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1 12 尿失禁婦女疾病認知與因應行為之相關性研究陳鳳櫻戴玉慈 * 謝玉賀 ** 本研究係一描述性及相關性研究, 主要目的是瞭解尿失禁婦女之疾病認知因應行為及其相關性以中部某社區尿失禁婦女為研究對象, 經方便取樣, 以自填結構型問卷進行資料收集, 共取得 190 份有效問卷結果發現 :⑴ 尿失禁婦女同意尿失禁是生病現象是個人和治療可以控制的是可以理解的以及是慢性的 ; 不同意尿失禁會有嚴重的後果影響會造成情緒認知困擾是反覆性的 ⑵ 因應行為中, 以避免引起漏尿的動作出門在外, 先找洗手間或選靠近它的位置以及常去解尿為有效的前三項 ⑶ 經多變量邏輯式迴歸分析發現, 影響骨盆底肌肉運動行為的重要因素是可理解性認知和原因認知 ; 求醫行為的重要影響因素有確認疾病認知個人可控性認知可理解性認知以及病程認知本研究結果有助於瞭解尿失禁婦女的整體疾病認知因應行為以及兩者的關係, 作為醫療專業人員提供醫療照護之參考尿失禁婦女疾病認知因應行為 International Continence Society, ICS Abrams, Cardozo, & Fall, % 35% Chen, Lin, Hu, Chen, & Lin, 2003; Yu, Chie, & Chiu, 1994 Hunskaar, Lose, Sykes, & Voss, 2004 Fantl et al., % % Yu et al., 1994 self-management psychological appraisal Umlauf & Burgio, illness perception ㈠㈡㈠ Mitteness & Barker, 1995 Weber incontinence a lack of control or * **

2 13 restrain Palmer, 1990 incompetence ㈡ Ashworth Hagan 1993 minimizing it renaming it paying studied inattention to the problem constant avoidance of danger maintenance of secrecy Robinson 2000 limiting learning monitoring speaking out letting it go Milne, 2000 Mitteness & Barker, 1995 Yu, Wong, Chen, & Chie, 2003 Milne, 2000 Fantl et al., 1996 ㈢ Skoner & Haylor, 1993 Mitteness, 1987 Burgio, Ives, Locher, Arena, & Kuller, 1994 Yu et al., 2003 Kinchen et al., 2003 Engberg, McDowell, Burgio, Watson, & Belle, 1995 Herzog, Fultz, Normolle, Brock, & Diokno, 1989 Herzog et al., 1989 odds 7.9 Engberg et al., 1995 Sandvik 1995 妳突然身體出力提重物咳嗽或打噴嚏, 是否會漏尿? 妳是否曾經突然很想解尿, 但是, 到達廁所前即已經漏尿? 20

3 % ㈠ Moss-Morris Illness Perception Questionnaire Revised, IPQ-R Moss-Morris et al., Cronbach s α r = ㈡ Milne, 2000; Mitteness, Cronbach s α =.76 4Cronbach s α =.77 ㈢ Bradley et al., 2005 Bradley α = r = severity index; Sandvik et al., drops or little 2 more r =.91 ㈣ 2 SPSS 12.0 multivariate logistic regression %

4 %21.6% 36.3% 32.6% 31.1% 9 3 N =190 n % a a a 86.8% 66.7% 57.4% 91.0% 77.2% 72.0% 43.4% 22.8% 94.8% 90.4% 89.4% 28.5% 23.3% 21.6% OR = 1.10, p <.05 OR = 1.11, p <.05 OR = 2.27, p <.001OR = 0.86, p <.05 OR = 1.15, p <.05 OR = 0.79, p <

5 16 n % n % n % n % n % n % OR OR *** * * 1.15* ** * 1.06 a b * 3.86* * c 0.24* a = 0 b = 0 c = 0 *p <.05. **p <.01. ***p <.001. Engberg Bush Castellucci Phillips 2001 Yu et al., 2003

6 Mitteness, % 1997 Chang, Tai, Chen, & Chen, 2006; Wang, Wang, & Chen, % 28.5% Mitteness & Barker, 1995 Yu 2003 Mitteness Barker 1995 disorder disease lay people Tsechkovski 1998 Horrocks, Somerset, Stoddart, & Peters, 2004 Mitteness Barker 1995 HK- SCHM HK-SCHM

7 18 Abrams, P., Cardozo, L. D., & Fall, M. (2002). The standardization of terminology of lower urinary tract function: Report from the standardization sub-committee of the international continence society. Neurourology & Urodynamics, 21(2), 167. Ashworth, P. D., & Hagan, M. T. (1993). The meaning of incontinence: A qualitative study of non-geriatric urinary incontinence suffers. Journal of Advanced Nursing, 18(9), Bradley, C. S., Rovner, E. S., Morgan, M. A., Berlin, M., Novi, J. M., Shea, J. A., et al. (2005). A new questionnaire for urinary incontinence diagnosis in women: Development and testing. American Journal of Obstetrics & Gynecology, 192(1), Burgio, K. L., Ives, D. G., Locher, J. L., Arena, V. C., & Kuller, L. H. (1994). Treatment seeking for urinary incontinence in older adults. Journal of the American Geriatrics Society, 42(2), Bush, T. A., Castellucci, D. T., & Phillips C. (2001). Exporing women s beliefs regarding urinary incontinence. Urologic Nursing, 21(3), Chang, S. J., Tai, H. L., Chen, G. D., & Chen, S. Y. (2006). Effects of a pelvic floor muscle training program for women with urinary incontinence. Journal of the Urological Association, 17(4), Chen, G. D., Lin, T. L., Hu, S. W., Chen, Y. C., & Lin, L. Y. (2003). Prevalence and correlation of urinary incontinence and overactive bladder in Taiwanese women. Neurourology & Urodynamics, 22(2), Engberg, S. J. (1993). Urinary incontinence: The relationship between common sense perceptions and self-care behaviors in rural community-dwelling older women. Unpublished doctoral dissertation. University of Pittsburgh, Pennsylvania. Engberg, S. J., McDowell, J., Burgio, K. L., Watson, J. E., & Belle, S. (1995). Self-care behaviors of older women with urinary incontinence. Journal of Gerontological Nursing, 21(8),7 14. Fantl, J. A., Newman, D. K., Colling, J., DeLancey, J. O., Keeys, C., Loughery, R., et al. (1996). Urinary incontinence in adults: Acute and chronic management. Rockville, MD: US Department of Health and Human Services. Herzog, A. R., Fultz, N. H., Normolle, D. P., Brock, B. M., & Diokno, A. C. (1989). Methods used to manage urinary incontinence by older adults in the community. Journal of the American Geriatrics Society, 37(4), Horrocks, S., Somerset, M., Stoddart, H., & Peters, T. J. (2004). What prevents older people from seeking treatment for urinary incontinence? A qualitative exploration of barriers to the use of community continence services. Family Practice, 21(6), Hunskaar, S., Lose, G., Sykes, D., & Voss, S. (2004). The prevalence of urinary incontinence in women in four European countries. BJU International, 93(3), Kinchen, K. S., Burgio, K., Diokno, A. C., Fultz, N. H., Bump, R., & Obenchain, R. (2003). Factors associated with women s decisions to seek treatment for urinary incontinence. Journal of Women s Health, 12(7), Milne, J. (2000). The impact of information on health behaviors of older adults with urinary incontinence. Clinical Nursing Research, 9(2), Mitteness, L. S. (1987). The management of urinary incontinence by community-dwelling elderly. Gerontologist, 27(2), Mitteness, L. S., & Barker, J. C. (1995). Stigmatizing a normal condition: Urinary incontinence in late life. Medical Anthropology Quarterly, 9(2), Moss-Morris, R., Weinman, J., Petrie, K. J., Horne, R., Cameron, L. D., & Buick, D. (2002). The revised illness perception questionnaire (IPQ-R). Psychology & Health, 17(1), Palmer, M. H. (1990). Urinary incontinence. Nurse Clinical North American, 25(4), Robinson, J. P. (2000). Managing urinary incontinence in the nursing home: Residents perspectives. Journal of Advanced Nursing, 31(1), Sandvik, H., Hunskaar, S., Seim, A., Hermstad, R., Vanvik, A., & Bratt, H. (1993). Validation of a severity index in female urinary incontinence and its implementation in an epidemiological survey. Journal of Epidemiology & Community Health, 47(6), Sandvik, H., Hunskaar, S., Vanvik, A., Bratt, H., Seim, A., & Hermstad, R. (1995). Diagnostic classification of female urinary incontinence: An epidemiological survey corrected for validity. Journal of Clinical Epidemiology, 48(3),

8 19 Skoner, M. M., & Haylor, M. J. (1993). Managing incontinence: Women s normalizing strategies. Health Care for Women International, 14(6), Tsechkovski, M. S. (1998). First international conference on urinary incontinence in the elderly August, Wissenschaftszentrum Bonn, Germany. World Journal of Urology, 16(suppl. 1), S2. Umlauf, M. G., & Burgio, K. L. (1996). Psychosocial issues in geriatric urology: Problem in treatment and treatment seeking. Urologic Clinics of North America, 23(1), Wang, A. C., Wang, Y. Y., & Chen, M. C. (2004). Single-blind, randomized trial of pelvic floor muscle training, biofeedback-assisted pelvic floor muscle training, and electrical stimulation in the management of overactive bladder. Urology, 63(1), Yu, H. J., Chie, W. C., & Chiu, T. Y. (1994). Prevalence and risk factors of urinary incontinence in community-dwelling women in the Taipei area. Medical Journal of Urology ROC, 5(1), Yu, H. J., Wong, W. Y., Chen, J., & Chie, W. C. (2003). Quality of life impact and treatment seeking of Chinese women with urinary incontinence. Quality of Life Research, 12(3),

9 20 A Correlational Study of Illness Perception and Coping Behaviors in Women With Urinary Incontinence Fong-Ying Chen Yu-Tzu Dai * Yu-Ho Hsieh ** ABSTRACT: The main purpose of this study was to explore the relationship between illness perception and coping behaviors in women with urinary incontinence. One hundred and ninety community-dwelling women with urinary incontinence were recruited by convenience sampling. A structured questionnaire was used to collect data from subjects via self-administration. Results of this study showed that: (1) Women agree that urinary incontinence is an illness, controllable, coherent and permanent, but do not agree that urinary incontinence has serious consequences and emotional impacts. (2) Avoiding activity which induced urinary incontinence, locating or staying near a bathroom when out, and, voiding more frequently, were the most effective coping behaviors. (3) Multivariate logistic regression analysis indicated that the main factors affecting pelvic muscle exercise behavior were intelligible and their causes were recognizable; the main factors affecting treatment seeking behavior were confirmation of a recognized disease, recognized personal controllability, recognized intelligibility and a recognized course of disease. The results of this study may help medical personnel understand the illness perception and coping behaviors of women with urinary incontinence. The results may also serve as a reference for providing better care of women with urinary incontinence. Key Words: urinary incontinence, women, illness perception, coping behaviors. RN, MSN, Instructor, School of Nursing, HungKuang University & Doctoral Student, Graduate Institute of Nursing, National Taiwan University; *RN, PhD, Professor & Dean, School and Graduate Institute of Nursing, National Taiwan University; **RN, BSN, Supervisor, Department of Nursing, Show Chwan Memorial Hospital. Received: August 24, 2007 Revised: October 16, 2007 Accepted: December 28, 2007 Address correspondence to: Yu-Ho Hsieh, No. 542, Chung-Shang Rd. Sec. 1, Changhua 50008, Taiwan, ROC. Tel: 886(4) ext ; showho66@yahoo.com.tw

行政院國家科學委員會補助專題研究計畫成果報告期中進度報告骨盆底肌訓練方案對產後婦女骨盆重建之成效 Pelvic floor muscle protecting / training program effe

行政院國家科學委員會補助專題研究計畫成果報告期中進度報告骨盆底肌訓練方案對產後婦女骨盆重建之成效 Pelvic floor muscle protecting / training program effe 行練女精類行年年行理林玲參理理理利年年行政院國家科學委員會補助專題研究計畫成果報告期中進度報告骨盆底肌訓練方案對產後婦女骨盆重建之成效 Pelvic floor muscle protecting / training program effect on pelvic