Study On Effects Of Self-management Intervention On Pelvic Floor Muscle Training Of Female Patients With Stress Urinary Incontinence

Objective1.To formulate the self-management intervention which is suitable for the female patients with SUI.2.To investigate the effect of self-management intervention on improving knowledge,the patients,compliance and symptoms in female patients with SUI.Methods1.The research on 2 communities from Zhengzhou were randomly divided into an intervention group and a control group by coin flipping,each community includes 53 female patients with SUI from November 2015 to May 2016.The control group was given routine nursing:health education,providing booklets-PFMT in Patients with SUI,teaching PFMT and telephone counseling;The intervention group was also given routine nursing.The researchers understood the knowledge of congnition,emotion management and exercise condition through the baseline data.Furthermore,based on the theory of self-management and the guideline for the diagnosis and treatment of famale patients with SUI,a self-management intervention program was constructed.It was implemented to the intervention group,which contains health education,sports guidance,reasonable guidance,strengthen follow-up.It was in the form of health education seminars,one-on-one teaching guidance,spiritual encouragement,phone We Chat tracking,health diary.The intervention lasted for 6 months.2.The patients' demographic and disease related data were collected by the general questionnaire.SUI knowledge scores,the severity of SUI and self-efficacy scores were assessed upon baseline,the 3rd month and 6th month after intervention.The patients' compliance and clinical therapeutic effect in the intervention group were assessed upon the 3rd month and 6th month after intervention.3.The data was analyzed with SPSS17.0.Statistical analysis methods include descriptive statistics,t test,chi-square test,rank test and analysis of variance of repeated measurement,etc.Results1.The valid sample finally contained 103 patients,52 patients in the control group,51 patients in the intervention group.In terms of population sociology,disease conditions,knowledge of SUI,pelvic muscle self-efficacy and severity of SUI,there were no significant differences between the two groups(P>0.05).2.The results of repeated measurement analysis of variance indicated that the intervention group had shown a better recovery in the tatal scores of SUI knowledge and various aspects than the control group(P<0.05).The intervention group patients with the tatal scores of SUI knowledge increased from 3.59±1.37 to 8.90±1.47,12.47± 1.57;the scores of SUI knowledge increased from 1.02±0.73 to 2.19±0.78,3.14±0.86;the scores of daily life management knowledge increased from 2.43±0.81 to 3.69± 0.78,4.78±0.85;the scores of PFMT knowledge increased from 0.19±0.40 to 3.02± 0.68,4.55±0.93;There were statistical differences in the scores of SUI knowledge,daily life management knowledge and PFMT knowledge between two groups at 3 months and 6 months after intervention respectively(P<0.05).3.The results of repeated measurement analysis of variance indicated that the intervention group had shown a better recovery in the tatal scores of self-efficacy and various aspects than the control group(P<0.05).The intervention group patients with the tatal scores of self-efficacy increased from 108.12±10.71 to 126.61±10.66,144.63 ±9.61;the scores of expected self-efficacy increased from 58.43±6.52 to 68.57±5.91,79.71±5.80;the scores of eexpected result increased from 49.69±8.56 to 58.04±8.22,64.92±7.59;There were statistical differences in the scores of expected self-efficacy and expected result between two groups at 3 months and 6 months after intervention respectively(P<0.05).4.The results of chi-square test indicated that there were statistical differences in the compliance of PFMT between two groups at 3 months and 6 months after intervention respectively(P<0.05);at 3 months and 6 months after intervention,the good compliance of PFMT was 31(60.78%)and 37(72.55%),respectively.5.The results of repeated measurement analysis of variance indicated that the intervention group had shown a better recovery in the scores of ICI-Q-SF than the control group(P<0.05).The intervention group patients with the scores of ICI-Q-SF declined from 10.86±3.80 to 6.47±3.91,3.25±2.74;There were statistical differences in the scores of ICI-Q-SF between two groups at 3 months and 6 months after intervention respectively(P<0.05).6.The results of Mann-Whitney U test indicated that there were statistical differences in one-hour pad test between two groups at 3 months and 6 months after intervention respectively(P<0.05).There were no statistical differences in the clinical therapeutic effect between mild(69.57%)and moderate(60.71%)SUI patients of the intervention group at 3 months(P>0.05).There were statistical differences in the clinical therapeutic effect between mild(86.96%)and moderate(75.00%)SUI patients of the intervention at 6 months(P<0.05).ConclusionSelf-management intervention is a safe and effective intervention style.It can improve the knowledge of SUI,the confidence of PFMT,the compliance of PFMT and the severity of SUI.We can promote this intervention.Long term self-management intervention in patients with mild stress urinary incontinence is superior to moderate stress urinary incontinence.