本文關鍵詞：孕婦盆底健康自我管理教育手冊的制定　出處：《重慶醫(yī)科大學》2017年碩士論文　論文類型：學位論文

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【摘要】：目的:調(diào)查孕婦盆底功能障礙相關癥狀情況、盆底功能障礙知信行現(xiàn)狀、盆底健康自我管理能力及相關需求,制定一套科學的《孕婦盆底健康自我管理教育手冊》(以下簡稱《手冊》),為孕婦進行妊娠期盆底主動康復的自我管理提供一個科學的工具。方法:1.采用問卷調(diào)查法對122名孕婦進行調(diào)查,內(nèi)容包括:孕婦一般人口社會學資料、孕婦盆底功能障礙相關癥狀情況、孕婦盆底功能障礙知信行情況。2.采用半結構式訪談法,從通過問卷調(diào)查存在盆底功能障礙相關癥狀且知信行水平較低者中選取9例孕婦,收集其盆底健康自我管理能力及相關需求的資料并進行分析。3.在問卷調(diào)查與質(zhì)性研究的基礎上完成《手冊》初稿,利用德爾菲法將條目化的《手冊》向21名專家進行函詢,最終完善《手冊》。結果:1.共發(fā)放調(diào)查問卷129份,其中有效問卷122份,有效回收率為94.57%。調(diào)查對象盆底功能障礙盆腔癥狀:42.62%的孕婦存在盆腔墜脹感,24.63%的孕婦存在排尿不盡感,32.79%的孕婦經(jīng)常體驗到下腹腹壓,7.38%的孕婦經(jīng)�？吹交蚋械疥幍烙心[物脫出,10.66%的孕婦曾經(jīng)需要推壓陰道或直腸周圍來協(xié)助排便;腸道癥狀:42.62%的孕婦存在便秘癥狀,29.51%、9.84%和17.21%的孕婦分別存在排便不盡感、排便疼痛感和排便急迫感,13.93%的孕婦表示常不能控制肛門排氣,4.92%的孕婦表示當大便松散時常無法控制排便;膀胱癥狀:62.30%的孕婦出現(xiàn)尿頻癥狀,31.87%和20.49%的孕婦分別出現(xiàn)壓力性尿失禁和急迫性尿失禁癥狀,29.51%的孕婦存在下腹或生殖道不適感。2.調(diào)查對象盆底功能障礙知信行情況:有48.36%~74.59%的孕婦不清楚盆底功能障礙相關知識;60%以上的孕婦渴望了解學習盆底功能障礙相關知識及預防措施,40.16%~45.90%的孕婦不認可盆底功能障礙相關癥狀可能對其日后生活質(zhì)量造成不良影響且不會進行盆底肌肉鍛煉;46.72%~64.75%的孕婦在孕期及產(chǎn)后完全做不到規(guī)律的盆底肌肉鍛煉。運用結構方程模型分析結果顯示,孕期盆底功能障礙相關知識對其相關態(tài)度信念有直接影響(路徑系數(shù)=0.48);孕期盆底功能障礙相關知識對其預防盆底功能障礙相關行為有直接影響(路徑系數(shù)=0.31),并通過影響孕期盆底功能障礙相關態(tài)度信念對其預防盆底功能障礙相關行為產(chǎn)生間接影響(路徑系數(shù)=0.13);孕期盆底功能障礙相關態(tài)度信念對其預防盆底功能障礙相關行為有直接影響(路徑系數(shù)=0.27),以上p值均小于0.01,各路徑系數(shù)均有統(tǒng)計學意義。3.分析歸納訪談資料,共提煉出5個相關主題:女性盆底相關知識缺乏及獲取途徑單一;盆底健康日常行為管理能力偏低;孕期情緒波動較大且需要多方位情感支持;生活習慣管理水平有待提高;需要多途徑盆底健康自我管理信息支持。4.兩輪函詢的專家積極系數(shù)分別為80.95%和100%,判斷系數(shù)分別為0.871和0.876,熟悉程度分別為0.825和0.830,權威程度分別為0.848和0.853,協(xié)調(diào)系數(shù)分別為0.310和0.484;第一輪《手冊》條目的重要性賦值均數(shù)為2.35~4.65,變異系數(shù)為0.060~0.474,第二輪的重要性賦值均數(shù)為3.53~4.65,變異系數(shù)為0.062~0.227。結論:1.孕期出現(xiàn)盆底功能障礙相關癥狀的情況較為普遍,且在不同程度上對孕婦的生活質(zhì)量造成影響,醫(yī)護人員應制定孕期盆底健康教育方案,幫助孕婦預防或降低相關癥狀的發(fā)生,減輕妊娠期不適,提高孕婦生活質(zhì)量。2.孕婦普遍缺乏孕期盆底及盆底功能障礙的相關知識,行盆底主動康復的態(tài)度及行為水平較差,醫(yī)護人員應加強孕期盆底健康教育工作,幫助孕婦樹立盆底健康責任感,在孕期積極進行盆底主動康復。3.孕婦盆底健康自我管理存在較多問題,醫(yī)護人員需要制定相關方案指導孕婦掌握盆底健康知識自我管理、盆底健康日常行為自我管理、心理調(diào)試及生活嗜好自我管理的方法與技巧,并提供多途徑信息支持。4.本《手冊》采用圖文結合的形式且在每個管理單元后設置了不同的反饋模塊,可以反饋閱讀者知識掌握及行為改變的程度,為孕婦進行妊娠期盆底健康自我管理提供了一個科學的工具,同時也為相關臨床護理工作者提供了一定的參考意見。
[Abstract]:Objective: To investigate the related symptoms of pregnant women with pelvic floor dysfunction, pelvic floor dysfunction KAP status, pelvic floor health self-management ability and related requirements, develop a set of scientific "maternal pelvic health self-management education (hereinafter referred to as the" manual manual > >), provide a scientific tool for self management of pregnant women during pregnancy and pelvic active rehabilitation methods: 1.. Using a questionnaire survey of 122 pregnant women included: pregnant women demographic data, symptoms of pelvic floor dysfunction in pregnant women, pregnant women with pelvic floor dysfunction KAP.2. using semi-structured interviews, selected 9 cases of pregnant women from the questionnaire exist related symptoms of pelvic floor dysfunction and knowledge for the lower level, collect the pelvic floor health self-management ability and related demand data were analyzed in.3. questionnaire survey and qualitative research base Based on the complete handbook > < draft, Delphy Fa will use the < > of manual entry inquiry to 21 experts, and ultimately improve the manual. < results: 1. a total of 129 questionnaires were issued and 122 effective questionnaires, the effective recovery rate for the 94.57%. survey of pelvic floor dysfunction symptoms: 42.62% pregnant women with pelvic pelvic bulge the sense of 24.63% pregnant women vesical tenesmus, 32.79% of pregnant women often experience abdominal abdominal pressure, 7.38% pregnant women often see or feel vaginal tumor prolapse, 10.66% of pregnant women who need to push the pressure surrounding the vagina or rectum to help defecation; intestinal symptoms: symptoms of constipation, 42.62% of pregnant women are 29.51%, 9.84% and 17.21% pregnant women are endless defecation, defecation pain and defecation urgency, 13.93% pregnant women that often cannot control the anus exhaust, 4.92% pregnant women said when loose stools often unable to control defecation; bladder disease Shape: 62.30% pregnant women had frequent symptoms, 31.87% and 20.49% of pregnant women were stress urinary incontinence and urge incontinence, 29.51% of pregnant women have lower abdominal or genital discomfort.2. survey of pelvic floor dysfunction KAP, 48.36%~74.59% pregnant women do not know the pelvic floor dysfunction related knowledge; more than 60% of pregnant women desire learn the related knowledge and prevention of pelvic floor dysfunction, 40.16%~45.90% pregnant women not recognized symptoms of pelvic floor dysfunction is likely to cause adverse effects on the quality of life and not for pelvic floor muscle training; 46.72%~64.75% of pregnant women during pregnancy and post partum to do regular pelvic floor muscle training. By using structural equation model analysis showed that, have a direct impact the pregnancy related knowledge of pelvic floor dysfunction related attitudes beliefs (R =0.48) during pregnancy; pelvic floor dysfunction Because knowledge has a direct impact on the prevention of pelvic floor dysfunction related behavior (R =0.31), and the influence of attitude belief in the prevention of pelvic floor dysfunction during pregnancy related behavior of pelvic floor dysfunction has indirect effect (R =0.13); pregnancy related attitudes of pelvic floor dysfunction beliefs have a direct effect on the prevention of pelvic floor dysfunction related behavior (path coefficient =0.27 above), P values were less than 0.01, the path coefficients were statistically significant.3. analysis of interview data, there were 5 related topics: female pelvic floor of lack of knowledge and access to a single low; pelvic floor health daily behavior management; maternal mood fluctuations and need more emotional support range; lifestyle management needs to be improved experts in many ways; pelvic health management information support.4. two rounds consultation positive coefficients were 8 0.95% and 100%, judgment coefficients were 0.871 and 0.876, respectively, 0.825 and 0.830 degree of familiarity, degree of authority were 0.848 and 0.853, the coordination coefficient were 0.310 and 0.484; the first round of the importance of the assignment Handbook > < entries are the number of 2.35~4.65, the coefficient of variation was 0.060~0.474, the importance of the second round of the assignment are the number of 3.53~4.65 conclusion: 0.062~0.227., the coefficient of variation was 1. during pregnancy related symptoms of pelvic floor dysfunction is common in pregnant women, and the quality of life impact in different degrees, the medical staff should develop health education during pregnancy, pelvic floor plan, help pregnant women to prevent or reduce the symptoms, reduce pregnancy discomfort, improve maternal quality of life.2. pregnant women generally lack the knowledge of pregnancy and pelvic pelvic floor dysfunction, pelvic floor rehabilitation active attitude and behavior level, medical personnel should strengthen the pelvic floor health during pregnancy Health education, establish a sense of responsibility to help pregnant women pelvic health during pregnancy, pelvic floor rehabilitation.3. positive active maternal pelvic health self-management problems, health care workers need to formulate relevant guidelines for pregnant women master pelvic health knowledge self management, self management of pelvic health daily actions, methods and skills of psychological adjustment and living habits of self management. And to provide information to support the way.4. < manual > the graphic combination form and in each management unit was set after the different feedback module, feedback reading knowledge and behavior change degree, provides a scientific tool during pelvic floor health self-management for pregnant women of pregnancy, but also provide a certain the reference for clinical nursing workers.

【學位授予單位】：重慶醫(yī)科大學
【學位級別】：碩士
【學位授予年份】：2017
【分類號】：R473.71

【參考文獻】

相關期刊論文 前10條

1 張淑萍;;盆底肌鍛煉定期隨訪對分娩結局和盆底肌恢復的影響[J];中國婦幼保健;2016年01期

2 甘紅霞;趙慶華;;病區(qū)臨床護理崗位工作任務指標體系的構建[J];解放軍護理雜志;2015年24期

3 鮑穎潔;胡孟彩;高桂香;黃杰;張志紅;;盆底功能障礙性疾病的多因素分析[J];中南大學學報(醫(yī)學版);2015年11期

4 謝陳漪;余e，

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