手机应用程序指导盆底肌肉训练控制产后尿失禁效果观察

Effect of mobile phone application program on promoting pelvic floor muscle training to manage postpartum urinary incontinence

目的评估通过手机应用程序提醒系统,对促进产后妇女盆底肌肉训练,控制尿失禁的效果。方法选择2018-04-12-2019-04-12南昌市妇幼保健计划生育服务中心就诊的经阴道自然分娩的产后妇女为研究对象,根据年龄、孕前体质量指数、孕期体质量增加量、新生儿的出生体质量等指标组间具有可比性的原则,选择观察组和对照组,每组32例,对照组就诊时间为2018-04-12-10-11,观察组就诊时间为2018-10-12-2019-04-12。观察组应用"317护"应用程序联合口头及书面指导的标准盆底肌肉训练方案,对照组仅接受口头及书面指导的标准盆底肌肉训练指导方案。对两组患者的依从率和尿失禁发生率进行比较,前者包括实施率(即在干预期间报告实施标准盆底肌肉训练的妇女的百分比)、训练强度(即每天盆底肌肉收缩次数)和训练频率(即每周进行标准盆底肌肉训练的天数),后者为8周干预期结束时的尿失禁患病率。结果8周后观察组的标准盆底肌肉训练依从性优于对照组,其中实施率为84.38%,优于对照组的43.75%,χ~2=11.47,P<0.001;平均训练强度为(14.62±3.25)次/d,优于对照组的(8.26±2.17)次/d,t=2.813,P=0.007;训练频率为(5.74±1.28)d/周,优于对照组的(2.33±1.49)d/周,t=2.351,P=0.022;尿失禁患病率为3.13%,低于对照组的21.88%,P=0.016。结论手机应用程序提醒系统可提高产后妇女对盆底肌肉训练的依从性和降低尿失禁发生率,提高产后妇女生活质量。

OBJECTIVE The purpose of this study was to evaluate the efficacy of a smartphonebased reminder system in promoting pelvic floor muscle training to help postpartum women manage urinary incontinence.METHODS From April 12,2018 to April 12,2019,the postpartum women who delivered naturally through vagina in Nanchang maternal and child health and family planning service center were selected as the research objects.According to the principle of comparability among age,BMI before pregnancy,weight gain during pregnancy and birth weight of newborn,the observation group and control group were selected,32 cases in each group.The treatment time of the control group was April 12 to October 11,2018,and the observation group was October 12,2018 to April 12,2019.Standard pelvic floor muscle training program for doctors using"317 Nursing"application program(APP)combined with oral and written guidance in observation group.Standard pelvic floor muscle training guidelines received oral and written guidance only in control group.Compliance rate and incidence of urinary incontinence were compared between the two groups.The former included implementation rate(percentage of women reporting standard pelvic floor muscle training during the intervention),training intensity(number of pelvic floor muscle contractions per day)and training frequency(number of days per week for standard pelvic floor muscle training),and the latter was the prevalence of urinary incontinence at the end of the eight-week intervention period.RESULTS After 8 weeks,the compliance of the standard pelvic floor muscle training in the observation group was better than that in the control group.The implementation rate was 84.38%,which was better than 43.75%in the control group,χ~2=11.47,P<0.001.In the observation group,the average training intensity was(14.62±3.25)times/d,better than the control group(8.26±2.17)times/d,t=2.813,P=0.007.Training frequency was(5.74±1.28)d/week,better than the control group(2.33±1.49)d/week,t=2.351,P=0.022.The prevalence of urinary incontinence was 3.13%,lower than 21.88%of the control group,P=0.016.CONCLUSIONS Mobile phone APP reminder system appears promising in enhancing pelvic floor muscle training adherence and managing postpartum UI in postpartum women.By enhancing pelvic floor muscle training adherence and improving women’s ability to manage the condition,the reminder system could improve the health-related quality of life of postpartum women.