Renal replasman tedavisi alan kadın hastalarda seksüel disfonksiyon sıklığının ve sosyokültürel-ekonomik özellikler ile ilişkisinin karşılaştırılması
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Date
2009
Authors
Koca, Tuba Güllü
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Publisher
Uludağ Üniversitesi
Abstract
Çalışmamızda Son Dönem Böbrek Yetmezliği (SDBY) tanısı ile Renal Replasman Tedavisi (RRT) alan kadın hastalardaki Seksüel Disfonksiyon (SD) sıklığını ve SD'nun medikal, psikolojik, sosyokültürel ve ekonomik faktörler ile ilişkisinin karşılaştırılmasını amaçladık.Bu amaçla RRT alan 115 (Hemodiyaliz 39, Periton diyalizi 43, Renal transplant 33) hasta ve bilinen herhangi bir sağlık problemi olmayan 103 sağlıklı, gönüllü premenopozal kadın çalışmaya dâhil edildi. RRT guruplarından ve kontrol gurubundan sosyodemografik veri formu, Hastane anksiyete depresyon (HAD) ölçeği, Arizona Cinsel Yaşantılar Ölçeği (ASEX) ve Golombok-Rust Cinsel Doyum Ölçeğini (GRISS) içeren anket formunu eksiksiz doldurmaları istendi. RRT guruplarının laboratuvar değerleri medikal kayıtlarından elde edildi.Çalışmaya katılan guruplar arasında yaş ortalaması, diyaliz süreleri ve vücut kitle indeksi (VKİ) açısından anlamlı fark yoktu. Ek sistemik hastalık varlığı açısında RRT gurupları ile Kontrol gurubu arasında anlamlı fark gözlenirken RRT guruplarının birbirleri arasındaki fark istatistiksel anlamlı değildi. Katılımcıların eğitim süresi ve bir işe sahip olmaları açısından aralarında anlamlı fark görülürken, ev sahibi olmak, araba sahibi olmak ve gelirin >1500 TL olması gibi değişkenlerin birlikte değerlendirildiği sosyoekonomik durum (SES) skorları arasında anlamlı fark saptanmadı. Katılımcıların eş ve aile özelliklerine yönelik sorgulamalarında görücü evliliği, evlilik süresi, eşinin yaşı, eğitim süresi ve çalışma süresi, eşiyle birlikte geçirdikleri zaman, cinsel birliktelik sayısı, çocuk sayısı, anne ve babanın eğitim sürelerinde anlamlı farklılık saptandı. Anksiyete ve depresyon açısından yapılan değerlendirmede RRT guruplarının Kontrol gurubuna göre daha depresif olduğu ancak gurupların birbirleri arasında depresyon açısından anlamlı farklılık olmadığı gözlendi. PD ve Tx guruplarının HD ve kontrol guruplarına göre daha anksiyöz oldukları saptandı. ASEX ile yapılan değerlendirmede HD, PD, Tx ve Kontrol guruplarında sırasıyla 29 (%74.4), 16 (%37.2), 6 (%18.2), 3 (%2.9) kişide SD olduğu belirlendi. Kontrol gurubu ile karşılaştırıldığında SD oranları Tx (p<0.01) ve diyaliz (p<0.001) hastalarında daha yüksek saptandı. HD gurubunun SD oranları, PD (p<0.01) ve Tx (p<0.001) gurubuna göre de anlamlı yüksek idi. GRISS ile yapılan değerlendirmede toplam skorda RRT guruplarının kontrol gurubuna göre anlamlı derecede yüksek skora sahip olduğu, HD gurubunun ayrıca Tx'e göre de daha yüksek skorunun olduğu belirlendi.Univariate analiz ile SD olan (n=54) ve olmayan (n=164) katılımcılarda tüm değişkenler karşılaştırıldı. Anlamlı olan uygun değişkenlere regresyon analizi uygulandı. Multivariate analiz hemodiyaliz, periton diyalizi hastası olmanın, depresyon varlığının ve evlilik süresinin SD için bağımsız risk faktörleri olduğunu gösterdi.Hem ASEX ile hem de GRISS ile değerlendirildiğinde Tx gurubunda Kontrol gurubuna göre daha fazla oranda SD olmakla beraber HD ve PD guruplarına göre anket skorları anlamlı düşük bulunmuştur. Sosyokültürel, ekonomik, medikal ve psikolojik faktörlerle ilişkisinin değerlendirmesinde SD'un birçok faktörden etkilendiği ve tüm bu faktörlerle ilişkili olduğu belirlendi.
In our study, we aimed to compare the relationship between medical, psychological, sociocultural-economic factors and Sexual Dysfunction (SD) frequency in patients on Renal Replacement Therapy (RRT) with the diagnosis of End Stage Renal Disease (ESRD). For this purpose, the 115 RRT patients (Hemodialysis 39, peritoneal dialysis 43, renal transplant 33) and 103 healthy premenopausal female volunteers without any known health problems, were included in the study. The questionnaire form containing demographic data form, the hospital anxiety depression scale (HAD), Arizona Sexual Experiences Scale (ASEX) and the Golombok-Rust Inventory of Sexual Satisfaction (GRISS) were asked to fill completely from the RRT groups and the control group. Laboratory values were obtained from medical records in RRT group.There were no significant difference about mean age, dialysis duration and body mass index (BMI) between the groups participating in the study. While there was a significant difference about presence of additional systemic disease between RRT groups and the control group, no statistically significant differences observed among the RRT groups. While there were significant differences among participants training period and job conditions, no significant differences were noted in socioeconomic status (SES) scores which contain having a home, to have a car and to have revenue> 1500 TL variables. In questioning about participants' spouses and family properties, it was revealed that there were significant differences in marriage type, marriage duration, husband's age, training period and working hours, spend time with each other, number of sexual intercourse in a week, the number of children, mothers and fathers training period. In the evaluation about anxiety and depression it was shown that RRT groups were depressed more compared to the control group, but no significant differences were observed among the RRT groups. PD and HD groups were more anxious than the Tx and Control groups. In ASEX evaluation it was identified that persons with SD in HD, PD, Tx and control groups were 29 (% 74.4), 16 (% 37.2), 6 (18.2%), 3 (2.9%) respectively. SD rates were higher in Tx (p <0.01) and dialysis (p <0.001) patients compared with the control group. SD rates in HD group were significantly higher than PD (p <0.01) and Tx (p <0.001) groups. The total score in the evaluation group GRISS it was determined that RRT groups have significantly higher scores compared to the control group, HD group have higher scores than Tx group.All variables were compared with univariate analysis in participants with SD (n = 54) and without SD (n = 164). Regression analysis was applied to the appropriate significant variables. Multivariate analysis showed that being hemodialysis or peritoneal dialysis patient, the presence of depression and marital duration are independent risk factors for SD.Although Tx group have greater percentage of SD than the control group, Tx group have significantly lower scores compared to the HD and PD groups when we evaluate SD with both ASEX and GRISS. In the evaluation of the relationship between sociocultural, economic, medical and psychological factors and SD it was identified that SD was affected by many factors and associated with all these factors.
In our study, we aimed to compare the relationship between medical, psychological, sociocultural-economic factors and Sexual Dysfunction (SD) frequency in patients on Renal Replacement Therapy (RRT) with the diagnosis of End Stage Renal Disease (ESRD). For this purpose, the 115 RRT patients (Hemodialysis 39, peritoneal dialysis 43, renal transplant 33) and 103 healthy premenopausal female volunteers without any known health problems, were included in the study. The questionnaire form containing demographic data form, the hospital anxiety depression scale (HAD), Arizona Sexual Experiences Scale (ASEX) and the Golombok-Rust Inventory of Sexual Satisfaction (GRISS) were asked to fill completely from the RRT groups and the control group. Laboratory values were obtained from medical records in RRT group.There were no significant difference about mean age, dialysis duration and body mass index (BMI) between the groups participating in the study. While there was a significant difference about presence of additional systemic disease between RRT groups and the control group, no statistically significant differences observed among the RRT groups. While there were significant differences among participants training period and job conditions, no significant differences were noted in socioeconomic status (SES) scores which contain having a home, to have a car and to have revenue> 1500 TL variables. In questioning about participants' spouses and family properties, it was revealed that there were significant differences in marriage type, marriage duration, husband's age, training period and working hours, spend time with each other, number of sexual intercourse in a week, the number of children, mothers and fathers training period. In the evaluation about anxiety and depression it was shown that RRT groups were depressed more compared to the control group, but no significant differences were observed among the RRT groups. PD and HD groups were more anxious than the Tx and Control groups. In ASEX evaluation it was identified that persons with SD in HD, PD, Tx and control groups were 29 (% 74.4), 16 (% 37.2), 6 (18.2%), 3 (2.9%) respectively. SD rates were higher in Tx (p <0.01) and dialysis (p <0.001) patients compared with the control group. SD rates in HD group were significantly higher than PD (p <0.01) and Tx (p <0.001) groups. The total score in the evaluation group GRISS it was determined that RRT groups have significantly higher scores compared to the control group, HD group have higher scores than Tx group.All variables were compared with univariate analysis in participants with SD (n = 54) and without SD (n = 164). Regression analysis was applied to the appropriate significant variables. Multivariate analysis showed that being hemodialysis or peritoneal dialysis patient, the presence of depression and marital duration are independent risk factors for SD.Although Tx group have greater percentage of SD than the control group, Tx group have significantly lower scores compared to the HD and PD groups when we evaluate SD with both ASEX and GRISS. In the evaluation of the relationship between sociocultural, economic, medical and psychological factors and SD it was identified that SD was affected by many factors and associated with all these factors.
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Keywords
Renal replasman tedavisi (RRT), Seksüel disfonksiyon, Bayan, Transplant, GRISS, ASEX, Renal replacement therapy (RRT), Sexual dysfunction, Female
Citation
Koca, T. G. (2009). Renal replasman tedavisi alan kadın hastalarda seksüel disfonksiyon sıklığının ve sosyokültürel-ekonomik özellikler ile ilişkisinin karşılaştırılması. Yayınlanmamış uzmanlık tezi. Uludağ Üniversitesi Tıp Fakültesi.