Investigation On Pelvic Floor Muscle Training Adherence And Influencing Factors In Postpartum Stress Urinary Incontinence Women

Background:Pregnancy and childbirth are independent risk factors of postpartum urinary incontinence.The incidence of postpartum urinary incontinence is high,the main type is stress urinary incontinence.Pelvic floor muscle training is a first-line treatment of the prevention and treatment of postpartum urinary incontinence.The effectiveness of pelvic floor muscle training depends on women's adherence.Unlike older women,postpartum women are in a period of physical and mental recovery,and the factors that affect their pelvic floor training may differ from those of other women.Therefore,it is necessary to investigate the current situation of pelvic floor muscle training adherence and analyze its influencing factors,so as to provide theoretical basis for clinical intervention of controllable factors.Objective:To describe the postpartum stress urinary incontinence women postpartum 12 weeks pelvic floor muscle training adherence status.To explore the influencing factors of pelvic floor muscle training in postpartum stress incontinence women at 12 weeks postpartum.Methods:This study is descriptive study.Convenient selection from January 2018 to January 2019 in Beijing Obstetrics and Gynecology Hospital maternity pelvic floor clinics 213 postpartum stress urinary incontinence women.At 6 weeks postpartum used questionnaire to collect data of women's general situation and son on;Chinese version of international incontinence advisory committee on urinary incontinence questionnaire summary table was used to measure the degree of postpartum stress urinary incontinence.Pelvic floor electromyography biofeedback instrument was used to evaluate the value of pelvic floor electromyography and the abdominal muscle involvement during pelvic floor muscle training.At 8 weeks postpartum,10 weeks postpartum and 12 weeks postpartum,the pelvic floor muscle training adherence questionnaire was used to measure the adherence level.The pelvic floor muscle training self-efficacy scale,postpartum social support scale,puerperal pelvic floor function training knowledge,practice and demand questionnaire were used to measure the self-efficacy,postpartum social support,knowledge,practice and demand of pelvic floor muscle training.The Chinese version of the international incontinence questionnaire was used to measure the degree of postpartum stress incontinence.The electrical value of pelvic floor muscle and the abdominal muscle involvement during pelvic floor muscle training were collected again.The significant variables in the single factor analysis were fitted to the multiple linear regression model,and the multiple linear regression equation was used to screen out the factors affecting the compliance of puerpera pelvic floor muscle training.Eight women with postpartum stress urinary incontinence were interviewed by semi-structured interview to further explore and analyze the factors affecting pelvic floor muscle training.Results:1.The total scores of pelvic floor muscle training adherence at 8 weeks,10 weeks and 12 weeks after delivery were 13.47 ±4.42,10.76 ±4.46 and 7.95±5.54,at a medium level and showed a declining trend.2.Multivariate analysis showed that the major factors influencing the adherence of pelvic floor muscle training in women with postpartum stress urinary incontinence were rapid contractile electromyography value at 12 weeks postpartum(P=0.010),sustained contractile electromyography value at 12 weeks postpartum(P=0.004),knowledge and practice status of pelvic floor function training(P<0.01),postpartum social support status(P<0.01),and self-efficacy level of pelvic floor muscle training(P<0.01),67.9%of the total variation was explained.The interview results showed that the main factors affecting the adherence of pelvic floor muscle training in women with postpartum stress incontinence were:Poor proprioception of pelvic floor muscles,poor pelvic-abdominal coordination,suffering from discomfort other than urinary incontinence,poor knowledge of pelvic floor muscle training,worrying about long-term symptoms,relying on medical means,family and child factors.Conclusion:The pelvic floor muscle training adherence of postpartum stress incontinence women was at the medium level and decreased with time.The influencing factors of pelvic floor muscle training adherence were constant systolic electromyography,rapid systolic electromyography,knowledge,self-efficacy,postpartum social support level,suffering from other discomfort and relying on medical means.In clinical,we should select effective methods to improve women's pelvic floor muscle training adherence.