Understanding and Improving Treatment Decision-Making for Older Males with Stress Urinary Incontinence

了解并改善患有压力性尿失禁的老年男性的治疗决策

基本信息

批准号：
9811955
负责人：
Lindsay Ann Hampson
金额：
$ 12.05万
依托单位：
UNIVERSITY OF CALIFORNIA, SAN FRANCISCO
依托单位国家：
美国
项目类别：
财政年份：
2019
资助国家：
美国
起止时间：
2019-09-01 至 2021-05-31
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/9811955
关键词：
Address Adult Aftercare Age Age-Years Aging Attitude Automobile Driving Belief Benefits and Risks Body Weight decreased California Caring Clinical Research Comorbidity Computerized Medical Record Consultations Counseling Data Decision Aid Decision Making Devices Disease Dryness Elderly Ensure Ethics Etiology Extravasation Foundations Frequencies Goals Gold Health Impaired cognition Incontinence Individual Infection Institution Intervention Interview Kegel exercise Knowledge Life Expectancy Liquid substance Manuals Measures Medical center Mental Depression Methods Mission Motivation Operative Surgical Procedures Outcome Patient-Focused Outcomes Patients Personal Satisfaction Population Postoperative Period Public Health Pump Quality of life Recommendation Regrets Repeat Surgery Research Research Personnel Research Proposals Risk San Francisco Scrotum Social isolation Sphincter Stress Urinary Incontinence Structure Surgeon Surveys Telephone Testing Time Training Treatment Factor United States National Institutes of Health Universities Urethra Urinary Incontinence Urination Urologist Urology Veterans age related base chronic pain cognitive function cohort cost demographics functional status health related quality of life improved innovation male men men&apos s group multiple chronic conditions novel older men operation patient oriented patient population personalized decision prostate surgery reconstruction surgery outcome treatment choice urinary urologic

项目摘要

PROJECT SUMMARY/ABSTRACT: Male stress urinary incontinence (SUI) is common, costly, and significantly impacts health-related quality of life among older men, yet little is known about patient-centered outcomes in this population. Moreover, current patient counseling for male SUI treatment is based upon surgical outcomes, lacking guidance from patient- centered factors and patients’ underlying attitudes and beliefs about the importance of these various factors on treatment decisions and outcomes. Data are needed to understand how multi-morbidity, cognitive function, functional limitations, and life expectancy impact quality of life and decisional regret among older men who have made SUI treatment decisions. The long-term goal is to broaden our understanding of patient-centered outcomes in this population and to ensure treatments are aligned with patients’ overall goals. The objective of this application is to gain an understanding of quality of life and decisional regret among older men who have made SUI treatment decisions, and to understand the beliefs and motivations that drive these decisions. The central hypothesis is that there are geriatric-specific factors that impact quality of life and decisional regret among older men who have made SUI treatment decisions which go beyond those that are usually considered by surgeons counseling patients about these decisions. This hypothesis will be tested by utilizing a cohort of men ≥ 65 who have made SUI treatment decisions at the University of California, San Francisco and the San Francisco Veterans Affairs Medical Center to pursue two specific aims: 1) To identify patient-, disease- and treatment-related factors associated with decisional regret and quality of life among older men who have made SUI treatment decisions; and 2) To understand the underlying beliefs and motivations driving treatment decisions among older men with SUI. This project is innovative because it is the first to focus on patient- centered outcomes in this patient population, goes beyond commonly measured surgical outcomes to bring geriatric principles to treatment decisions, and importantly, will be the first to identify what patient-identified treatment factors are important to older men considering SUI treatment. The proposed research is significant because it will improve patient counseling and informed decision-making among older adults facing treatment decisions for SUI, which is critical to patient-centered surgical care.

项目摘要/摘要：男性压力性尿失禁 (SUI) 很常见，成本高昂，并且会严重影响健康相关的生活质量在老年男性中，但对该人群中以患者为中心的结果知之甚少。男性 SUI 治疗的患者咨询基于手术结果，缺乏患者的指导中心因素以及患者对这些不同因素的重要性的潜在态度和信念需要数据来了解多发病、认知功能、老年男性的功能限制、预期寿命影响生活质量和决策后悔做出 SUI 治疗决策的长期目标是加深我们对以患者为中心的理解。该人群的结果，并确保治疗与患者的总体目标保持一致。该应用程序旨在了解患有以下疾病的老年男性的生活质量和决策后悔程度：做出 SUI 治疗决定，并了解推动这些决定的信念和动机。中心假设是，存在影响生活质量和决策后悔的老年人特异性因素做出超出通常考虑范围的 SUI 治疗决定的老年男性由外科医生就这些决定向患者提供咨询，该假设将通过一组人进行检验。已在加州大学旧金山分校和旧金山大学做出 SUI 治疗决定的 ≥ 65 岁男性弗朗西斯科退伍军人事务医疗中心追求两个具体目标：1）确定患者、疾病和与已做出决定的老年男性的决定后悔和生活质量相关的治疗相关因素 SUI 治疗决策；以及 2) 了解推动治疗的基本信念和动机该项目具有创新性，因为它是第一个关注患者的项目。以该患者群体为中心的结果超出了通常测量的手术结果治疗决策的老年病学原则，重要的是，将首先确定患者确定的内容治疗因素对于考虑 SUI 治疗的老年男性很重要。拟议的研究具有重要意义。因为它将改善接受治疗的老年人的患者咨询和知情决策 SUI 的决策，这对于以患者为中心的外科护理至关重要。