Compliance Of Pelvic Floor Muscle Training And Its Influencing Factors In Patients After Radical Prostatectomy

Urinary incontinence is one of the common complications in patients after radical prostatectomy,and pelvic floor muscle training is the first-line conservative treatment for managing urinary incontinence,but its effectiveness depends on patients’ compliance.Among the existing studies on pelvic floor muscle training adherence,there are few studies focusing on patients’ compliance and influencing factors after radical prostatectomy.It is helpful to clarify the current status and main influencing factors of pelvic floor muscle training in such patients,so as to apply targeted clinical interventions for them and improve their compliance,thereby improving their quality of life.Objective:（1）To describe the status of pelvic floor muscle training compliance in patients after radical prostatectomy;（2）To clarify the main factors affecting the compliance of pelvic floor muscle training in patients after radical prostatectomy;（3）To analyze the mediating role of pelvic floor muscle training self-efficacy between patients’ anxiety,depression,social support and pelvic floor muscle training compliance,so as to provide empirical evidence for developing corresponding intervention programs.Methods: Patients who underwent radical prostatectomy in the Department of Urology,a tertiary hospital in Anhui Province from December 2019 to July 2021 were enrolled in this study.Before discharge,the patients were asked to fill in the sociodemographic data,disease-related data,and Broome Pelvic Muscle Self-Efficacy Scale（BPMSES）,General Hospital Anxiety and Depression Scale（HADS）,Social Support Rating Scale（SSRS）to evaluate the level of pelvic floor muscle training selfefficacy,anxiety,depression,and social support.At one month after operation,the pelvic floor muscle training compliance scale,International Continence Advisory Committee urinary incontinence questionnaire short form（ICI-Q-SF）were used to evaluate the compliance of pelvic floor muscle training and the degree of urinary incontinence by telephone,outpatient or We Chat.Independent samples t-test,one-way ANOVA,Pearson correlation analysis,multiple linear regression analysis were used to explore the influence of PFMT adherence in patients after radical prostatectomy.Mplus8.1 was used to analyze the mediating effect of pelvic floor muscle training self-efficacy between patients’ anxiety,depression,social support and pelvic floor muscle training compliance after radical prostatectomy,and the significance of the mediating effect was tested by Bootstrap analysis.Results:1.The average score of pelvic floor muscle training compliance of patients after radical prostatectomy at one month after surgery was（11.88 ± 4.29）points.Among them,29.2% were in good compliance,58.5% in general compliance,and 12.3% in poor compliance.2.Results of univariate analysis showed statistically significant differences（P<0.05）in patients’ pelvic floor muscle training adherence scores according to demographic factors（age,marital status,annual household income per capita,educational level,occupation,Medicare type）.3.Pearson’s correlation analysis showed that the score of the pelvic floor muscle training compliance in patients after radical prostatectomy was positively correlated with the total score of urinary incontinence（r = 0.631,P < 0.001）,the total score of pelvic floor muscle training self-efficacy and the total score of each dimension（r = 0.792～0.818,P < 0.001）and the total score of social support and the total score of each dimension（r = 0.652～0.787,P < 0.001）.It was negatively correlated with anxiety and depression levels（r =-0.744,P < 0.001;r =-0.776,P < 0.001）.4.Multiple linear regression analysis showed that patients’ age,annual household income,education level,urinary incontinence level,self-efficacy level of pelvic floor muscle training,anxiety and depression level,social support status were significant influencing factors for pelvic floor muscle training compliance of patients after radical prostatectomy（P < 0.05）.5.The results of mediating effects analysis showed that pelvic floor muscle training self-efficacy has a partial mediating effect between anxiety,depression,social support and pelvic floor muscle training compliance and the percentage of mediating effects was32.20%,28.00%,27.60% respectively,and the test of the significance of mediating effects showed that the mediating effect was significant.Conclusion: Pelvic floor muscle training compliance in patients after radical prostatectomy was at a low to medium level.The main factors affecting pelvic floor muscle training compliance include: Patients’ age,annual household income per capita,education level,urinary incontinence level,pelvic floor muscle training self-efficacy,anxiety,depression,social support status.When patients after radical prostatectomy are younger,their family per capita annual income is higher,their education level is higher,their urinary incontinence is more serious,their self-efficacy level for pelvic floor muscle training is higher,their mental health is better,their social support is better,then their compliance of pelvic floor muscle training is better.And pelvic floor muscle training selfefficacy had a partial mediating effect between anxiety,depression,social support and pelvic floor muscle training compliance among patients after radical prostatectomy,and the mediating effect was significant.