社區婦女對漏尿知識、態度、嚴重度及其自我照顧行為之相關因素

研究背景：漏尿常被認為是因分娩或自然老化所產生的現象。目前全球針對各年齡層有輕微漏尿並未就醫之婦女，及生產過程中接受宮底施壓(Fundal pressure)所造成的產後漏尿潛在風險顯少被關注及重視。研究目的：針對高屏地區20 歲以上64 歲以下（含64 歲）社區婦女進行漏尿知識、態度、嚴重度及其自我照顧行為之相關因素探討，作為婦女漏尿的預防與加強自我照顧介入措施之參考。研究方法：採橫斷式調查法(Cross-sectional survey)，以方便取樣 (Convenience sampling)於高屏地區之社區篩選符合條件之婦女，共 227 位婦女採面對面訪談結構性問卷進行資料收集。針對個案基本屬性與漏尿各變項進行描述性分析；獨立樣本t 檢定、one-way ANOVA 檢定、卡方檢定以及皮爾森積差相關等進行推論性統計分析，並採用多元逐步回歸分析漏尿自我照顧行為之重要預測因子。研究結果：本研究教育程度（F=2.65, p=.034）及生產經驗（t=2.19, p=.029）與漏尿自我照顧行為達顯著差異。漏尿知識與尿失禁自我照顧行為無顯著相關，漏尿態度（r=.180, p<.01）以及嚴重度（r=.204, p<.05）與漏尿自我照顧行為達顯著相關。有無漏尿兩組婦女，在漏尿知識（t=-.311, p=.756）及態度（t=1.815, p=.071）結果未達顯著差異，無漏尿婦女自我照顧行為(Mean=3.19，SD=.68)明顯高於有漏尿者(Mean=2.76, SD=.51)。生產時曾宮底施壓與有無漏尿達統計顯著相關（χ2=7.312, p=.007），但與漏尿的嚴重度，無統計顯著差異，漏尿態度(β= .174， p = .038)以及漏尿嚴重度(β= .199, p = .018)，為漏尿自我照顧行為之重要預測因子，其可解釋力為7.2%。結論：本研究發現婦女漏尿自我照顧行為之影響因素，並非單一提升知識即能促使行為改變，護理人員應評估婦女執行自我照顧行為過程可能之困難，並提供諮詢與合宜的指導以增進婦女執行之意願。此外，本研究發現接受宮底施壓之婦女罹患漏尿比例高於未接受宮底施壓者。期望透過本研究能提供醫護人員未來臨床指導漏尿自我照顧之參考與臨床上執行宮底施壓前，應先審慎評估其執行之必要性。

關鍵字

漏尿；尿失禁；尿失禁知識；尿失禁態度；尿失禁嚴重度；自我照顧行為

並列摘要

Abstract Background: Urinary incontinence in women is often considered a consequence of labor or natural aging. Currently, the study of the potential risks of the women who has slight urinary in- continence without seeking medical treatment of all ages, or women who has postpartum urinary incontinence because of accepting Fundal pressure in laboring is limited. Research objectives: The purpose of this study is to prevent women’s urinary incontinence and strengthen the self-care involving.To explore all the associated factors such as women’s knowledge of urinary incontinence, attitude, severity and behavior of self -care in women in age of 20 to 64 of Kaohsiung. Research method: The Cross-sectional survey is selected to recruit the quality of data in this study. Convenience sampling of 227 women by face-to-face interview was conducted in the survey. The data was analyzed by using Independent Simple T test, one-way ANOVA, Chi-square test, Pearson product-moment correlation. And prediction the important factors by using Stepwise multiple regression. The study uses Stepwise multiple regression to predict important factors. Result: (1) Education（F=2.65, p=.034） and experience of laboring（t=2.19, p=.029） had significant difference in self-care of urinary incontinence. (2)Knowledge and self-care of urinary incontinence had no significant related.(3) Attitude（r=.180, p<.01） and severity（r=.204, p<.05） had significantly related in self-care of urinary incontinence. Women in urinary incontinence had no significant difference in knowledge（t=-.311, p=.756） and attitude（t=1.815, p=.071） comparing to women without urinary incontinence. Women without urinary incontinence have higher scores in self -care. Laboring with Fundal pressure has significant related （χ2=7.312, p=.007）, but severity has not. 7.2% of behvaior of self-care is explained by attitude(β= .174， p = .038) and severity(β= .199, p = .018). Conclusion: Enhancing knowledge is not the only effected factor to self-caring. Nursing Personnel should evaluate the difficulties of self-caring and to provide advisory to increase the behavior of self-care. Otherwise, women who had Fundal pressure is found to be at higher risk of having urinary incontinence to the women who had not. Through this survey, it can provide nursing personnel the ways to guide the women in urinary incontinence and also to re-evaluate before performing fundal pressure and the necessity of performing fundal pressure as well.