基于和谐护理理论的群组教育对初孕女性盆底功能锻炼康复效果的研究

Group education on the rehabilitation effect of pelvic floor function exercise in first gestation women based on harmonious nursing theory

目的探讨基于和谐护理理论的群组教育干预策略对初孕女性盆底知识与锻炼技能理解与应用的效果,以促进初孕女性产后盆底功能早期恢复。方法采用类实验研究,选择山西医科大学第一医院孕妇学校的80名初孕女性为研究对象,将2023年4—5月纳入的40名作为对照组,2023年6—7月纳入的40名作为试验组。对照组采用常规健康教育,试验组采用基于和谐护理理论的群组教育护理干预。采用女性盆底功能障碍一级预防自我护理能力量表评价并比较2组孕期1~4周干预前后盆底功能障碍一级预防自我护理能力,并于产后42~49 d(以下简称产后42 d)门诊复查时进行盆底肌力测评及评估盆底功能锻炼依从性,比较2组产后42 d盆底功能锻炼康复效果。结果最终,对照组纳入38名,年龄为(29.97±3.68)岁,试验组纳入38名,年龄为(29.79±3.66)岁。干预前2组初孕女性盆底功能障碍一级预防自我护理能力得分比较差异无统计学意义(P>0.05),孕期干预后试验组自护知识得分、自护责任感得分、自护技能得分、自我调控得分以及量表总分分别为(58.13±6.46)、(11.73±1.18)、(10.16±0.86)、(29.21±2.74)、(109.21±8.92)分,高于对照组的(47.76±4.25)、(11.05±1.09)、(8.82±1.78)、(27.34±2.18)、(94.97±6.46)分,2组比较差异均有统计学意义(t值为-8.26~-2.63,均P<0.05);产后42 d 2组盆底肌力比较,试验组盆底肌力测评中快肌阶段最大值和慢肌阶段平均值分别为48.25(44.75,53.45)、31.00(27.33,34.23)μV,高于对照组的36.80(32.25,44.28)、22.40(19.28,25.88)μV,2组比较差异均有统计学意义(Z=-4.98、-5.37,均P<0.01),而前静息阶段平均值和后静息阶段平均值2组比较差异均无统计学意义(均P>0.05);2组盆底功能锻炼依从性比较,试验组依从性良好占比居多,为73.7%(28/38),一般占比为26.3%(10/38),而对照组初产妇盆底功能锻炼依从性一般占比居多86.8%(33/38),良好占比为7.9%(3/38),2组比较差异有统计学意义(χ^(2)=34.46,P<0.01)。结论应用和谐护理理论对初孕女性进行群组教育护理干预,可有效提高初孕女性孕期盆底功能锻炼一级预防自我护理能力水平,增强产后女性盆底肌力,提高其产褥期盆底功能锻炼依从性,协调和优化了初孕女性早期进行盆底功能康复的护理程序。

Objective To explore the effect of group education intervention strategy based on harmonious nursing theory on understanding and application of pelvic floor knowledge and exercise skills in first gestation women,so as to promote the early recovery of pelvic floor function in postpartum women.Methods This study was a quasi-experimental study.A total of 80 first gestation women in the pregnant women′s school of the First Hospital of Shanxi Medical University were selected as the research objects,40 women from April to May 2023 were involved in the control group and 40 women from June to July 2023 were involved in the intervention group.The control group was given routine health education,while the intervention group was given group educational nursing intervention based on harmonious nursing theory.The Primary Prevention of Female Pelvic Floor Dysfunction-self-care Ability Scale was used to evaluate and compare the primary prevention self-care ability of pelvic floor dysfunction among pregnancy 1-4 weeks between the two groups before and after pregnancy intervention.Pelvic floor muscle strength was measured and pelvic floor function exercise compliance was evaluated during outpatient follow-up at 42-49 days postpartum(hereinafter referred to as postpartum 42 days)to evaluate and compare the rehabilitation effect of pelvic floor skills exercise between the two groups at 42 days postpartum.Results Finally,the control group was(29.97±3.68)years old involved 38 cases,and the intervention group was(29.79±3.66)years old involved 38 cases.There was no significant difference in self-care ability score of primary prevention of pelvic floor dysfunction between the two groups before intervention(P>0.05).After pregnancy intervention,the scores of self-care knowledge,self-care responsibility,self-care skills,self-regulation and total score of the intervention group were(58.13±6.46),(11.73±1.18),(10.16±0.86),(29.21±2.74)and(109.21±8.92)points,respectively,which were higher than the control group(47.76±4.25),(11.05±1.09),(8.82±1.78),(27.34±2.18),(94.97±6.46)points,and the differences between the two groups were statistically significant(t values were-8.26--2.63,all P<0.05).In the intervention group,the maximum value of the fast muscle stage and the mean value of the slow muscle stage of the comparison of pelvic floor muscle strength between the two groups 42 days after delivery were 48.25(44.75,53.45)μV and 31.00(27.33,34.23)μV,respectively,which were higher than the control group 36.80(32.25,44.28)μV and 22.40(19.28,25.88)μV,the differences between the two groups were statistically significant(Z=-4.98,-5.37,both P<0.01).There was no significant difference in the average value of the pre-resting stage and the average value of the post-resting stage between the two groups(P>0.05).Comparison of pelvic floor functional exercise compliance between the two groups showed that in the intervention group,the proportion of good compliance was 73.7%(28/38),and the proportion of general compliance was 26.3%(10/38),while in the control group,the proportion of general compliance was 86.8%(33/38)and the proportion of good compliance was 7.9%(3/38).The difference between the two groups was statistically significant(χ^(2)=34.46,P<0.01).Conclusions Application of the theory of harmonious nursing group educational nursing intervention was carried out on the first gestation women,can effectively improve the first gestation women during pregnancy pelvic floor functional exercise primary prevention self-care ability level,strengthen puerperal women pelvic floor muscle,improve the puerperal pelvic floor functional exercise adherence,coordination and optimization of the first gestation women early for pelvic floor functional rehabilitation nursing process.