| Objectives To investigate the effect of cognitive behavioral intervention on the quality of life(QOL) among elderly patients with Overactive Bladder(OAB), and develop a feasible and practical approach on cognitive behavioral therapy for OAB patients, so that provide methodological evidences for clinical application.Methods This a quasi-experimental study, 60 patients over 45 years old with OAB were selected as the research object, the patients meeting inclusion and exclusion criteria were from out-patient department of urology, in tertiary referral center of Zhengzhou city, range from October 2014 to May 2015.And patients with informed consent were enrolled in this study, they were randomly divided into the control group(n=30) and intervention group(n=30), the control group was given routine drug treatment, health education and bladder function re-education, intervention group was to be added the cognitive behavioral intervention based on control group.In this study, a general information questionnaire was used to compare the demographic data, the baseline situation of patients was investigated before intervention, and patients were evaluated by anxiety level, self-efficacy, improvement of symptoms and quality of life, according to GAS, GSES, OABSS, OAB-q scale, resspectively in one, three, six months after intervention.Double entry the data of investigation and experiment with Epidata3.1, statistical analysis was performed with SPSS17.0. Statistical analysis methods including descriptive statistics analysis, t-test, Chi-Square test, single factor and repeated measurement of variance.Results 1.The SAS scores in OAB patients were 66.7±7.58, higher than the standard value of 50, and the difference is statistically significant, before the intervention the scores of self-efficacy were 1.50±0.36 in control group, and the scores were 1.49 ± 0.44 in intervention group, the GSES scale scores in two groups were lower than those in the elderly with the national norm scores of 2.86±0.52. 2.Two independent samples t-test demonstrated that SAS scores were not statistically significant(t=-1.346, P=0.178) in intervention group and control group before the intervention. According to paired t-test compared within two groups, significant differences of SAS scores were observed both in intervention group(t=15.793, P<0.001) and control group(t=6.388, P<0.001) before and after the intervention. However, after the intervention, the intervention group SAS scores decreased significantly than the control group obviously. Two independent samples t-test demonstrated that SAS scores difference were statistically significant(t=7.665, P<0.001) between two groups before and after the intervention.Repeated measures analysis of variance showed that SAS scores were significant difference(P<0.001) between two groups at four different time points during the whole period(before intervention, in 1, 3, 6 months after intervention), time effect was statistically significant(P <0.001), the situation of SAS changed with time in two groups, while group effect was statistically significant(P<0.001), interaction effect was existence between time effect and group effect(P<0.001). 3.Two independent samples t-test demonstrated that GSES scores were not statistically significant(t=-0.658, P=0.510) in intervention group and control group before the intervention. According to paired t-test compared within two groups, significant differences of GSES scores were observed both in intervention group(t=-25.928, P<0.001) and control group(t=-29.810, P<0.001) before and after the intervention.However, after the intervention, the intervention group GSES scores increased significantly than the control group obviously. Two independent samples t-test demonstrated that GSES scores difference were statistically significant(t=4.300, P<0.001) between two groups before and after the intervention.Repeated measures analysis of variance showed that GSES scores were significant difference(P<0.001) between two groups at four different time points during the whole period(before intervention, in 1, 3, 6 months after intervention), time effect was statistically significant(P<0.001), the situation of GSES changed with time in two groups, while group effect was statistically significant(P<0.001), interaction effect was existence between time effect and group effect(P<0.001). 4.Two independent samples t-test demonstrated that OABSS scores were not statistically significant(t=-2.541, P=0.071) in intervention group and control group before the intervention. According to paired t-test compared within two groups, significant differences of OABSS scores were observed both in intervention group(t=9.816, P<0.001) and control group(t=5.814, P<0.001) before and after the intervention. However, after the intervention, the intervention group OABSS scores decreased significantly than the control group obviously. Two independent samples t-test demonstrated that OABSS scores difference were statistically significant(t=3.729, P<0.001) between two groups before and after the intervention. Repeated measures analysis of variance showed that OABSS scores were significant difference(P<0.001) between two groups at four different time points during the whole period(before intervention, in 3, 6 months after intervention), time effect was statistically significant(P<0.001), the situation of OABSS changed with time in two groups, while group effect was statistically significant(P<0.001), interaction effect was existence between time effect and group effect(P<0.001). 5.Two independent samples t-test demonstrated that OAB-q scores were not statistically significant(t=-0.407, P=0.684) in intervention group and control group before the intervention. According to paired t-test compared within two groups, significant differences of OAB-q scores were observed both in intervention group(t=18.192, P<0.001) and control group(t=8.758, P<0.001) before and after the intervention. However, after the intervention, the intervention group OAB-q scores decreased significantly than the control group obviously.Two independent samples t-test demonstrated that OAB-q scores difference were statistically significant(t=12.371, P<0.001) between two groups before and after the intervention. Repeated measures analysis of variance showed that OAB-q scores were significant difference(P<0.001) between two groups at four different time points during the whole period(before intervention, in 3,6 months after intervention), time effect was statistically significant(P<0.001), the situation of OAB-q changed with time in two groups, while group effect was statistically significant(P<0.001), interaction effect was existence between time effect and group effect(P<0.001). 6.For four kinds of urination symptom scores, at each time point during the whole period, t-test showed that there was no significant difference(P>0.05) in day-time voiding frequency between two groups before the intervention and in 1 month after the intervention, there was statistically significant(P<0.001) after 3 and 6 months after the intervention, there was no significant difference(P>0.05) in night-time voiding frequency between two groups before the intervention, in 1 month and 3 months after the intervention, the scores of both urgency and urgency incontinence symptoms between two groups all showed significant difference(P< 0.001), taking the scores of SAS and four kinds of urinary symptoms into Spearman correlation analysis, the results showed that the anxiety status in OAB patients was positively correlated with the symptoms of urinary symptoms, and the largest correlation with urgency incontinence(Rs=0.890).Conclusion 1.Generally, there are different degrees of anxiety in OAB patients, whose general self-efficacy level is lower than the domestic norm, which should be paid to attention and given intervention. 2.With the intervention, it’ suggested a significant difference that anxiety and general self-efficacy sense level evaluation index in intervention group compared with those in control group,which demonstrated that CBI can efficiently improve the anxiety status and the general self-efficacy sense level in patients with OAB, so that the decline of anxiety level and ascension of self management level, can make sure the treatment carried out smoothly. 3.CBI could effectively improve urinary symptoms in patients with OAB, especially on the urgency and urgency incontinence intervention, which is most obvious. However, it is not obvious to improve the symptoms of night-time voiding frequency, also, CBI effectively improved the health related quality of life of patients with OAB, so that the overall living standard of patients would be further improved. |
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