行为干预改善慢性心力衰竭尿失禁患者生命质量的随机对照试验

Behavioral intervention on quality of life in chronic heart congestive failure patients with urinary incontinence: a pilot randomized controlled trial

目的 探讨行为干预对慢性心力衰竭尿失禁患者生命质量的影响,为临床进一步提出更有效的护理措施提供参考依据.方法 将62例慢性心力衰竭尿失禁患者按随机数字表法随机分为对照组和干预组各31例,对照组患者应用常规护理,干预组患者在应用常规护理的基础上,实行综合行为干预.行为干预的措施主要包括盆底肌锻炼、耻骨肌锻炼、重建排尿习惯等.观察干预前后2组患者尿失禁、生命质量及抑郁状况.结果 共有61例患者参与并完成了本项研究,其中干预组30例,对照组31例.2组患者干预前尿失禁问卷简表(ICI-Q-SF)、健康调查简表(SF-36)、Zung抑郁自评量表(SDS)评分的差异无统计学意义,P>0.05;连续干预6周后,干预组ICI-Q-SF评分为(8.69±1.94)分, SDS评分为(55.91±4.57)分,均明显低于对照组的(11.07±2.14)分和(61.44±5.98)分,t=5.04和3.18,P<0.01,差异均有统计学意义;干预组SF-36评分中生理功能、社会功能两方面评分分别为(76.77±10.34)分和(77.69±6.17)分,明显高于对照组的(60.39±10.07)分和(59.38±8.25)分,t=43.31和120.36,P<0.01,差异均有统计学意义.结论 行为干预能有效地改善慢性心力衰竭尿失禁患者的失禁症状,提高患者的生命质量,减轻患者的抑郁情绪,促进患者的身心健康.

Objective To explore the effect of behavioral intervention on the quality of life of chronic heart congestive failure patients with urinary incontinence, to further provide basis for more effective clinical nursing measures. Methods 62 patients with chronic heart congestive failure combining urinary incontinence were divided into two groups by random digital table method, the control group and the intervention group, with 31 cases in each group. Patients in the control group received routine nursing care, while patients in the intervention group received behavioral intervention on the basis of routine care. The behavioral intervention included pelvic floor muscle training, pectineus exercise and reconstruction of micturition habits. The effect of the intervention on incontinence, quality of life and depression were observed in two groups. Results 61 patients completed the study, including 30 cases in the intervention group and 31 cases in the control group. There were no significant differences in the scores of the International Consultation on Incontinence Questionnaire-Urinary Incontinence Short Form (ICI-Q-SF), the MOS item Short Form Health Survey (SF-36) and Zung Self-rating Depression Scale ( SDS) between two groups before the intervention (P>0.05). After 6 weeks of continuous intervention, the scores of ICI-Q-SF and SDS in the intervention group were(8.69±1.94)points and (55.91±4.57) points, which were significantly lower than (11.07±2.14) points and (61.44±5.98) points of the control group (t=5.04, 3.18, P<0.01). About the SF-36, scores of physical functioning and social functioning in the intervention group were (76.77 ±10.34) points and (77.69±6.17) points, which were significantly higher than (60.39±10.07) points and (59.38±8.25) points in the control group (t=43.31, 120.36, P<0.01). Conclusions For chronic heart congestive failure patients with urinary incontinence, behavioral intervention can effectively ameliorate symptoms of urinary incontinence, improve the quality of life and relieve patients' depression, which thereby potentially promote patients′physical and mental health.