提高社区压力性尿失禁患者自我锻炼依从性观察*

张艳青韩兰萍奚晓君储雅琴（.上海市浦东新区黄楼社区卫生服务中心 上海 099；.上海市浦东新区人民医院护理部 上海 000；.上海市浦东新区川沙社区卫生服务中心 上海 09）

提高社区压力性尿失禁患者自我锻炼依从性观察*

张艳青1韩兰萍2奚晓君3储雅琴3
（1.上海市浦东新区黄楼社区卫生服务中心 上海 201299；2.上海市浦东新区人民医院护理部 上海 201200；3.上海市浦东新区川沙社区卫生服务中心 上海 201229）

摘 要目的：探讨一种适合社区压力性尿失禁患者提高自我锻炼依从性的服务方式。方法：选择2014年1月-12月有压力性尿失禁症状的年龄＞55岁的女性68例，分为对照组33例和研究组35例，研究组接受团队服务。3个月后，比较两组患者盆底肌锻炼依从性和1 h尿垫试验漏尿例数。结果：研究组盆底肌锻炼依从性好23例，1h尿垫试验漏尿率为37.4%，对照组则分别为12例和93.9%，组间差异均有统计学意义（P＜0.05）。结论：团队服务方式能有效提高压力性尿失禁患者自我锻炼依从性，缓解漏尿情况。

关键词压力性尿失禁 团队服务方式 依从性

*基金项目：中国社区健康联盟护理中心美国卫生基金会PSBH课题（2014043）

Observation of the improvement of the adherence of self exercise of the community patients with stress urinary incontinence

ZHANG Yanqing1, HAN Lanping2, QI Xiaojun3, CHU Yaqing3
(1.Nursing Department of Huanglou Community Health Service Center of Pudong New District, Shanghai 201299, China; 2.Nursing Department of People’s Hospital of Pudong New District, Shanghai 201200, China; 3. Nursing Department of Chuansha Community Health Service Center of Pudong New District, Shanghai 201229, China)

ABSTRACTObjective: To explore a service method which was suitable for the community patients with stress urinary incontinence to improve their adherence of self exercise. Methods: From Jan to Dec. 2014, 68 women over 55 years old who had the symptom of stress urinary incontinence were selected and randomly divided into a control group with 33 cases and a study group with 35 ones. The study group received the team service. After three months, the adherence of the pelvic floor muscle exercise and the case number of the urinary leakage in the 1 h urine pad test were compared in two groups. Results: The study group had 23 cases with the good adherence of the pelvic floor muscle exercise and the urinary leakage rate in the 1 h urine pad test was 37.4%, while the control group had 12 cases with the good adherence and the urinary leakage rate was 93.9%. The difference between two groups had the statistical significance (P＜0.05). Conclusion: The team service approach can effectively improve the adherence of self exercise of the patients with stress urinary incontinence and ease the urinal leakage.

KEY WORDSstress urinary incontinence; team service approach; compliance

压力性尿失禁是当腹内压突然增高（咳嗽、喷嚏、大笑、屏气等）时尿液不自主流出的现象[1]。据统计，女性23%~45%有不同程度的尿失禁，其中压力性尿失禁约为50%[2]，上海市社区的中老年女性压力性尿失禁的患病率达21%[3]，对患者生理、心理等影响较大。近年来，压力性尿失禁已逐渐引起医务工作者的重视，盆底肌锻炼作为最常用的治疗方法，是一种有效的、低风险、低成本的干预措施[4]。……