          Background

          This study aimed to investigate the relationships among overactive bladder (OAB) symptom severity, bother, help-seeking behavior, and quality of life (QOL) in patients with type 2 diabetes.

          Methods

          A total of 127 diabetic patients, aged at least 18 years, with overactive bladder from a hospital in Shandong Province, China, were recruited for this study. Symptom severity, bother, and quality of life were assessed using the Overactive Bladder Symptom Score (OABSS), Patient Perception of Bladder Condition (PPBC), and Overactive Bladder Questionnaire Short Form (OAB-q SF), respectively. Help-seeking behavior was assessed by asking patients whether they consulted health care professionals or received treatment for their bladder problems. A two-step path analysis was performed to analyze the data.

          Results

          OAB symptom severity was directly associated with lower levels of QOL, and the strength of this association was no longer significant when taking bother and help-seeking behavior into account. Bother increased with OAB symptom severity, and patients with bothersome OAB tended to have lower levels of QOL. Moreover, bother increased help-seeking behavior; however, patients who sought help tended to have lower levels of QOL.

          Conclusions

          Our findings highlight the role of bother and help-seeking behavior in the relationship between OAB symptom severity and QOL. To improve a patient’s QOL, health care providers should focus not only on symptom bother but also on dysfunctional help-seeking patterns.

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          Most cited references31

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          Worldwide prevalence estimates of lower urinary tract symptoms, overactive bladder, urinary incontinence and bladder outlet obstruction.

          Debra E Irwin, Zoe S Kopp, Barnabie Agatep … (2011)
          • To estimate and predict worldwide and regional prevalence of lower urinary tract symptoms (LUTS), overactive bladder (OAB), urinary incontinence (UI) and LUTS suggestive of bladder outlet obstruction (LUTS/BOO) in 2008, 2013 and 2018 based on current International Continence Society symptom definitions in adults aged ≥20 years. • Numbers and prevalence of individuals affected by each condition were calculated with an estimation model using gender- and age-stratified prevalence data from the EPIC study along with gender- and age-stratified worldwide and regional population estimates from the US Census Bureau International Data Base. • An estimated 45.2%, 10.7%, 8.2% and 21.5% of the 2008 worldwide population (4.3 billion) was affected by at least one LUTS, OAB, UI and LUTS/BOO, respectively. By 2018, an estimated 2.3 billion individuals will be affected by at least one LUTS (18.4% increase), 546 million by OAB (20.1%), 423 million by UI (21.6%) and 1.1 billion by LUTS/BOO (18.5%). • The regional burden of these conditions is estimated to be greatest in Asia, with numbers of affected individuals expected to increase most in the developing regions of Africa (30.1-31.1% increase across conditions, 2008-2018), South America (20.5-24.7%) and Asia (19.7-24.4%). • This model suggests that LUTS, OAB, UI and LUTS/BOO are highly prevalent conditions worldwide. Numbers of affected individuals are projected to increase with time, with the greatest increase in burden anticipated in developing regions. • There are important worldwide public-health and clinical management implications to be considered over the next decade to effectively prevent and manage these conditions. © 2010 THE AUTHORS. BJU INTERNATIONAL © 2010 BJU INTERNATIONAL.
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            Symptom assessment tool for overactive bladder syndrome--overactive bladder symptom score.

            Masayuki Takeda, Hidehiro Kakizaki, Osamu Yamaguchi … (2006)
            Overactive bladder (OAB) is a common symptom syndrome with urgency, urinary frequency, and urgency incontinence. To collectively express OAB symptoms, we developed the overactive bladder symptom score (OABSS). Four symptoms--daytime frequency, nighttime frequency, urgency, and urgency incontinence--were scored. The weighing score was based on a secondary analysis of an epidemiologic database. Psychometric properties were examined in five patient groups: OAB (n = 83), asymptomatic controls (n = 34), stress incontinence (n = 29), benign prostatic hyperplasia (n = 28), and other diseases with urinary symptoms (n = 26). The maximal score was defined as 2, 3, 5, and 5 for daytime frequency, nighttime frequency, urgency, and urgency incontinence, respectively. The sum score (OABSS 0 to 15) was significantly greater in the patients with OAB (8.36) than in the other patient groups (1.82 to 5.14). The distribution of the OABSS showed a clear separation between those with OAB and asymptomatic controls. The OABSS correlated positively with the individual scores (Spearman's r = 0.10 to 0.78) and quality-of-life scores assessed by the King's Health Questionnaire (Spearman's r = 0.20 to 0.49). The weighted kappa coefficients were 0.804 to 1.0 for each symptom score and 0.861 for OABSS. The posttreatment reduction in the OABSS was consistent with the global impression of patients of the therapeutic efficacy. The OABSS, the sum score of four symptoms (daytime frequency, nighttime frequency, urgency, and urgency incontinence), has been developed and validated. OABSS may be a useful tool for research and clinical practice.
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              The validation of the patient perception of bladder condition (PPBC): a single-item global measure for patients with overactive bladder.

              Paul Abrams, Louis Matza, Zoe Kopp … (2006)
              The purpose of this study was to evaluate the validity and responsiveness of a global measure for overactive bladder (OAB), the Patient Perception of Bladder Condition (PPBC). Post-hoc analyses were conducted on two 12-wk clinical trials for OAB (Study 1: n = 865; Study 2: n = 520). In addition to the PPBC, patients completed two condition-specific health-related quality of life (HRQL) measures, the Overactive Bladder Questionnaire (OAB-q) and King's Health Questionnaire (KHQ), and bladder diaries at baseline and 12 wk. Validity of the PPBC was evaluated through correlations with baseline diaries, OAB-q, and KHQ. The responsiveness of the PPBC was evaluated using correlations and general linear models to assess the degree of association between change in PPBC and change in the diaries, OAB-q, and KHQ. Both samples were primarily women and white with mean ages of 61.0 and 58.8 yr. The majority of patients were incontinent (75.3% and 80.4%) with the greatest proportion of patients indicating that they had "moderate problems" (47.5% and 51.2%) on the PPBC at baseline. Significant correlations were present at baseline and among change scores between the PPBC and the bladder diaries (p < 0.001), OAB-q (p < 0.001), and KHQ (p < 0.01). In both studies, patients with major PPBC improvement had significantly greater reductions in frequency, urgency episodes, incontinence episodes, and Symptom Bother and significantly greater improvements in HRQL than patients with only a minor PPBC improvement. The PPBC, a global patient-reported measure of bladder condition, demonstrated good construct validity and responsiveness to change. These findings support the use of the PPBC as a global assessment of bladder condition among patients with OAB.
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                Author and article information

                Contributors
                Dongjuan Xu: xu976@purdue.edu
                Meng Zhao: zhaomengbd@126.com
                Liqun Huang: 15165121960@163.com
                Kefang Wang: 86-531-88382201 , wangkf@sdu.edu.cn
                Journal
                Journal ID (nlm-ta): Health Qual Life Outcomes
                Journal ID (iso-abbrev): Health Qual Life Outcomes
                Title: Health and Quality of Life Outcomes
                Publisher: BioMed Central (London )
                ISSN (Electronic): 1477-7525
                Publication date (Electronic): 2 January 2018
                Publication date PMC-release: 2 January 2018
                Publication date Collection: 2018
                Volume: 16
                Electronic Location Identifier: 1
                Affiliations
                [1 ]ISNI 0000 0004 1761 1174, GRID grid.27255.37, School of Nursing, , Shandong University, ; No. 44, Wenhua Xi Road, Jinan, Shandong 250012 People’s Republic of China
                [2 ]ISNI 0000 0004 1937 2197, GRID grid.169077.e, School of Nursing, , Purdue University, ; West Lafayette, Indiana 47907 USA
                Article
                Publisher ID: 829
                DOI: 10.1186/s12955-017-0829-z
                PMC ID: 5749008
                PubMed ID: 29291738
                SO-VID: 50b53df3-bcea-4486-842e-cf1dd4eb5fd5
                Copyright © © The Author(s). 2017
                License:

                Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License ( http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver ( http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.

                History
                Date received : 23 March 2017
                Date accepted : 14 December 2017
                Funding
                Funded by: Natural Science Foundation of Shandong Province (CN)
                Award ID: ZR2015HM033
                Categories
                Subject: Research
                Custom metadata
                issue-copyright-statement © The Author(s) 2018

                ScienceOpen disciplines: Health & Social care
                Keywords: overactive bladder,symptom severity,quality of life,help-seeking behavior,bother
                Data availability:
                ScienceOpen disciplines: Health & Social care
                Keywords: overactive bladder, symptom severity, quality of life, help-seeking behavior, bother

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