A causal model: Factors influencing pelvic muscle exercise adherence among Taiwanese women with urinary incontinence.

摘要

The purposes of this study were twofold. This study was primarily designed to test the theoretical model proposing that pelvic muscle exercise (PME) adherence could be predicted by five key concepts: knowledge of PME, attitudes towards PME, partner cohesion, perceived PME benefits, and PME self-efficacy. The PME adherence studied was adherence behavior and perceived adherence. Secondarily, this study was designed to explore Taiwanese women's experiences of performing PME for urinary incontinence (UI).; Using a cross-sectional, correlational design, this study incorporated both quantitative causal modeling and qualitative data. A convenience sample of fifty-five Taiwanese women with UI completed the research questionnaires measuring the key concepts in the theoretical model. Multiple regression analysis and path analysis were used for quantitative data analysis. The qualitative data were collected during in-depth interviews with 8 women who were recruited from the total sample of 55 women. Content analysis was used to analyze the interview data.; As predicted in the path analysis, PME self-efficacy showed a positive direct effect on both PME adherence behavior and perceived adherence to PME. Attitudes towards PME, partner cohesion, and perceived PME benefits, respectively, had an indirect effect on both adherence behavior and perceived adherence, mediated by the PME self-efficacy. Menopausal status, and knowledge of PME had a direct positive erect on PME adherence behavior along with PME self-efficacy, respectively. Age was not a significant predictor. Qualitative data revealed that some cases confirmed some paths while the other cases confirmed other paths. Content analysis showed that women's experiences in performing PME for UI involved (a) shifts in personal priorities, (b) PME procedure uncertainty, and (c) partial PME benefit attainment. The three themes were all related to perceived PME barriers.; Overall, PME self-efficacy affected both PME adherence behavior and perceived adherence to PME directly and mediated the effects of attitudes towards PME, partner cohesion, and perceived PME benefits on both outcome variables. These findings suggest that clinical interventions which facilitate PME self-efficacy may improve women's adherence to PME. Finally, perceived PME barriers may also be an influential factor of PME adherence.