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护理学报 ›› 2023, Vol. 30 ›› Issue (3): 1-5.doi: 10.16460/j.issn1008-9969.2023.03.001

• 研究生园地 •    下一篇

孕产妇盆底肌训练自我效能发展轨迹及其对产后尿失禁的影响

刘莎1,2, 陈玲1, 李甜甜1, 张丹莉1,2, 蔡文智1,2   

  1. 1.南方医科大学深圳医院 护理部,广东 深圳 518101;
    2.南方医科大学 护理学院,广东 广州 510515
  • 收稿日期:2022-10-28 出版日期:2023-02-10 发布日期:2023-03-14
  • 通讯作者: 蔡文智（1970-）,女,福建南安人,博士,主任护师,副院长,博士研究生导师。E-mail：caiwzh@smu.edu.cn
  • 作者简介:刘莎（1997-）,女,重庆人,本科学历,硕士研究生在读。
  • 基金资助:
    国家自然科学基金青年科学基金项目（71904075）; 教育部人文社会科学研究规划基金项目(21YJAZH001); 南方医科大学深圳医院临床研究启动计划（LCJH202001）

Developmental trajectory of pelvic floor muscle training self-efficacy in antenatal and postnatal women and its impact on postpartum urinary incontinence

LIU Sha1,2, CHEN Ling1, LI Tian-tian1, ZHANG Dan-li1,2, CAI Wen-zhi1,2   

  1. 1. Dept. of Nursing Administration,Shenzhen Hospital,Southern Medical University, Shenzhen 518101, China;
    2. School of Nursing,Southern Medical University, Guangzhou 510515, China
  • Received:2022-10-28 Online:2023-02-10 Published:2023-03-14

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摘要： 目的 探讨孕产妇盆底肌训练自我效能发展轨迹及其对产后尿失禁的影响。方法 数据来源于前期开展的1项随机对照试验,于2020年6—10月在深圳市某三级甲等医院产科门诊招募了126名研究对象。对照组采用常规护理,观察组在此基础上,使用APP进行尿失禁自我管理。于干预前、干预后2个月及产后42 d收集资料。采用Mplus 7.4对盆底肌训练自我效能发展轨迹进行潜类别增长模型分析;采用Logistic回归,分析干预因素对盆底肌训练自我效能发展轨迹的影响,探讨盆底肌训练自我效能发展轨迹对产后尿失禁的预测效果。结果 最终共有103名研究对象完成所有时间节点的随访。年龄（28.75±3.33）岁。潜类别增长模型拟合了4个潜类别,分别是：C1高功能组（56.3%）、C2发展组（9.7%）、C3阻滞组（22.3%）、C4低功能组（11.7%）。回归分析发现,相比于低功能组的孕妇,高功能组和发展组的孕妇产后尿失禁的风险是降低的（分别为P=0.002及P=0.025）;观察组孕妇盆底肌训练自我效能发展轨迹更有可能呈现上升趋势（OR：0.055,95%CI：0.016~0.188,P<0.001）。结论 孕产妇盆底肌训练自我效能发展轨迹存在不同类别,基于APP的尿失禁管理手段对其增长趋势有促进作用,盆底肌训练自我效能呈增长趋势者发生产后尿失禁的风险更低。

关键词: 尿失禁, 围产期, 移动医疗, 随机对照试验, 潜类别增长模型

Abstract: Objective To explore the development trajectory of pelvic floor muscle training self-efficacy in antenatal and postnatal women and its impact on postpartum urinary incontinence. Methods Data were collected from a randomized controlled trial in which 126 participants were recruited from June to October 2020 in the obstetric clinic of one tertiary grade-A hospital in Shenzhen. In the control group, conventional care was performed, while in the observation group, self-management of urinary incontinence was carried out using the APP in addition to conventional care. Data were collected before the intervention, 2 months after the intervention and 42d after delivery. Mplus 7.4 was used to analyze the latent category growth model of the pelvic floor training self-efficacy development trajectory. Logistic regression was used to analyze the effect of intervention factors on pelvic floor training self-efficacy development trajectory and to explore the predictive effect of pelvic floor training self-efficacy development trajectory on postpartum incontinence. Results One hundred and three participants eventually completed follow-up at all-time points, with mean age of 28.75±3.33 years. Latent class growth model were fitted to four latent categories: C1 (high functioning group, 56.3%), C2 (developmental group, 9.7%), C3 (blocked group, 22.3%), and C4 (low functioning group, 11.7%). Regression analysis found that the risk of postpartum incontinence was reduced in the high-functioning and developmental group when compared to that in the low-functioning group (P=0.002 and P=0.025); pregnant women in the observation group were more likely to show an upward trajectory of pelvic floor muscle training self-efficacy development (OR: 0.055, 95%CI: 0.016~0.188, P<0.001). Conclusion There is significant heterogeneity in the development trajectory of maternal pelvic floor training self-efficacy. APP-based incontinence management tools contribute to the increasing trend of the development, and those with an increasing trend in pelvic floor training self-efficacy are with lower risk of developing postpartum incontinence.

Key words: urinary incontinence, perinatal, mobile health, randomized controlled trial, latent class growth model

中图分类号: 

  • R473.71
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