**3. Results**

#### **3.1 Verification of the preliminary model of factors conditioning HRQOL for the research group**

Tables 1 - 4 present the results of our pathways analysis, the coefficients of the model, the covariance matrices observed in the sample, and the matrices reflected by the model.





Table 2. Coefficients for the model

138 Urinary Incontinence

Tables 1 - 4 present the results of our pathways analysis, the coefficients of the model, the

**3.1 Verification of the preliminary model of factors conditioning HRQOL for the** 

covariance matrices observed in the sample, and the matrices reflected by the model.

Table 1. Results of pathway analysis for factors conditioning HRQOL in the study

NEO.FFI agree -0.47 0.20 -2.37 **0.02**

NEO.FFI agree 0.06 0.20 0.28 0.78


NEO.FFI neuro -0.14 0.20 -0.72 0.47

NEO.FFI neuro -0.38 0.20 -1.89 **0.05**

NEO.FFI Agree 0.28 0.20 1.41 0.16

NEO.FFI neuro -0.01 0.26 -0.05 0.96

task -0.40 0.18 -2.25 **0.02**

emotion -0.28 0.26 -1.06 0.29

Coefficient SD z value *Compatibility*



Coefficient Value GFI (Goodness-of –fit-index) 0.96 AGFI (Adjusted goodness-of-fit –index) 0.88 RMSEA index 0 NFI (Bentler-Bonnett) 0.95 NNF (Tucker-Lewis) 1.38 CFI (Bentler) 1

*Chi squared* = 3.03 df= 9 Pr (>chsq)= 0.96

**3. Results** 

population

CISS emotionNEO.F FI agree

CISS avoid

CISS task

CISS emotion

CISS avoid

CISS task

NEO.FFI agree NEO.FFI neuro

HRQOL

HRQOL

HRQOL CISS

HRQOLCISS

**research group** 


Table 3. Observed covariance matrix


Table 4. Covariance matrix replicated by the model

A Model of the Psychological Factors Conditioning Health

Related Quality of Life in Urodynamic Stress Incontinence Patients After TVT 141

scores show better outcomes after surgical treatment (Berglund et al., 1997). It is reasonable

The model also shows a relationship between HRQOL and the task-oriented coping style, which may result from the possibility of overcoming the symptoms, which are much less in subjective evaluation after TVT. At the same time, the model shows a relationship between less frequent use of the task-oriented style and a higher level of HRQOL. It may seem that this dependence should be rather the reverse, since, in the opinion of many researchers (Janssen et al., 2001) coping with the symptoms of urinary incontinence requires a task-oriented approach. In the literature the most effective methods of coping with the symptoms of urinary incontinence are thought to include a restriction in the intake of fluids, very regular urination, making toilet maps (e.g. on the road from work to home), using single-use sanitary pads and napkins, and keeping a log of urination (Kinn & Zaar, 1998; Fitzerald et al., 2001; Janssen et al., 2001). These techniques correspond, interestingly enough, with both a task-oriented approach and an avoidance approach (all forms of restriction, such as avoiding fluids), though this is seldom stated directly. This may be at least a partial explanation of the dependency we found. It should also be emphasized that many researchers (e.g. Czapiński, 1994; Bidzan et al., 2004b) emphasize the advantages gained from combining styles of coping with the problem, e.g. task-oriented with emotion, since in this case the patient begins to take some action: to undergo treatment, to comply with physician's orders, to search for their own ways of coping with the problem (using also support networks), or finally to decide on surgery. In other words, they cope more effectively with the disease (cf. Shaw, 2001), which can have a favorable impact on their evaluation of HRQOL. The task-oriented approach alone, though it seems more efficient, is

to assume that improved psychological functioning has a positive effect on HRQOL.

not optimal, and when it is the only strategy used, it can lower HRQOL.

patients, and broader cooperation in the sphere of HRQOL.

undergone TVT: Neurotism - task style - HRQOL.

1. There is one indirect sequence of factors influencing HRQOL in USI patients who have

2. The relation between HRQOL and the task-oriented style may be associated with the possibility of overcoming the symptoms, which are significantly less in the evaluation

3. Our results point to the necessity for interdisciplinary cooperation between physicians and psychologists to develop effective interventions for genuine stress incontinence

Abrams, P.; Bliavas, J.G.; Stanton, S.L. & Andersen, J.T. (1988). Standarization of terminology of lower urinary tract function. *Neurourology and Urodynamics*, vol. 7, pp. 403-428 Abrams, P.; Cardozo, L.; Fall, M.; Griffiths, D.; Rosier, P.; Ulmsten, U.; van Kerrebroeck, P.;

Anders, K. (2000). Coping strategies for women with urinary incontinence. *Best Practice &* 

Banach, R. (2004). Wytyczne postępowania w nietrzymaniu moczu u kobiet. *Medycyna* 

tract function. *Neurourology and Urodynamics*, vol. 21, pp. 167-178

*Research in Clinical Obstetrics & Gynaecology*, vol. 2, pp. 355-61

*Rodzinna*, DOA 6 September 2011, Available from:

Victor, P. & Wein, A. (2002). ICS standarization of terminology of lower urinary

**5. Conclusions** 

**6. References** 

of patients after TVT.

These results made it possible to construct a model (see Fig. 2) of the factors conditioning HRQOL for these patients.

Fig. 2. A model of relations between selected psychological dimensions and HRQOL in women patients with UUI

In this model developed for patients who have undergone TVT surgery, one indirect sequence influencing the quality of life is observed: Neurotism – task-oriented style – quality of life. Neurotism has a negative effect on the selection of the CISS task-oriented style, and this determines a low level of HRQOL. The observed association with the task-oriented style may possibly be the result of dealing with the symptoms, whose severity decreased markedly in the patients' opinion following TVT surgery. Moreover, a direct positive influence of Neurotism is observed for the selection of the CISS emotion-oriented coping style. Additionally, Neurotism promoted a decrease in Agreeability (and therefore supported a confrontational attitude), hence activating emotion-oriented and avoidance-oriented styles. These latter findings, however, are not directly associated with the quality of life.
