Abstract：Objective To evaluate the impact of comprehensive nursing based on the behavioral goal attainment model on the clinical intervention effect among elderly female patients with stress urinary incontinence (SUI), so as to provide a basis for optimizing the nursing strategies for patients with SUI and improving their quality of life. Methods A total of 190 elderly female patients with SUI who were treated in the Department of Gynecology of the First Hospital of Jilin University from January 2023 to August 2024 were selected and randomly divided into the intervention group and the control group. The control group received routine nursing care, while the intervention group received comprehensive nursing based on the behavioral goal attainment model. The 1-hour pad test was used to assess urinary incontinence symptoms. The bio-electrical stimulation feedback instrument was employed to detect the electromyogram (EMG) values in the pre-resting stage and slow-muscle stage for evaluating pelvic floor function. The bladder function scale was utilized to evaluate bladder function. The Chinese version of urinary incontinence ego-efficacy rating scales and incontinence quality of life assessment scale (IQOL) were used to assess self-efficacy and quality of life. The data on intervention compliance and nursing satisfaction were collected by a questionnaire survey. The differences between the two groups before and after the intervention were compared using the analysis of variance for repeated-measures data to evaluate the intervention effect. Results There were 95 cases in the control group and 95 cases in the intervention group, with median ages were 64.00 (interquartile range, 23.50) and 64.50 (interquartile range, 19.50) years, respectively. The proportion of patients with cesarean section as the last delivery method was 21.05% in the control group and 12.63% in the intervention group. The proportion of patients with moderate disease severity was 67.36% in the control group and 58.95% in the intervention group. There were no statistically significant differences in age, body mass index, number of pregnancies, number of deliveries, marital status, educational level, mode of last delivery and severity of the disease between the two groups of patients (all P>0.05). The analysis of variance of repeated-measures data showed that there were significant interactions between time and group for the urine leakage volume in the 1-hour pad test, the EMG values in the pre-resting stage, the EMG values in the slow-muscle stage, the scores of the bladder function, the self-efficacy scores, and the IQOL scores (all P<0.05). After 12 weeks of intervention, the EMG values in the slow-muscle stage, the scores of the bladder function, the self-efficacy scores, the IQOL scores in the intervention group were higher than those in the control group, while the urine leakage volume in the 1-hour pad test and the EMG values in the pre-resting stage in the intervention group were lower than those in the control group (all P<0.05). The good compliance rate of intervention and the satisfaction rate of nursing in the intervention group were higher than those in the control group (83.16% vs. 60.00%, 90.53% vs. 75.79%, both P<0.05). Conclusion Comprehensive nursing based on the behavioral goal attainment model can improve urinary incontinence symptoms, pelvic floor function, bladder function, self-efficacy, quality of life, and intervention compliance of elderly female patients with SUI.
[1] 顾逸藜,孙晓燕,谢臻蔚.女性糖尿病与压力性尿失禁研究进展[J].预防医学,2023,35(2):130-133. GU Y L,SUN X Y,XIE Z W.Progress of researches on the association between diabetes and stress urinary incontinence among women[J].China Prev Med J,2023,35(2):130-133.(in Chinese) [2] CHEN Y Z,ZHANG C,YANG S Q,et al.Long-term outcomes of surgical interventions for stress urinary incontinence:a systematic review and network meta-analysis[J].Int J Surg,2024,110(1):520-528. [3] NAMBIAR A K,ARLANDIS S,BØ K,et al.European association of urology guidelines on the diagnosis and management of female non-neurogenic lower urinary tract symptoms.Part 1:diagnostics,overactive bladder,stress urinary incontinence,and mixed urinary incontinence[J].Eur Urol,2022,82(1):49-59. [4] 梁静,张魁,牛力春,等.基于互联网的自我管理干预对中老年女性压力性尿失禁患者临床治疗的随机对照研究[J].中国全科医学,2024,27(36):4575-4581,4597. LIANG J,ZHANG K,NIU L C,et al.Application of Internet-based self-management intervention in the clinical treatment of middle-aged and elderly female patients with stress urinary incontinence:a randomized controlled trial[J].Chin Gen Pract,2024,27(36):4575-4581,4597.(in Chinese) [5] HERTEL S,KARLEN Y.Implicit theories of self-regulated learning:interplay with students' achievement goals,learning strategies,and metacognition[J].Br J Educ Psychol,2021,91(3):972-996. [6] 李莉,高文彬,黄文贞,等.基于行为目标达成度理念的干预策略对甲状腺功能亢进患者出院后用药依从性的影响[J].中华现代护理杂志,2021,27(7):929-933. LI L,GAO W B,HUANG W Z,et al.Effects of intervention strategy based on concept of behavioral goal attainment on medication compliance of patients with hyperthyroidism after discharge[J].Chin J Mod Nurs,2021,27(7):929-933.(in Chinese) [7] 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. Female Pelvic Floor Study Group of Chinese Society of Obstetrics and Gynecology.Guidelines for diagnosis and treatment of female stress urinary incontinence(2017)[J].Chin J Obstet Gynecol,2017,52(5):289-293.(in Chinese) [8] HAYLEN B T,DE RIDDER D,FREEMAN R M,et al.An International Urogynecological Association(IUGA)/International Continence Society(ICS)joint report on the terminology for female pelvic floor dysfunction[J].Int Urogynecol J,2010,21(1):5-26. [9] 周红俊,刘根林,汪家琮.脊髓损伤后膀胱功能的量表评定[J].现代康复,2000,4(6):830. ZHOU H J,LIU G L,WANG J Z.Scale evaluation of bladder function of spinal cord injury[J].Mod Rehabil,2000,4(6):830.(in Chinese) [10] 孙自红,孙建萍,杨支兰,等.尿失禁自我效能量表中文版的信效度研究[J].护理研究,2011,25(13):1212-1213. SUN Z H,SUN J P,YANG Z L,et al.A study on reliability-validity of Chinese version of urinary incontinence ego-efficacy rating scales[J].Chin Nurs Res,2011,25(13):1212-1213.(in Chinese) [11] 蔡舒,刘雪琴.老年尿失禁病人生活质量评价量表的研究概况[J].护理研究(下旬版),2006,20(33):3010-3012. CAI S,LIU X Q.Research overview on quality of life assessment scale for senile patients with urinary incontinence[J].Chin Nurs Res,2006,20(33):3010-3012.(in Chinese) [12] ALOUINI S,MEMIC S,COUILLANDRE A.Pelvic floor muscle training for urinary incontinence with or without biofeedback or electrostimulation in women:a systematic review[J].Int J Environ Res Public Health,2022,19(5):1-14. [13] 徐正娴,潘伟婷,于灿灿,等.基于fNIRS对女性不同膀胱状态下盆底肌收缩任务的前额叶激活情况[J].新医学,2024,55(4):280-286. XU Z X,PAN W T,YU C C,et al.fNIRS-based study of prefrontal cortex activation during pelvic floor muscle contraction in women under different bladder states[J].J New Med,2024,55(4):280-286.(in Chinese) [14] HAGEN S,BUGGE C,DEAN S G,et al.Basic versus biofeedback-mediated intensive pelvic floor muscle training for women with urinary incontinence:the OPAL RCT[J].Health Technol Assess,2020,24(70):1-144. [15] ECONOMOU D,BURHENN P S,URANGA C,et al.Using goal achievement as an outcome measure following a gero-oncology educational program for oncology nurses:the GrOW curriculum[J].Oncol Nurs Forum,2022,49(1):11-20. [16] STOLEE P,MALLINSON S,KERNOGHAN A,et al.Feasibility of Goal Attainment Scaling as a patient-reported outcome measure for older patients in primary care[J/OL].J Patient Rep Outcomes,2023,7(1)[2025-07-31].https://doi.org/10.1186/s41687-023-00615-6. [17] MANRIQUE-ABRIL F G,HERRERA-AMAYA G M,MORALES L M M,et al.Academic goals orientation questionnaire for Colombian nursing students:validity and reliability study[J/OL].Nurse Educ Today,2020,84[2025-07-31].https://doi.org/10.1016/j.nedt.2019.104226. [18] ARAUJO C C,DE A MARQUES A,JULIATO C R T.The adherence of home pelvic floor muscles training using a mobile device application for women with urinary incontinence:a randomized controlled trial[J].Female Pelvic Med Reconstr Surg,2020,26(11):697-703. [19] GARCÍA-CASTRO F J,HERNÁNDEZ A,BLANCA M J.Life satisfaction and the mediating role of character strengths and gains in informal caregivers[J].J Psychiatr Ment Health Nurs,2022,29(6):829-841.
