Impact and path analysis of disease uncertainty on pelvic floor muscle exercise compliance in patients with urinary incontinence after LRP
10.3760/cma.j.cn115682-20241204-06686
- VernacularTitle:疾病不确定感对LRP术后尿失禁患者盆底肌功能锻炼依从性的影响及路径分析
- Author:
Danjing SHEN
1
;
Jiangmei XU
;
Zhuoran GU
;
Xulin HE
;
Ruimei SONG
Author Information
1. 同济大学医学院，上海 200092
- Publication Type:Journal Article
- Keywords:
Prostatic neoplasms;
Urinary incontinence;
Disease uncertainty;
Pelvic floor muscle exercise;
Compliance;
Influencing factors;
Path analysis
- From:
Chinese Journal of Modern Nursing
2025;31(32):4412-4421
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To analyze the influencing factors of pelvic floor muscle exercise (PFME) compliance in patients with urinary incontinence after laparoscopic radical prostatectomy (LRP) based on the theory of disease uncertainty, and construct a structural equation model, so as to explore the impact mechanisms of disease uncertainty, social support, PFME self-efficacy, and disease coping styles on exercise compliance in patients with urinary incontinence after LRP.Methods:Convenience sampling was used to select 300 postoperative urinary incontinence patients who underwent LRP and PFME at Tenth People's Hospital of Tongji University between June 2023 and June 2024 as study subjects. Patients were assessed using the General Information Questionnaire, PFME Compliance Scale, Mishel Uncertainty in Illness Scale-Adult (MUIS-A), Broome Pelvic Muscle Self-Efficacy Scale (BPMSES), Social Support Rating Scale (SSRS), and Medical Coping Modes Questionnaire (MCMQ). Multiple linear regression analysis was employed to identify factors influencing PFME compliance in patients with urinary incontinence after LRP. Pearson correlation was used to analyze the correlation between PFME compliance and disease uncertainty, self-efficacy, social support, and medical coping styles in patients with urinary incontinence after LRP. AMOS 26.0 software was used for path analysis.Results:A total of 300 questionnaires were distributed, and 282 valid questionnaires were collected, with a valid response rate of 94.00% (282/300). Among 282 patients with urinary incontinence after LRP, the PFME Compliance Scale, MUIS-A, BPMSES, SSRS, and MCMQ scores for confrontation, avoidance, and resignation coping styles were (11.92±2.60), (72.37±14.56), (166.98±17.10), (50.69±6.73), (14.46±2.56), (14.12±2.91), and (12.32±2.58), respectively. PFME compliance showed negative correlations with MUIS-A scores and resignation coping style ( r=-0.559, -0.606; P<0.01), while exhibiting positive correlations with PFME self-efficacy, social support and confrontation coping style ( r=0.494, 0.539, 0.118; P<0.05). Bootstrap mediating analysis showed that disease uncertainty not only directly affected PFME compliance in patients with urinary incontinence after LRP, but also indirectly affected PFME compliance through three pathways: disease uncertainty→ PFME self-efficacy→ PFME compliance, with an effect value of -0.147 [95% CI (-0.250, -0.085) ], accounting for 18.1% of the total effect; disease uncertainty→ resignation coping style→ PFME compliance, with an effect value of -0.184 [95% CI (-0.270, -0.115) ], accounting for 22.7% of the total effect; disease uncertainty→ social support → PFME compliance, with an effect value of -0.173 [95% CI (-0.300, -0.070) ], accounting for 21.4% of the total effect. The indirect total effect constituted 62.2% of the total effect. Conclusions:Patients with urinary incontinence after LRP have low PFME compliance. Disease uncertainty not only directly affects PFME compliance, but also indirectly affects it through PFME self-efficacy, social support, and coping styles.
