Gallo M L, Staskin D R
Beth Israel Deaconess Medical Center, Urodynamic and Continence Center, Boston, Massachusetts, USA.
Neurourol Urodyn. 1997;16(3):167-77. doi: 10.1002/(sici)1520-6777(1997)16:3<167::aid-nau6>3.0.co;2-c.
Pelvic floor muscle exercises are recommended as an initial treatment to women with stress urinary incontinence. This treatment is often unsuccessful because of patient noncompliance. A post-test, experimental control group design was used to examine Pender's (1992) concept of an external cue to action, an audiocassette tape, to enhance patient compliance to pelvic floor exercises. Eighty-six women with urodynamically evaluated stress urinary incontinence participated through a Pelvic Floor Exercise Unit at a large teaching hospital. Patients received biofeedback training and written information to reinforce pelvic floor muscle exercises during a 45-min appointment with a nurse. Patients were instructed to perform the exercises for 10 min twice daily. Forty-three women randomly assigned to an experimental group received an audiocassette tape. Four to 6 weeks later all patients completed a researcher-developed questionnaire that was validity and reliability tested assessing pelvic floor exercise compliance. The 43 patients (100%) who received the audiocassette tape reported compliance with "routine" exercises. Twenty-two of 34 patients (65%) who did not receive the tape were compliant (P = 0.0003). Thirty-four of 41 patients (83%) who received the tape reported exercise compliance twice a day, while 4 of 34 patients (12%) in the control group were similarly compliant (P = 0.0000). The findings suggest adding an audiocassette tape to a pelvic floor exercise program enhances patient compliance for incontinent women compared to verbal and written instruction combined with biofeedback.
盆底肌锻炼被推荐为压力性尿失禁女性的初始治疗方法。由于患者依从性差，这种治疗往往不成功。采用后测实验对照组设计，以检验彭德（1992年）提出的行动外部线索概念，即一盒增强患者对盆底肌锻炼依从性的盒式录音带。86名经尿动力学评估为压力性尿失禁的女性通过一家大型教学医院的盆底肌锻炼单元参与了研究。在与护士进行45分钟的预约期间，患者接受生物反馈训练和书面信息，以强化盆底肌锻炼。患者被指示每天进行两次10分钟的锻炼。随机分配到实验组的43名女性收到了一盒盒式录音带。4至6周后，所有患者都完成了一份由研究人员编制的问卷，该问卷经过效度和信度测试，用于评估盆底肌锻炼的依从性。收到盒式录音带的43名患者（100%）报告遵守了“常规”锻炼。未收到录音带的34名患者中有22名（65%）遵守了锻炼要求（P = 0.0003）。收到录音带的41名患者中有34名（83%）报告每天进行两次锻炼，而对照组的34名患者中有4名（12%）同样遵守了锻炼要求（P = 0.0000）。研究结果表明，与言语和书面指导结合生物反馈相比，在盆底肌锻炼计划中增加一盒盒式录音带可提高尿失禁女性的患者依从性。
