Abstract：Objective To analyze the factors affecting the compliance of postpartum pelvic floor muscle training, so as to provide insights into prevention of postpartum pelvic floor dysfunction (PFD). Methods The lying-in women with delivery at the Hangzhou First People's Hospital Affiliated to Zhejiang University School of Medicine were sampled using the convenient sampling method from August to December, 2021. Their compliance of pelvic floor muscle training was investigated using the questionnaires for compliance of pelvic floor muscle training, and their age, educational level, types of delivery, subjective symptoms of PFD, self-efficacy level and postpartum depression were collected. The factors affecting the compliance of postpartum pelvic floor muscle training were identified using a multivariable linear regression model. Results A total of 250 questionnaires were allocated, and 241 were recovered, with an effective recovery rate of 96.40%. The lying-in women had a mean age of (29.19±3.62) years, and 75.60% had an educational level of diploma and above. There were 31 women with depression (12.86%), 148 primiparous women (61.41%) and 164 women with vaginal delivery (68.05%). The mean score of compliance of postpartum pelvic floor muscle training was (10.38±4.10) scores. In addition, multivariable linear regression analysis identified an educational level of diploma and above (β'=0.377), subjective symptoms of PFD (β'=0.186), spouse support (β'=0.209), having received health education about pelvic floor rehabilitation (β'=0.221), a high self-efficacy score (β'=0.314) and presence of depressive symptoms (β'=-0.295) as factors affecting the compliance of postpartum pelvic floor muscle training. Conclusions The compliance of postpartum pelvic floor muscle training is associated with maternal educational levels, subjective symptoms of PFD, health education about pelvic floor rehabilitation, self-efficacy, depression and spouse support.
[1] 唐红,吴辉.产后性功能障碍、盆底肌障碍治疗及锻炼对孕妇盆底功能与性功能的影响分析[J].中国妇幼保健,2018,33(21):4854-4857. TANG H,WU H.The effect of pelvic floor muscle treatment and exercise on postoperative pelvic floor function and sexual function in patients with postpartum sexual dysfunction disorder[J].Matern Child Health Care China,2018,33(21):4854-4857. [2] 顾春怡. 育龄妇女产后盆底康复管理[J].上海护理,2021,21(6):71-75. GU C Y.Postpartum pelvic floor rehabilitation management of women of reproductive age[J].Shanghai Nurs Care,2021,21(6):71-75. [3] JENNIFER K,TODD D,ALAN C W L.Telerehabilitation for treating pelvic floor dysfunction:a case series of 3 patients' experiences[J].J Women's Health,2019,43(1):44-50. [4] 中华医学会妇产科学分会妇科盆底学组.女性压力性尿失禁诊断和治疗指南(2017)[J].中华妇产科杂志,2017,52(5):289-293. Pelvic Floor Group of Obstetrics and Gynecology Branch of Chinese Medical Association.Guidelines for the diagnosis and treatment of stress urinary incontinence in women(2017)[J].Chin J Obstet Gynecol,2017,52(5):289-293. [5] CELIKER TOSUN O,KAYA MUTLU E,ERGENOGLU A M,et al.Does pelvic floor muscle training abolish symptoms of urinary incontinence?A randomized controlled trial[J].Clin Rehabil,2015,29(6):525-537. [6] 谷瑞芮. 产后压力性尿失禁妇女盆底肌训练依从性及影响因素研究[D].北京:北京协和医学院,2019. GU R R.Investigation on pelvic floor muscle training adherence and influencing factor in postpartum stress urinary incontinence women[D].Beijing:Peking Union Medical College,2019. [7] 张明娜,肖倩,吴瑛.产褥期妇女盆底肌功能锻炼知信行及需求现状调查[J].中华现代护理杂志,2017,23(30):3862-3869. ZHANG M N,XIAO Q,WU Y.Investigation on the status of knowledge and demand of pelvic floor muscle functional exercise in puerperial women[J].Chin J Mod Nurs,2017,23(30):3862-3869. [8] 白雪,苏芳静,李红玉.中文版盆底肌肉锻炼自我效能量表的信效度评价[J].中国全科医学,2015,18(15):4-6. BAI X,SU F J,LI H Y.Chinese version of the Broome Pelvic Muscle Self-efficacy Scale:reliability and validity[J].Chin Gen Pract,2015,18(15):4-6. [9] 郭秀静,王玉琼,陈静.爱丁堡产后抑郁量表在成都地区产妇中应用的效能研究[J].中国实用护理杂志,2009,25(1):4-6. GUO X J,WANG Y Q,CHEN J.Study on the efficacy of the Edinburgh postnatal depression scale in puerperas in Chengdu[J].Chin J Pract Nurs,2009,25(1):4-6. [10] CHEN S Y,TENG Y L.Path analysis for adherence to pelvic floor muscle exercise among women with urinary incontinence[J].J Nurs Res,2009,17(2):83-92. [11] 张娇娇,蔡峰成,谢丽君,等.高龄产妇产后盆底肌力受损的影响因素分析[J].预防医学,2021,33(12):1273-1275. ZHANG J J,CAI F C,XIE L J,et al.Influencing factor for impaired pelvic floor muscle strength among older parturient women[J].Prev Med,2021,33(12):1273-1275. [12] 吴惠琰,钱林,李娜娜.产妇盆底功能状况及影响因素分析[J].预防医学,2019,31(6):625-627. WU H Y,QIAN L,LI N N.Status and determinants of pelvic floor function among postpartum women[J].Prev Med,2019,31(6):625-627. [13] SALLES A.Self-efficacy as a measure of confidence[J].JAMA Surg,2017,152(5):506-507. [14] 谷瑞芮,吴丽萍.产后妇女盆底肌训练依从性的研究进展[J].山东医学高等专科学校学报,2019,41(2):129-131. GU R R,WU L P.Progress in pelvic floor muscle training compliance in postpartum women[J].J Shandong Med Coll,2019,41(2):129-131. [15] 崔为,程亚平.生物反馈电刺激治疗联合康复护理对产妇产后盆底功能的恢复及焦虑抑郁的影响[J].贵州医药,2021,45(9):1499-1500. CUI W,CHENG Y P.Effect of biofeedback electrical stimulation therapy combined with rehabilitation care on the recovery of maternal postpartum pelvic floor function and anxiety and depression[J].Guizhou Med,2021,45(9):1499-1500. [16] MOOSSDORFF-STEINHAUSER H F,ALBERS-HEITNER P,WEDMHOFF M,et al.Factors influencing postpartum women's willingness to participate in a preventive pelvic floor muscle training program:a web-based survey[J].Eur J Obstet Gynecol Reprod Biol,2015,195(10):182-187. [17] 梁带娣,林东红,谢秋燕.经产妇产后盆底康复相关知识认知与需求调查[J].牡丹江医学院学报,2017,38(5):146-148. LIANG D D,LIN D H,XIE Q Y.Knowledge cognition and demand survey of transmaternal postpartum pelvic floor rehabilitation[J].J Mudanjiang Med Coll,2017,38(5):146-148. [18] 陈莉,杨珺.盆底肌肉锻炼依从性影响因素及干预策略的研究进展[J].按摩与康复医学,2020,11(3):4-7. CHEN L,YANG J.Progress on factors influencing pelvic floor muscle exercise compliance and intervention strategies[J].Chin Manipulation Rehabil Med,2020,11(3):4-7.
