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巴西女性尿失禁家庭盆底肌锻炼方案依从性的预测因素。

Predictors for adherence to a home-based pelvic floor muscle exercise program for treating female urinary incontinence in Brazil.

机构信息

School of Kinesiology, Universidad Bernardo O'Higgins, Santiago de Chile, Chile.

Pelvic care Centre Maastricht, Maastricht University Medical Centre, Maastricht, The Netherlands.

出版信息

Physiother Theory Pract. 2020 Jan;36(1):186-195. doi: 10.1080/09593985.2018.1482583. Epub 2018 Jun 4.

Abstract

: To assess predictors for adherence to a home-based pelvic floor muscle exercise (PFME) program supplemented with three physical therapy sessions in women with urinary incontinence (UI). : Secondary analysis of a randomized controlled trial of interventions to enhance self-efficacy with respect to PFME. : Patients were referred from public primary or secondary care providers in Florianópolis, Brazil. : Adult women with UI. : Three supervised physiotherapy sessions for the treatment of UI combined with home-based PFME program. Treatment groups were combined for predictive modelling because there was no difference after intervention between groups regarding UI and adherence rates. : Adherence to PFME at 3-month follow-up (structured questionnaire). Baseline Predictors: self-efficacy and outcome expectation scales; severity of UI (ICIQ-SF), pelvic floor muscle strength, age, body mass index (BMI), and educational level. : 86 women with UI of whom 72 completed the study. An intention-to-treat analysis was performed. Forty-three women reported carrying out PFME every day. Adherence was correlated to: baseline self-efficacy ( = 0.299); age ( = 0.242); and educational level ( = -0.273). Hierarchical regression analyses incorporating treatment group, age, education, disease-related factors (severity of UI; pelvic floor muscle strength; BMI), and outcome expectations and self-efficacy showed that only baseline self-efficacy predicted adherence ( = 0.217). : Adherence to home-based PFME is a complex phenomenon. Assessing self-efficacy may help physiotherapists to detect patients' confidence in performing home-based exercises and, when necessary, give patients additional incentives.

摘要

: 评估伴有 3 次物理治疗的家庭盆底肌锻炼(PFME)方案对尿失禁(UI)女性依从性的预测因素。 : 针对增强 PFME 自我效能干预的随机对照试验的二次分析。 : 患者来自巴西弗洛里亚诺波利斯的公共初级或二级保健提供者。 : 患有 UI 的成年女性。 : 3 次监督物理治疗用于治疗 UI 合并家庭 PFME 方案。由于干预后两组之间在 UI 和依从率方面没有差异,因此将治疗组合并进行预测建模。 : 在 3 个月随访时对 PFME 的依从性(结构化问卷)。基线预测因素:自我效能和结果预期量表;UI 严重程度(ICIQ-SF),盆底肌力量,年龄,体重指数(BMI)和教育水平。 : 86 名患有 UI 的女性,其中 72 名完成了研究。进行了意向治疗分析。43 名女性报告每天进行 PFME。依从性与:基线自我效能(= 0.299);年龄(= 0.242);和教育水平(= -0.273)。纳入治疗组,年龄,教育程度,疾病相关因素(UI 严重程度;盆底肌力量;BMI)以及结果期望和自我效能的层次回归分析表明,仅基线自我效能可预测依从性(= 0.217)。 : 家庭 PFME 的依从性是一个复杂的现象。评估自我效能可以帮助物理治疗师检测患者对进行家庭锻炼的信心,并在必要时为患者提供额外的激励。

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