Mason L, Glenn S, Walton I, Hughes C
School of Health, Liverpool John Moores University, UK.
Midwifery. 2001 Mar;17(1):55-64. doi: 10.1054/midw.2000.0235.
to examine the instruction in pelvic floor exercises given to women during pregnancy or following delivery, to assess the quality of any instruction provided, and to consider these in light of the women's views about the service.
a postal questionnaire was sent to a sample of women when they reached 34 weeks of pregnancy and a second at 8 weeks postpartum. A sub-sample of women who reported symptoms of stress incontinence at 8 weeks postpartum were interviewed about the instruction in pelvic floor exercises that they received during their pregnancy, or in the puerperium.
of the 918 women who were sent the first questionnaire, 717 returned it completed (78%). Five-hundred-and-seventy-two of 894 women (64%) completed the second questionnaire. Forty-two of 179 symptomatic women (23%) took part in an interview.
55% of women received some form of instruction in pelvic floor exercises by 34 weeks of pregnancy. Eighty-six percent received instruction following birth. The way the information was given varied, ranging from a brief reminder, to exercising in a class with an instructor. The information was provided by a range of health professionals, and no single profession appeared to undertake responsibility for the service. As a result, the views of the service varied. A few women reported that they had received good quality instruction, others were critical of it, and a small number reported that they had received no instruction at all. The widespread practice of leaving a leaflet by the women's beds during their stay in hospital, was criticised by a large proportion of the women.
the instruction in pelvic floor exercises by health service professionals was provided on an ad hoc basis. In many instances, the programme of instruction did not meet recommendations made in the literature. It is likely that the success of randomised controlled trials reported in the literature would not be repeated in the 'real world' Implications for practice: there is a need for the service to be reorganised so that all women receive high-quality instruction during pregnancy, with a reminder to exercise following birth. This could help to prevent, or relieve, the symptoms of stress incontinence that frequently occur at these times.
研究孕期或产后给予女性盆底肌锻炼指导的情况，评估所提供指导的质量，并结合女性对该服务的看法进行考量。
在女性怀孕34周时向其样本发送邮政调查问卷，产后8周时发送第二份问卷。对产后8周报告有压力性尿失禁症状的女性子样本就其孕期或产褥期接受的盆底肌锻炼指导进行访谈。
在918名收到第一份问卷的女性中，717名（78%）完成并返回问卷。894名女性中有572名（64%）完成了第二份问卷。179名有症状的女性中有42名（23%）参与了访谈。
55%的女性在怀孕34周时接受了某种形式的盆底肌锻炼指导。86%的女性在产后接受了指导。提供信息的方式各不相同，从简短提醒到在有教练的班级中锻炼。信息由一系列卫生专业人员提供，没有单一专业似乎对该服务负责。因此，对该服务的看法各不相同。一些女性报告说她们得到了高质量的指导，另一些则对此表示批评，少数女性报告说她们根本没有得到指导。很大一部分女性批评了在女性住院期间在其床边留下传单的普遍做法。
卫生服务专业人员对盆底肌锻炼的指导是临时提供的。在许多情况下，指导方案不符合文献中的建议。文献中报道的随机对照试验的成功在“现实世界”中可能无法重现。对实践的启示：需要对服务进行重组，以便所有女性在孕期都能接受高质量的指导，并在产后得到锻炼提醒。这有助于预防或缓解这些时期经常出现的压力性尿失禁症状。
