Application Of Nursing Intervention Based On The Theory Of Planned Behavior In Pelvic Floor Rehabilitation Exercise Of Puerperal Women

Objective:This study developed a nursing intervention program based on the theory of planned behavior,and explored the effects of the program on the cognition level of pelvic floor dysfunction diseases,pelvic floor muscle exercise self-efficacy,pelvic floor muscle exercise compliance and pelvic floor muscle fiber strength of puerperal women,aiming to improve the cognition of puerperal diseases,promote the transformation of exercise intention to exercise behavior,so as to obtain good rehabilitation outcomes.Method:From December 2021 to June 2022,convenience sampling was used to select 80 primiparas aged 18-35 who underwent vaginal delivery in the obstetrics department of a Grade A hospital in Shanxi Province as the research objects.In order to avoid contamination between groups,primiparas in ward 1(n=40)were selected as the intervention group and primiparas in ward 2(n=40)were selected as the control group.The control group was given routine pelvic floor rehabilitation guidance,such as the distribution of pelvic floor rehabilitation knowledge manual,pelvic floor muscle exercise guidance,discharge education,telephone follow-up and other routine nursing.The intervention group implemented the pelvic floor rehabilitation intervention program based on the theory of planned behavior on the basis of the control group.The pelvic floor dysfunction knowledge questionnaire,pelvic floor muscle exercise self-efficacy scale and pelvic floor functional exercise compliance questionnaire were used to evaluate the intervention effects before the intervention,7 days,14 days,28 days and 42 days after delivery,and the differences in pelvic floor muscle fiber strength between the two groups were compared at postpartum reexamination.The data were analyzed and processed by SPSS 26.0 statistical software.Results:1.The baseline data of 76 primiparas were collected in this study,including 37 cases in the intervention group and 39 cases in the control group.Before intervention,there was no statistically significant difference in general information of primiparas between the two groups(P>0.05),which were comparable.2.The knowledge scores of pelvic floor dysfunction were compared between the two groups.The results of repeated measures ANOVA showed that there was a time effect in the knowledge scores of the two groups at different time points(F=1444.185,P<0.001),indicating that the knowledge scores at each time point in the two groups had changed.There was an interaction effect between time and group(F=57.067,P<0.001),indicating that the knowledge scores of the two groups changed with time,and the increase of knowledge scores of the intervention group was greater than that of the control group.The knowledge scores were compared between the two groups at each time point.Before intervention,there was no statistical difference in scores between the two groups(P>0.05).At 7 d,14 d,28 d and 42 d postpartum,the scores of the intervention group were higher than those of the control group(P<0.05).3.The self-efficacy scores of pelvic floor muscle exercise were compared between the two groups.The results of repeated measures ANOVA showed that there was a time effect in the self-efficacy scores of pelvic floor muscle exercise at different time points in the two groups(F=480.493,P<0.001),which showed that the self-efficacy scores of pelvic floor muscle exercise at each time point in the two groups had changed.There was an interaction effect between time and group(F=17.241,P<0.001),indicating that the self-efficacy scores of pelvic floor muscle exercise in the two groups varied with time,and the increase in the intervention group was better than that in the control group.The self-efficacy scores of pelvic floor muscle exercise were compared between the two groups at each time point.Before intervention,there was no statistically significant difference between the two groups(P>0.05).The scores of the intervention group were higher than those of the control group at 7 d,14 d,28 d and 42 d after delivery(P<0.05).4.The compliance scores of pelvic floor muscle exercise were compared between the two groups.The results of repeated measures ANOVA showed that there was a time effect on the compliance scores of pelvic floor muscle exercise at different time points in the two groups(F=1111.210,P<0.001),which showed that the compliance of pelvic floor muscle exercise at each time point in the two groups had changed.There was an interaction effect between time and group(F=39.150,P<0.001),indicating that the compliance scores of the two groups showed an increasing trend with time,and the compliance of the intervention group was better than that of the control group.The compliance scores of the two groups at each time point were compared,and there was no statistical difference in the pelvic floor functional exercise compliance scores between the two groups before the intervention and7 days after delivery(P>0.05).At 14,28 and 42 days after delivery,the compliance of the intervention group was better than that of the control group(P<0.05).5.The postpartum pelvic floor muscle fiber muscle strength between the two groups was compared at 42 days after delivery.The grading of pelvic floor muscle fiber strength in the intervention group was better than that in the control group,and the difference was statistically significant(P<0.05).Conclusion:Nursing intervention based on the theory of planned behavior can effectively improve the cognitive level of pelvic floor dysfunction of primiparas,enhance the self-efficacy of pelvic floor muscle exercise of primiparas,improve the compliance of pelvic floor muscle exercises and pelvic floor muscle fiber muscle strength.