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Sleep and quality of life in men with lower urinary tract symptoms: and their partners
Linköping University, Faculty of Health Sciences. Linköping University, Department of Clinical and Experimental Medicine, Urology . Östergötlands Läns Landsting, Centre of Surgery and Oncology, Department of Urology in Östergötland.
2009 (English)Doctoral thesis, comprehensive summary (Other academic)
Abstract [en]

Aims: The overall aim was to determine how lower urinary tract symptoms (LUTS) suggestive of benign prostatic obstruction (BPO) affect sleep, health related quality of life and disease specific quality of life, and how the men’s urinary symptoms affect their partners.

Subjects and methods: In papers I–II, a descriptive design with a pre-test and post-test was used and in papers III-IV the design was descriptive and comparative. The method was self-administered questionnaires. In papers I- II: The questionnaires were translated in the ethnographic mode. In paper I the reliability of the questionnaire was tested in 122 patients with LUTS/ BPO. The disease specific quality of life was studied before and after intervention in 572 consecutive patients with BPO, aged 45-94 yrs. In paper II, the partner specific quality of life was studied in partners to men with BPO before and after TURP. The reliability and the responsiveness of the questionnaire were tested in two groups with 51 partners each. Papers III-IV: A study of 239 men with LUTS, aged 45-80 yrs, and their partners (n=126) who were compared to randomly selected men from the population (n=213) and their partners (n=131). The men had an extra control group, men with inguinal hernia (n=200). Sleep and health related quality of life was studied in both men and their partners. The partners’ specific quality of life was also studied and the men with LUTS answered questions about urinary symptoms and disease specific quality of life.

Results: Papers I-II: All the tested questionnaires showed an acceptable reliability and responsiveness. I: Before and after intervention the prevalence of urinary incontinence was 46 % and 16 % respectively. II: Partners were affected by the patients’ BPO symptoms before and improved after the patients TURPs. III: Most sleep variables were significantly impaired in men with LUTS compared to one or both of the control groups. The men with LUTS had a significantly higher prevalence of insomnia (40 %) than both control groups and significantly lower sleep efficiency (49 %) than men with hernia. The men with LUTS were significantly impaired in most domains of the health related quality of life compared to men in the population. IV: There were no significant differences between the two partner groups regarding the quantity and quality of sleep or the health related quality of life.

Conclusions: All tested questionnaires showed an acceptable reliability and responsiveness.

The prevalence of urinary incontinence before and after intervention was higher than earlier reported.

Men with LUTS had significantly poorer sleep quality, reduced sleep efficiency and a higher prevalence of insomnia than men in the population and men with inguinal hernia.

The HRQOL is impaired in men with LUTS compared to men in the population and men with inguinal hernia.

Partners are affected by the patients’ symptoms, and it is emotional rather than practical aspects that affect them most.

Partners of men with LUTS did not differ significantly from partners in the population with regard to sleep and health related quality of life.

Place, publisher, year, edition, pages
Linköping: Linköping University Electronic Press , 2009. , 80 p.
Series
Linköping University Medical Dissertations, ISSN 0345-0082 ; 1092
Keyword [en]
Benign prostatic hyperplasia, Benign prostatic obstruction, Disease specific quality of life, Health related quality of life, Inguinal hernia, Insomnia, Lower urinary tract symptoms, Population, Sleep disorders, Sleep quality
National Category
Urology and Nephrology
Identifiers
URN: urn:nbn:se:liu:diva-15946ISBN: 978-91-7393-724-5 (print)OAI: oai:DiVA.org:liu-15946DiVA: diva2:128432
Public defence
2009-01-30, Berzeliussalen, Campus US, Hälsouniversitetet, Linköpings Universitet, Linköping, 09:00 (Swedish)
Opponent
Supervisors
Available from: 2008-12-17 Created: 2008-12-17 Last updated: 2009-08-21Bibliographically approved
List of papers
1. Bothersome urinary symptoms and disease-specific quality of life in patients with benign prostatic obstruction: High prevalence of urinary incontinence before and after intervention
Open this publication in new window or tab >>Bothersome urinary symptoms and disease-specific quality of life in patients with benign prostatic obstruction: High prevalence of urinary incontinence before and after intervention
2007 (English)In: Scandinavian Journal of Urology and Nephrology, ISSN 0036-5599, Vol. 41, no 1, 32-41 p.Article in journal (Refereed) Published
Abstract [en]

Objectives: Firstly, to describe self-reported urinary symptoms and bothersomeness, including disease-specific quality of life (QOL), in patients with symptomatic benign prostatic obstruction (BPO) before and 6 months after intervention. Secondly, to identify factors which predict disease-specific QOL. Thirdly, to develop and test the reliability of an instrument to evaluate incontinence, the Linköping Incontinence Questionnaire (LIQ). Finally, to translate and test the reliability of Swedish versions of the International Prostate Symptom Score, including the bother question, the American Urological Association Symptom Problem Index (SPI) and the Benign Prostatic Hyperplasia Impact Index.

Material and methods: Disease-specific QOL was studied in 572/720 consecutively treated patients using structured questionnaires. The reliability of the instruments was tested in 122 patients with lower urinary tract symptoms (LUTS) or BPO.

Results: The frequency and weak stream items of the SPI were among those that best explained the patients' disease-specific QOL both before and after intervention. Before and after intervention the prevalence of urinary incontinence, assessed using the LIQ instrument, was 46% and 16%, respectively. Symptoms and disease-specific QOL improved most in the surgery group, intermediately in the transurethral incision of the prostate/transurethral microwave thermotherapy group and least in the drug therapy group.

Conclusions: The frequency and weak stream items of the SPI were the factors that best explained disease-specific QOL. The prevalence of incontinence before and after intervention was higher than that previously

Place, publisher, year, edition, pages
Taylor & Francis, 2007
Keyword
Benign prostatic obstruction, benign prostatic hyperplasia, disease-specific quality of life, interventions, lower urinary tract symptoms, predicting factors, treatment, urinary incontinence, urinary symptoms
National Category
Urology and Nephrology
Identifiers
urn:nbn:se:liu:diva-15942 (URN)10.1080/00365590601068926 (DOI)
Available from: 2008-12-17 Created: 2008-12-17 Last updated: 2009-08-19Bibliographically approved
2. A Swedish version of a quality of life questionnaire for partners of men with symptoms suggestive of benign prostatic obstruction
Open this publication in new window or tab >>A Swedish version of a quality of life questionnaire for partners of men with symptoms suggestive of benign prostatic obstruction
2008 (English)In: Scandinavian Journal of Urology and Nephrology, ISSN 0036-5599, Vol. 42, no 2, 126-131 p.Article in journal (Refereed) Published
Abstract [en]

Objectives: Little is known about the quality of life experienced by the partners of men with lower urinary tract symptoms (LUTS) suggestive of benign prostatic obstruction (BPO). The aims of this study were to translate a specific quality of life questionnaire for partners to patients with benign prostatic enlargement (BPE)/BPO to swedish and to test its reliability and responsiveness. A secondary aim was to evaluate the impact the patients' urinary symptoms have on their partners' specific quality of life.

Material and methods: This study was conducted using two groups: a reliability partner group; and a responsiveness/evaluation partner group. Both groups consisted of the partners of patients on the waiting list for transurethral resection of the prostate (TURP). The reliability of the quality of life questionnaire for the partners of men with BPE/BPO was tested in 51 partners, with a test-retest interval of 5 weeks. The partners' specific quality of life and the responsiveness of the questionnaire were evaluated in 51 partners by administering the questionnaire before and 3 months after the patient's TURP.

Results: At the test-retest, the Spearman's rank correlation coefficient for each question varied between 0.59 and 0.86 and Cronbach's was 0.80. Partners were affected by the patients' BPO symptoms. Compassion, worry about cancer and worry about an operation were the aspects of the specific quality of life that affected most partners (92%, 77% and 65%, respectively), whereas effects on spare time and household activities affected fewer partners: 35% and 24%, respectively. The specific quality of life among partners improved significantly after the patient's TURP.

Conclusions: The Swedish version of a partner-specific quality of life questionnaire for men with LUTS suggestive of BPE/BPO had an acceptable reliability and responsiveness. Partners are affected by the patients' symptoms, and it is emotional rather than practical aspects which most affect them.

Place, publisher, year, edition, pages
Taylor & Francis, 2008
Keyword
Benign prostatic enlargement; benign prostatic obstruction; lower urinary tract symptoms; transurethral resection of the prostate; partner; quality of life; questionnaire; urinary symptoms
National Category
Urology and Nephrology
Identifiers
urn:nbn:se:liu:diva-15943 (URN)10.1080/00365590701725698 (DOI)
Available from: 2008-12-17 Created: 2008-12-17 Last updated: 2009-08-19Bibliographically approved
3. Sleep and health-related quality of life in patients with lower urinary tract symptoms suggestive of benign prostatic obstruction compared to the general population and patients with inguinal hernia
Open this publication in new window or tab >>Sleep and health-related quality of life in patients with lower urinary tract symptoms suggestive of benign prostatic obstruction compared to the general population and patients with inguinal hernia
2010 (English)In: Scandinavian Journal of Urology and Nephrology, ISSN 0036-5599, E-ISSN 1651-2065, Vol. 44, no 5, 304-314 p.Article in journal (Refereed) Published
Abstract [en]

Abstract Objective. To determine whether there are differences in the quantity and quality of sleep, including sleep efficiency and insomnia, and health-related quality of life (HRQoL) between patients with lower urinary tract symptoms (LUTS) suggestive of benign prostatic obstruction (BPO), men from the general population and patients with inguinal hernia. Material and methods. The designs were descriptive and comparative. The groups consisted of 239 patients aged 45-80 years who were referred to urological departments with LUTS suggestive of benign prostatic obstruction. The comparison groups consisted of 213 randomly selected men from the general population, stratified according to age and geographical region, and 200 patients with inguinal hernia. The setting was one university and two general hospitals. The method was self-administered questionnaires about demography, comorbidity, sleep and health-related quality of life. Further, patients with LUTS answered questions about urinary symptoms and disease-specific quality of life. Results. The prevalence of insomnia was 40%, 26% and 19% and the prevalence of sleep efficiency < 85% was 49%, 38.5% and 31% in the LUTS, general population and hernia groups, respectively. The median number of nocturnal micturitions was 2, 1 and 1. In the LUTS group (n = 216), 47% had IPSS 8-19 and 44% had >/= 20 points. The HRQoL was significantly impaired in patients with LUTS compared with one or both of the comparison groups (p values < 0.05). Conclusions. Patients with LUTS suggestive of BPO had significantly impaired sleep, a higher prevalence of insomnia and significantly impaired HRQoL compared with one or both of the comparison groups.

Place, publisher, year, edition, pages
Informa Healthcare, 2010
Keyword
Benign prostatic hyperplasia, Benign prostatic obstruction, Disease specific quality of life, Health related quality of life, Inguinal hernia, Insomnia, Lower urinary tract symptoms, Population, Sleep disorders, Sleep quality
National Category
Urology and Nephrology
Identifiers
urn:nbn:se:liu:diva-15944 (URN)10.3109/00365599.2010.488246 (DOI)000283129200005 ()20476852 (PubMedID)
Available from: 2008-12-17 Created: 2008-12-17 Last updated: 2015-03-31Bibliographically approved
4. Sleep and specific quality of life (QOL) in partners of men with lower urinary tract symptoms (LUTS) compared with partners to men from the population
Open this publication in new window or tab >>Sleep and specific quality of life (QOL) in partners of men with lower urinary tract symptoms (LUTS) compared with partners to men from the population
2008 (English)Article in journal (Refereed) Submitted
Abstract [en]

Objective: To determine whether there are significant differences in sleep, partner specific and health related quality of life between partners of men with LUTS suggestive of benign prostatic obstruction (BPO) and partners of men from the population. Secondly, to identify factors related to the specific quality of life in partners of men with LUTS and the sleep efficiency.

Subjects and methods: The study designs were descriptive and comparative. The subjects were partners of men with LUTS suggestive of BPO (n=126) referred to departments of urology at one university and two general hospitals and partners (n=131) of randomly selected men from the general population. Self-administered questionnaires about demography, comorbidity, sleep, sexuality, partner specific and health related quality of life were used.

Results: Partners to men with LUTS suggestive of BPO were significantly more affected in all variables measuring partner specific quality of life compared to partners from the population. The most impaired aspects were compassion and worry about an operation or cancer.

In logistic regression, the only explanatory factors were having a partner belonging to the LUTS group for impaired partner specific quality of life and having a bed partner for high sleep efficiency.

There were no significant differences between the two groups regarding the quantity andquality of sleep or the health related quality of life.

Conclusions: The partner specific quality of life was impaired in partners of men with LUTS suggestive of BPO. Sleep and health related quality of life did not differ between partners of men with LUTS and partners in the population.

Keyword
Benign prostatic hyperplasia, Insomnia, Lower urinary tract symptoms, Partner, Quality of life, Sleep disorders
National Category
Urology and Nephrology
Identifiers
urn:nbn:se:liu:diva-15945 (URN)
Available from: 2008-12-17 Created: 2008-12-17 Last updated: 2009-08-19Bibliographically approved

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