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健康行为改变整合理论在早期宫颈癌术后合并盆底功能障碍性疾病患者盆底肌锻炼中的应用研究

Application of integrated theory of health behavior change in pelvic floor muscle exercise of patients with pelvic floor dysfunction after early cervical cancer surgery

摘要目的:探讨基于健康行为改变整合理论的护理干预对于早期宫颈癌术后合并盆底功能障碍性疾病(PFD)患者盆底肌锻炼的应用效果。方法:选取134例早期宫颈癌术后合并盆底功能障碍性疾病的患者,采用随机数字表法将其分为试验组67例和对照组67例,试验组接受为期3个月的基于健康行为改变整合理论的盆底肌锻炼,对照组接受常规盆底康复护理,分别在干预前、干预1个月和干预3个月时采用盆底功能障碍简表(PFDI-20)、盆底功能障碍影响简易问卷(PFIQ-7)、一般自我效能量表(GSES)以及社会支持评定量表(SSRS)进行评估。结果:重复测量方差分析结果显示,PFDI-20和PFIQ-7评分交互作用显著( F交互值为29.196、13.213,均 P<0.05);GSES与SSRS评分交互作用显著( F交互值为25.664、70.240,均 P<0.05)。干预3个月时,试验组PFDI-20与PFIQ-7评分分别为(66.54 ± 14.04)分和(73.20 ± 7.41)分,低于同期对照组的(77.47 ± 15.91)分和(78.39 ± 8.51)分,2组比较差异有统计学意义( t值为-4.216、-3.765,均 P<0.01);试验组GSES和SSRS评分分别为(2.86 ± 0.30)分和(50.37 ± 2.45)分,高于同期对照组的(2.51 ± 0.34)分和(46.42 ± 2.82)分,2组比较差异有统计学意义( t值为6.447、8.662,均 P<0.01)。 结论:基于健康行为改变整合理论的护理干预方案能显著提高早期宫颈癌术后合并PFD患者的自我效能感、社会支持水平和生命质量,改善患者的近期及远期盆底康复效果。

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abstractsObjective:To explore the effect of nursing intervention based on the integration theory of health behavior change in pelvic floor muscle exercise of patients with pelvic floor dysfunction (PFD) after early cervical cancer surgery.Methods:A total of 134 patients with pelvic floor dysfunction after early cervical cancer surgery were selected and divided into test group ( n=67) and control group ( n=67) by random digits table method. The test group received three months of pelvic floor muscle exercise based on the theory of healthy behavior change. The control group received conventional pelvic floor rehabilitation care. The Pelvic Floor Distress Inventory-Short Form 20(PFDI-20), Pelvic Floor Impact Questionnaire-7(PFIQ-7), General Self-Efficacy Scale (GSES) and Social Support Rating Scale (SSRS) were evaluated before the intervention (T0), After one month of intervention (T1) and at the end of the intervention (T2). Results:The results of repeated measurement analysis of variance showed significant group/time interaction between PFDI-20 and PFIQ-7 scores ( Finteraction=29.196,13.213, both P<0.05); significant group/time interaction between GSES and SSRS scores ( Finteraction value was 25.664,70.240, both P<0.05). At the end of the intervention, the scores of PFDI-20 and PFIQ-7 in the test group were 66.54±14.04 and 73.20±7.41, which were lower than 77.47±15.91 and 78.39±8.51 in the control group over the same period. The difference was statistically significant ( t value was -4.216, -3.765, both P<0.01); the GSES and SSRS scores of the test group were 2.86±0.30 and 50.37±2.45, which were higher than the control group (2.51±0.34 and 46.42±2.82), the differences between the groups were statistically significant ( t value was 6.447, 8.662, both P<0.01). Conclusion:The nursing intervention plan based on the integration theory of health behavior change can significantly improve the self-efficacy, social support level and quality of life of patients with PFD after early cervical cancer surgery, and enhance the short-term and long-term pelvic floor rehabilitation effect of patients.

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