| Object:The psychosocial status of female Pelvic Floor disorders(PFD)patients was investigated and its influencing factors were explored.On this basis,Cognitive Behavioral Therapy(CBT)program was made for female PFD patients,and applied to PFD patients.The efficacy of CBT was evaluated,and the theoretical basis for the psychosocial intervention of female PFD patients was provided.Methods:This study was divided into two parts.PART One: Eligible subjects were selected from participants who participated in the screening of PFD in Alaer and Shihezi of Xinjiang from April 2019 to May 2019.Among them,109 patients with PFD were set as the PFD group,and 109 patients without PFD were set as the control group.General Demography Questionnaire,PFDI-20,Hamilton Depression Scale(HAMD),Hamilton Anxiety Scale(HAMA),Eysenck Personality Questionnaire(EPQ),Simplified Coping Style Questionnaire(SCSQ),Social Support Revalued Scale(SSRS)and Life Events Scale(LES)were measured.Two independent samples t-test or non-parametric test(Mann-Whitney U test)were used to compare the differences in the scores of each scale between the two groups.Spearman correlation was used to analyze the correlation between various factors in the PFD group,and binomial logistic regression was used to analyze the influencing factors of PFD.PART Two: In the outpatient department of the First Affiliated Hospital of the School of Medicine of Shihezi University from August 2019 to December 2019,60 PFD patients who came for pelvic floor rehabilitation were randomly selected by coin toss method,and they were divided into intervention group and control group with 30 patients each by random number table method.The control group was given routine rehabilitation treatment,and the intervention group was given CBT on the basis of the control group.General Demography Questionnaire,EPQ,LES,PFDI-20,HAMD,HAMA,SSRS,SCSQ were evaluated before intervention,and PFDI-20,HAMD,HAMA,SSRS,SCSQ were evaluated again after intervention for 4weeks.To evaluate the effect of CBT on women with PFD,Two independent samples t-test or non-parametric test(Mann-Whitney U test)were used to compare the differences of each scale scores between the intervention group and the control group before and after the intervention,and the paired t-test or nonparametric paired test(Wilcoxon test)was used to compare the differences between before and after the intervention in the intervention group and the control group.Results:PART One:(1)There were no statistical differences in age,Body Mass Index(BMI),educational level and parity between the PFD group and the control group(P>0.05),and they were comparable.(2)PFDI-20 total score(Z=-8.231,P<0.001)and three subscales PODI-6(Z=-4.401,P<0.001),CRADI-8(Z=-3.467,P=0.001),UDI-6(Z=-10.478,P<0.001)were higher in the PFD group than in the control group.(3)The total score of HAMD(Z=-3.093,P=0.002)and HAMA(Z=-2.918,P=0.004)in PFD group were higher than in the control group.The degree of depression(Z=-3.195,P=0.001)and anxiety(Z=-3.360,P=0.001)in the PFD group were more serious than in the control group.(4)The scores of negative coping(t=-2.901,P=0.004),neuroticism(Z=-2.017,P=0.044)and negative life events(Z=-2.018,P=0.044)in the PFD group were higher than those in the control group(Z=-2.018,P=0.044).(5)The total score of SSRS(t=-2.286,P=0.023),the factor score of subjective social support(Z=-2.012,P=0.044)and available social support(Z=-3.442,P=0.001)in the PFD group were lower than in the control group.(6)PFDI-20 scores were positively correlated with HAMA and neuroticism scores.HAMD scores were positively correlated with HAMA,negative coping,neuroticism and negative life events.HAMA score was positively correlated with negative coping and neuroticism.Negative coping scores were positively correlated with neuroticism scores.The neuroticism score was positively correlated with the score of negative life events.(7)HAMD(OR=2.150,95%CI=1.044～4.428),HAMA(OR=2.085,95%CI=1.101～3.948)and negative coping(OR=1.830,95%CI=1.016～3.295)were the risk factors of PFD.SSRS(OR=0.472,95%CI=0.247-0.901)was a protective factor for PFD.PART Two:(1)Before intervention,there was no statistical difference in age,BMI,educational level,EPQ and LES scores between the intervention group and the control group,indicating comparability.(2)Before intervention,there was no statistical difference in PFDI-20 scores between the intervention group and the control group.After intervention,PFDI-20 scores in both the intervention group and the control group were lower than before intervention(t=7.575,P<0.001;Z=5.101,P<0.001);the PFDI-20 score of the intervention group was lower than that of the control group(Z=-2.961,P=0.003).(4)Before intervention,there was no statistical difference in HAMD scores between the intervention group and the control group.After intervention,the score of HAMD in the intervention group was lower than that before intervention(t=5.385,P<0.001),and less than the control group(Z=-3.016,P=0.003).(5)Before intervention,HAMA score difference between the intervention group and the control group was not statistically significant.After intervention,HAMA scores in both the intervention group and the control group were lower than before intervention(t=10.317,P<0.001;t=4.569,P<0.001),and HAMA score of the intervention group was lower than that of the control group(Z=-4.422,P<0.001).(6)Before intervention,there was no statistical difference in SSRS scores between the intervention group and the control group.After intervention,total SSRS score(t=-3.839,P<0.001),the factor score of subjective social support(t=-3.813,P<0.001)and available social support(t=-2.400,P=0.023)in the intervention group were all higher than those before intervention;the total SSRS score of the intervention group(t=2.208,P=0.031)and the factor score of available social support(Z=-2.354,P=0.019)were higher than those of the control group.(7)Before intervention,there was no statistical difference in SCSQ scores between the intervention group and the control group.After intervention,the score of positive coping was higher than that before intervention(t=-5.089,P<0.001),while the score of negative coping was lower than that before intervention(t=3.419,P=0.002);the positive coping score of the intervention group was higher than that of the control group(t=2.100,P=0.040),and the negative coping score of the intervention group was lower than that of the control group(t=-2.123,P=0.038).Conclusion:1.Compared with the general population,the pelvic floor symptoms of PFD patients are obvious,PFD patients have some characteristics of psychosocial factors,including common depression and anxiety,neurotic personality,more negative coping styles,poor social support,and more negative life events.There is a certain correlation between psychosocial factors in patients with PFD,and psychosocial factors and the symptoms of PFD also have a certain correlation.Depression,anxiety and negative coping style are the risk factors for PFD,and good social support is the protective factor for PFD.2.To PFD patients,CBT can improve the pelvic floor symptoms,make their quality of life enhanced,alleviate the depression and anxiety of patients,improve the social support of patients,increase the subjective feeling and use of support,and make patients prefer positive response to events. |
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