基于信息-动机-行为技巧模式的康复训练在产后盆底肌修复中的应用

胡凌波; 潘程瑶; 杨素娟; 麻彬彬; 王荣跃

doi:10.16766/j.cnki.issn.1674-4152.003264

基于信息-动机-行为技巧模式的康复训练在产后盆底肌修复中的应用

doi: 10.16766/j.cnki.issn.1674-4152.003264

温州医科大学附属第二医院产科, 浙江温州 325000

基金项目:

浙江省医药卫生科技计划项目 2020KY641

温州市科技局项目 Y20210530

详细信息

通讯作者:
胡凌波，E-mail：hulingb12365@126.com

中图分类号: R714.46 R493
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- 被引次数: 0
出版历程
- 收稿日期: 2023-05-21
- 网络出版日期: 2024-01-13

Application of rehabilitation training based on information-motivation-behavioral skills model in postpartum pelvic floor muscle repair

Department of Obstetrics, the Second Affiliated Hospital of Wenzhou Medical University, Wenzhou, Zhejiang 325000, China

摘要

摘要: 目的探讨基于信息-动机-行为技巧模式的康复训练干预对产妇盆底功能修复的影响。方法选取2021年10月—2022年10月在温州医科大学附属第二医院产后康复门诊进行产后42 d盆底肌筛查并确诊为盆底功能障碍的135例产妇为研究对象，根据随机数字法分为观察组(68例)和对照组(67例)。对照组给予法国杉山盆底康复治疗仪PHENIX USB 4进行治疗；观察组在此基础上给予基于信息-动机-行为技巧模式的康复训练，包括产后盆底肌修复的知识信息宣教、主动参与康复训练的动机干预、康复训练的行为技巧干预。比较2组产妇产后42 d和产后3个月时盆底肌力、尿失禁评分、盆腔脏器脱垂和盆底肌肉锻炼自我效能得分情况。结果观察组产妇产后3个月盆底肌Ⅰ、Ⅱ类肌力等级，尿失禁评分和盆底肌锻炼自我效能得分分别为(4.35±0.46)级、(4.68±0.54)级、(2.81±0.97)分、(182.81±10.16)分，盆腔脏器脱垂发生率为32.4%(22/68)，均优于对照组[(3.15±0.33)级、(3.24±0.17)级、(4.01±1.02)分、(164.74±11.09)分、50.7%(34/67)，均P < 0.05]。结论基于信息-动机-行为技巧模式的康复训练可以增强盆底肌力，改善尿失禁和盆腔脏器脱垂症状，提高盆底肌肉锻炼自我效能感。
- 盆底功能障碍 /
- 尿失禁 /
- 盆腔脏器脱垂 /
- 盆底肌肉锻炼自我效能
Abstract: Objective To explore the effect of rehabilitation training intervention based on the information-motivation-behavioral skills model on the repair of pelvic floor function in parturients. Methods One hundred and thirty-five women who underwent pelvic floor muscle screening at 42 d postpartum and diagnosed with pelvic floor dysfunction in the Postpartum Rehabilitation Clinic of the Second Affiliated Hospital of Wenzhou Medical University from October 2021 to October 2022 were selected as the study subjects, and were divided into an observation group (68 cases) and a control group (67 cases) according to a random number method. The control group was treated with PHENIX USB 4 pelvic floor rehabilitation instrument. The experimental group was additionally given rehabilitation training based on the information-motivation-behavioral skills model, including knowledge and information education of postpartum pelvic floor muscle repair, motivation intervention of active participation in rehabilitation training, and behavioral skills intervention of rehabilitation training. Pelvic floor muscle strength, urinary incontinence scores, pelvic organ prolapse, and pelvic floor muscle exercise self-efficacy scores were compared between the 2 groups at 42 d postpartum and 3 months postpartum. Results In the experimental group, the scores of type Ⅰ and Ⅱ pelvic floor muscle strength, urinary incontinence and self-efficacy of pelvic floor muscle exercise were (4.35±0.46) grades, (4.68±0.54) grades, (2.81±0.97) points, and (182.81±10.16) points, respectively. The incidence of pelvic organ prolapse was 32.4% (22/68). The results were better than those in the control group [(3.15±0.33) grades, (3.24±0.17) grades, (4.01±1.02) points, (164.74±11.09) points, 50.7% (34/67), all P < 0.05]. Conclusion Rehabilitation training based on the information-motivation-behavioral skills model can enhance the pelvic floor muscle strength, improve the symptoms of urinary incontinence and pelvic organ prolapse, and improve the pelvic floor muscle exercise self-efficacy.
- Pelvic floor dysfunction /
- Urinary incontinence /
- Pelvic organ prolapse /
- Pelvic floor muscle exercise self-efficacy

HTML全文

表 1 2组产后盆底功能障碍产妇一般资料比较

Table 1. Comparison of general data between two groups of puerperal with pelvic floor dysfunction

组别	例数	年龄(x±s, 岁)	学历[例(%)]		月收入[例(%)]		孕期体重(x±s, kg)	新生儿体重(x±s, kg)
组别	例数	年龄(x±s, 岁)	大专及以下	本科及以上	≤5 000元	>5 000元	孕期体重(x±s, kg)	新生儿体重(x±s, kg)
对照组	67	28.85±4.53	31(46.3)	36(53.7)	39(58.2)	28(41.8)	70.85±8.76	3.22 ±0.46
观察组	68	28.73±3.89	33(48.5)	35(51.5)	40(58.8)	28(41.2)	70.64±9.62	3.19±0.52
统计量		0.165^a	0.069^b		0.005^b		0.133^a	0.355^a
P值		0.869	0.793		0.942		0.895	0.723
注：^a为t值，^b为χ²值。

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表 2 2组产妇治疗前后盆底肌Ⅰ、Ⅱ类肌力比较(x±s，级)

Table 2. Comparison of Ⅰ and Ⅱ types of pelvic floor muscle strength between two groups of puerperal before and after treatment (x±s, grade)

组别	例数	Ⅰ类盆底肌肌力		t值	P值	Ⅱ类盆底肌肌力		t值	P值
组别	例数	治疗前	治疗后	t值	P值	治疗前	治疗后	t值	P值
对照组	67	1.79±0.62	3.15±0.33	15.850	＜0.001	1.79±0.62	3.24±0.17	18.462	＜0.001
观察组	68	1.80±0.53	4.35±0.46	29.963	＜0.001	1.80±0.53	4.68±0.54	31.388	＜0.001
t值		0.101	17.393			0.101	20.833
P值		0.920	＜0.001			0.920	＜0.001

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表 3 2组产妇治疗前后尿失禁评分比较(x±s, 分)

Table 3. Comparison of urinary incontinence scores between two groups of puerperal before and after treatment (x±s, points)

组别	例数	治疗前	治疗后	t值	P值
对照组	67	13.52±2.34	4.01±1.02	30.450	＜0.001
观察组	68	13.94±3.01	2.81±0.97	29.022	＜0.001
t值		0.904	7.005
P值		0.368	＜0.001

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表 4 2组产妇盆腔脏器脱垂发生情况比较[例(%)]

Table 4. Comparison of the incidence of pelvic organ prolapse between two groups of puerperal [cases (%)]

组别	例数	治疗前	治疗后	χ²值	P值
对照组	67	59(86.5)	34(50.7)	21.964	＜0.001
观察组	68	60(88.2)	22(32.4)	44.350	＜0.001
χ²值		0.001	4.704
P值		0.975	0.030

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表 5 2组产妇治疗前后盆底肌肉锻炼自我效能得分比较(x±s, 分)

Table 5. Comparison of self-efficacy scores of pelvic floor muscle exercise between two groups of puerperal before and after treatment (x±s, points)

组别	例数	治疗前	治疗后	t值	P值
对照组	67	108.36±12.67	164.74±11.09	27.408	＜0.001
观察组	68	106.97±11.78	182.81±10.16	40.202	＜0.001
t值		0.660	9.874
P值		0.510	＜0.001

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