基于跨理论模型的护理干预在产后尿失禁患者盆底肌功能锻炼中的应用

目的探讨基于跨理论模型的护理干预在产后尿失禁患者盆底肌功能锻炼中的应用效果。方法采用便利抽样法,选取2019年8月—2020年8月于北京协和医院盆底康复中心就诊的128例产后尿失禁患者为研究对象。按照患者就诊先后时间进行分组,将2019年8—12月收治的64例患者设为对照组,将2020年1—8月收治的64例患者设为观察组。对照组接受常规护理及健康指导,观察组在此基础上进行基于跨理论模型的护理干预。干预前及干预12周后评估两组患者的1 h尿垫试验漏尿量、盆底肌锻炼依从性及所处行为改变阶段。结果干预12周后,观察组的依从性优于对照组,差异有统计学意义(P<0.01)。干预12周后,观察组患者的1 h尿垫试验漏尿量少于对照组,差异有统计学意义(P<0.01)。干预12周后,观察组行动阶段和维持阶段人数多于对照组,差异有统计学意义(P<0.01)。结论应用基于跨理论模型的护理干预能够提高产后尿失禁患者盆底肌锻炼依从性、治疗效果,促进健康行为的建立。

Application of nursing intervention based on the trans-theoretical model in pelvic floor muscle training of patients with postpartum urinary incontinence

Objective To explore the application effect of nursing intervention based on the transtheoretical model(TTM)in pelvic floor muscle training(PFMT)of patients with postpartum urinary incontinence.Methods Using the convenient sampling method,a total of 128 patients with postpartum urinary incontinence who were treated at the Pelvic Floor Rehabilitation Center of Peking Union Medical College Hospital from August 2019 to August 2020 were selected as the research objects.The patients were grouped according to the time of their visits.A total of 64 patients admitted from August to December 2019 were set as the control group and the 64 patients admitted from January to August 2020 were set as the observation group.The control group received routine nursing and health guidance and the observation group received nursing intervention based on the trans-theoretical model on this basis.Before intervention and 12 weeks after intervention,patients in the two groups were evaluated for urine leakage volume in 1-hour pad test,compliance of pelvic floor muscle training and the stage of behavior change.Results After 12 weeks of intervention,the compliance of the observation group was better than that of the control group,and the difference was statistically significant(P<0.01).After 12 weeks of intervention,the urine leakage volume in 1-hour pad test in observation group was less than that in the control group,and the difference was statistically significant(P<0.01).After 12 weeks of intervention,the number of patients in the action stage and maintenance stage in the observation group was higher than that in the control group,and the difference was statistically significant(P<0.01).Conclusions The application of nursing intervention based on the trans-theoretical model can improve the compliance and treatment effect of pelvic floor muscle training in patients with postpartum urinary incontinence and promote the establishment of healthy behaviors.