神經康復中性功能評估：來自脊髓損傷隊列的見解和挑戰 Assessing sexual function in neurorehabilitation: insights and challenges from a spinal cord injury cohort ——《性醫學雜誌》第23卷，第1期，2026年1月—— <The Journal of Sexual Medicine> Volume 32, Issue 1, Jan. 2026 【摘要】背景：脊髓損傷（SCI）後性功能障礙很常見，並會影響生活質量，但由於不適感和知識不足，醫療保健專業人員可能會迴避這一話題。性健康數據的缺失可能會導致研究結果出現偏差，但在脊髓損傷領域，這一問題在很大程度上仍未得到充分研究。目的：描述與其他臨床領域相比，性功能數據的缺失情況，並評估在脊髓損傷急性期後專科康復期間，數據收集程序的變化與女性和男性數據缺失之間的關聯。方法：本研究利用基於人群的多中心瑞士脊髓損傷（SwiSCI）初始隊列研究的數據進行橫斷面分析，以評估脊髓損傷康復期間多個功能領域的漏診和評估不完整情況。採用邏輯回歸分析比較不同臨床評估中的數據缺失情況，並評估性功能數據收集與人口統計學特徵、脊髓損傷特徵、康復中心和時間段之間的關聯。最終標準：國際脊髓學會（ISCoS）數據集中女性性功能和生殖功能、男性性功能、下尿路（LUT）、腸道、皮膚和肺功能的數據缺失情況。結果：在1126名個體（29%為女性）的數據集中，與下尿路、腸道、皮膚和肺功能相比，ISCoS性功能數據集的漏診率最高（46% vs 2%、4%、2%、2%；P < 0.0001）。不同數據集的評估不完整率也各不相同（性功能 vs 下尿路、腸道、皮膚和肺功能：4% vs 50%、45%、1%、1%；P < 0.0001）。女性完成性功能評估的比例低於男性（43% vs 58%，P < 0.0001）。2013-2016年，3個中心的數據收集率低於26%，但在一個常規提供醫生性功能諮詢的中心，數據收集率達到67%（P < 0.001）。在開展一項提高意識的活動後，所有中心的數據收集率均提高到≥61%。臨床意義：研究結果表明，與其他領域相比，性功能數據收集需要更多關注，例如，需要對醫護人員進行相關培訓。優勢和局限性：這是首項旨在描述性功能數據缺失情況並確定改善脊髓損傷急性期後康復期間性功能數據收集潛在策略的研究；然而，一些影響性功能的障礙因素仍未得到探討。結論：本研究強調，在脊髓損傷康復期間，性功能數據收集與其他臨床領域的數據收集存在顯著差異，尤其是在女性患者中。需要開展進一步研究，結合患者和醫護人員的視角，探討性功能評估被忽視的原因。 【關鍵詞】脊髓損傷、康復、性功能障礙、生理性性功能障礙、心理性性功能障礙、數據收集、調查和問卷 [Abstract] Background: Although sexual dysfunction after spinal cord injury (SCI) is common and impacts quality of life, healthcare professionals may avoid this topic due to discomfort and knowledge gaps. Missing sexual health data can bias research findings, yet this issue remains largely unexplored in the context of SCI. Aim: To describe missing sexual function data compared to other clinical domains and evaluate the association between changes in data collection procedures and missing data in females and males during post-acute specialized SCI rehabilitation. Methods: Data from the population-based, multi-center Swiss Spinal Cord Injury (SwiSCI) Inception Cohort study were utilized in cross-sectional analyses to evaluate missed and incomplete assessments across multiple areas of functioning during SCI rehabilitation. Logistic regression analyses were used to compare missing data across clinical assessments and to evaluate the associations between sexual function data collection and demographic characteristics, SCI characteristics, rehabilitation center, and time period. Outcomes: Missing data in the data sets from the International Spinal Cord Society (ISCoS) for female sexual and reproductive function, male sexual function, lower urinary tract (LUT), bowel, skin, and pulmonary function. Results: In data sets from 1126 individuals (29% female), ISCoS sexual function data sets had the highest rates of missed assessments compared to LUT, bowel, skin, and pulmonary function (46% vs 2%, 4%, 2%, 2%; P < .0001). Rates of incomplete assessments also varied across data sets (sexual function vs LUT, bowel, skin, and pulmonary: 4% vs 50%, 45%, 1%, 1%; P < .0001). Females had a lower percentage of completed sexual function assessments than males (43% vs 58%, P < .0001). From 2013-2016, data collection was <26% from the participants at 3 centers, but 67% at a center that routinely included a sexual function consultation with a physician (P < .001). Following an awareness initiative, the data collection rate improved to ≥61% at all centers. Clinical Implications: Findings highlight that compared to other domains, sexual function data collection requires additional consideration, for example, training of healthcare providers. Strengths and Limitations: This is the first study aimed at describing missing sexual function data and identifying potential strategies for improving sexual function data collection during post-acute SCI rehabilitation; however, some barriers to addressing sexual function remain unexamined. Conclusion: This study highlights significant disparities in sexual function data collection relative to other clinical domains during SCI rehabilitation, especially among females. Further research, incorporating both patient and provider perspectives, is needed to explore why sexual function assessments are overlooked. [Key words] Spinal cord injuries, rehabilitation, sexual dysfunction, physiological, sexual dysfunction, psychological, data collection, surveys and questionnaires 論文原文：Collene E Anderson, Gideon Sartorius, Sue Bertschy, et al (2026). Assessing sexual function in neurorehabilitation: insights and challenges from a spinal cord injury cohort. The Journal of Sexual Medicine, Volume 23, Issue 1, January 2026, https://doi.org/10.1093/jsxmed/qdaf330 （翻譯兼責任編輯：MARY） （需要英文原文的朋友，請聯繫微信：millerdeng95或iacmsp）
|
