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Mental Health Mediating the Relationship Between Symptom Severity and Health‐Related Quality of Life in Patients with Lower Urinary Tract Symptoms
Author(s) -
CHOI Edmond P. H.,
LAM Cindy L. K.,
CHIN Weng Yee
Publication year - 2016
Publication title -
luts: lower urinary tract symptoms
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.451
H-Index - 15
eISSN - 1757-5672
pISSN - 1757-5664
DOI - 10.1111/luts.12086
Subject(s) - lower urinary tract symptoms , mediation , mental health , quality of life (healthcare) , medicine , psychological intervention , anxiety , clinical psychology , depression (economics) , sf 36 , health related quality of life , psychiatry , disease , prostate , nursing , cancer , political science , law , economics , macroeconomics
Objectives Lower urinary tract symptoms ( LUTS ) can impact both mental health and health‐related quality of life ( HRQOL ). To date, however, their associations with outcomes have only been examined in isolation and the interactive relationship between LUTS , mental health and HRQOL remains poorly understood. The aim of this study was to determine whether mental health mediates the relationship between LUTS severity and HRQOL . Methods Five hundred and nineteen primary care subjects with LUTS completed a structured questionnaire including the I nternational P rostate S ymptom S core ( IPSS ), the adapted I ncontinence I mpact Q uestionnaire‐7 ( IIQ ‐7), the C hinese ( HK ) SF ‐12 H ealth S urvey V ersion 2 ( SF ‐12 v2) and the D epression, A nxiety and S tress S cale‐21 ( DASS ‐21). Mediation modeling was tested using B aron and K enney's multistage regression approach and bootstrapping method. Results Overall, mental health partially mediated the association between LUTS severity and HRQOL as measured by the SF ‐12 v2 physical component summary ( PCS ) and the IIQ ‐7. The depression, anxiety and stress scores all have similar mediation effects in the relationship between LUTS severity and HRQOL . Subgroup analysis by gender showed that anxiety fully mediated the relationship between LUTS severity and HRQOL as measured by the SF ‐12 v2 PCS in males whilst the mediation effects of mental health in the relationship between LUTS severity and HRQOL as measured by the SF ‐12 v2 PCS could not be found in females. Conclusions In order to enhance HRQOL , LUTS interventions should address the mental health of patients in addition to providing physical relief of symptoms.