Health-Related Quality of Life and Psychosocial Variables in Women with Colorectal Pelvic Floor Dysfunction: A Cross-Sectional Study
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MDPI
Fecha
2024-03-15Referencia bibliográfica
Molina-Barea, R.; Slim, M.; Calandre, E.P. Health-Related Quality of Life and Psychosocial Variables in Women with Colorectal Pelvic Floor Dysfunction: A Cross-Sectional Study. Healthcare 2024, 12, 668. https://doi.org/10.3390/healthcare12060668
Resumen
Pelvic floor dysfunction comprises various disorders, including urinary incontinence,
fecal incontinence, pelvic organ prolapse, and chronic pelvic pain. This study aimed to evaluate
health-related quality of life (HRQoL), anxiety, depression, sleep disturbance, and sexual functioning
in women with pelvic floor dysfunction of colorectal etiology compared with control women. Patients
were recruited from a specialized colorectal unit and controls were selected from among the patients’
friends and relatives. Sociodemographic and clinical data were collected. Pelvic floor dysfunction distress
and impact, HRQoL, depression, anxiety, insomnia, and sexual functioning were assessed using
the following validated questionnaires: Short-Form Pelvic Floor Distress Inventory (PFDI-20), Short
Form Pelvic Floor Impact Questionnaire (PFIQ-7), 36-Item Short-Form Health Survey (SF-36), Beck
Depression Inventory II (BDI-II), Beck Anxiety Inventory (BAI), Insomnia Severity Index (ISI), and
Changes in Sexual Functioning Scale (CSFQ). Statistical analyses included Welch’s t-test, Fisher’s exact
test, and Spearman’s correlation coefficients. Eighty-four patients and 57 controls were included.
Compared with controls, patients were more likely to be obese or overweight, have had higher
numbers of deliveries, more vaginal deliveries, more frequent use of forceps, and have had more
associated comorbidities, mainly in the urinary, neurological, and psychiatric domains. As expected,
patients scored significantly higher than controls on both the PFDI-20 and PFIQ-7 and their respective
sub-scales, with the highest mean values in the patient group on the sub-scales related to the
colorectal–anal domain. QoL, depression, anxiety, insomnia, and sexual functioning were significantly
worse in patients than in controls (p < 0.0001 in every case). In patients, PFIQ-7 scores correlated significantly
with HRQoL (p < 0.001 for the physical component and p < 0.01 for the mental component),
depression (p < 0.001), anxiety (p < 0.001), insomnia (p < 0.05), and sexual functioning scores (p < 0.05).
Colorectal pelvic floor dysfunction had a markedly deleterious impact on the HRQoL, depression,
anxiety, sleep disturbance, and sexual functioning of patients. It is concluded that colorectal pelvic
floor dysfunction exerts a considerable burden on patients’ lives. Addressing these issues in clinical
settings could significantly improve patients’ well-being.