| ObjectiveUrinary incontinence is a common and popular disease in the female population. According to International Continence Society, it is defined as"One of the elements of social and sanitary problems, involuntary leakage of urine which can be objectively proved."In mid-ninetieth of the 20th century, it was ranked by ICS as one of the five major human diseases, labeled as"Social Cancer". The latest report shows that there are almost 2000,000,000 UI patients all through the world. UI influences badly on female health, career and their quality of life. It does great harm to female psychic, and places heavy burden on both families and society. Particularly after radical hysterectomy of cervical cancer, with the different anatomic structure of pelvic cavit, and the anatomic position of bladder and urethra caused by prolapse of uterus and bulge of paries anterior vaginase, the strength of ligaments weakens, which leads to ptosis of vagina stump. When abdominal pressure increases, the weak parts of the supporting tissue cannot resist the chronic gravity, and the contract of pubourethral ligament and pubococcygeus cannot tractate vagina. Hence the urethra cannot be occluded effectively, which causes UI. Besides neurologic damage, UI is associated most often with exudation, hemorrhage, adhesion and fibrosis around bladder.Therefore it is of great clinical instructive significance to perform systematical action intervention to cure or alleviate the symptoms of UI after radical hysterectomy of cervical cancer, and help to increase the satisfactory state of patients'physiological, psychological, and social aspects, which is also the pressing requirement of clinical work.This research is based on the demands of developing medical treatment of UI, aims to cure or alleviate the symptoms of patients with UI after radical hysterectomy of cervical cancer by performing systematical action intervention, thereby enhancing their life quality, and also provides theoretical foundation for bringing action intervention into the clinical routine nursing care.Objects61 case patients with UI after radical hysterectomy of cervical cancer are selected, who were hospitalized in No.1 and 2 Sanatorium of the department of medical oncology of the Second Hospital of Jilin University between May 2006 and November 2008. They must satisfy the following conditions:â‘ aware and awake, with ability of normal speechâ‘¡diagnosed with UI specificly.â‘¢agreed to write the tests, and communicate with researcher through words or speech.â‘£severe physiological barrier, mental disorder, hearing problem and eyesight obstacle excluded. MethodsPut these 61 case patients into two groups: 31 of No.1 Sanatorium as experimental group with action intervention performance, and 30 of No.2 Sanatorium as control group.For experimental group, action intervention is conducted based on the routine nursing care of UI, including pelvic floor muscle exercises, policy on urgency and bladder training. Meantime only daily routine nursing care is given to control group.30 minutes a day of intervention last for 6 weeks. Before-and-after intervention, ICI-Q-SF, SDS and SF-36 of International UI Consultative Committee are separately adopted for evaluation on both groups.ResultBefore intervention, patients of both groups have no significant difference in age, career, marital status, educational level, disease stage, payment mode and economic income(p>0.05),which shows experimental subjects are homogeneous.After intervention, patients of both groups have significant differences in PF, RP, GH, SF, RE and MH(p<0.01)according to the result of ICI-Q-SF, SDS and SF-36, yet the changes of BP and VT in SF-36 are in no statistical sense(p>0.05).Before-and-after intervention, the self-reflection of experimental group shows grade points of ICI-Q-SF and SDS reduce greatly. And they are significantly different(p<0.01),so are grade points of PF, RP, GH, SF, RE and MH in SF-36(p<0.01).ConclusionBy adopting brigade laboratory method, this research constructs a pointed scheme of action intervention based on the main and direct factors affecting on quality of life of patients with UI after radical hysterectomy of cervical cancer. After 6 weeks'action intervention on 31 case patients with UI of experimental group, the following result is obtained:This research proves action intervention helps to significantly improve continent ability of patients with UI. After action intervention, continent ability of patients is improved, urination intervals are extended, and the embarrassment of missing toilet is avoided.Action intervention can enhance the social function of patients with UI, encourage them to communicate more often with their families, friends and other patients, so that they can truly express their inner yearning. Also it helps to increase patients'availability of social support. After action intervention, patients'social function and social support are greatly improved.Action intervention improves remarkably the psychological and physical status of patients with UI. After systematic action intervention the psychological and physical status of patients are improved. Their life satisfaction rating is increased, so is their QOL eventuallyAction intervention improves the sleep quality as well. After action interv-ention, about half of the patients state their sleep quality is improved, and they do not get up in the night to urinate as frequently as they used to. This effect associates with the fact that during the process of action intervention researcher encourages the patients to confront against UI actively, and relieves their mental stress. Beyond this, urination intervals are extended, frequency of getting up in the night to urinate is reduced. As a result, they do not have to change pads frequently, and sleep quality is adequately improved.This research proves it is feasible to improve quality of life of patients with UI after radical hysterectomy of cervical cancer by means of action intervention, also with great theoretical significance and practical value. |
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