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Wednesday, 9 July 2008
Learning Objective 1: The learner will be able to know a client-centered approach to help women with SUI improving knowledge, attitude, behavior and decreasing the severity of UI.
Learning Objective 2: The learner will be able to know the research methods and process of evaluating the effects of a community-based intervention program.
Stress urinary incontinence (SUI) is the major type of urinary incontinence (UI) for women; client-centered programs are needed to improve the quality of care especially for community women. In this study, we developed a two-step approach (including health education needs assessment and instruction, and Kegel's exercise training) to help community women who had diagnosed by physicians based on bladder function tests and clinical signs to reduce the severity of UI and improve their knowledge, attitude, and behavior. An experimental research design was conducted in this study. Questionnaires and measurements were used to collect data. Each subject needed complete two tests: at baseline (pretest) and one month following the intervention (posttest). Of 100 women with SUI, 78 completed this study (34 in the experimental group, 44 in the control group). At the pretest, there were no significant differences between the two groups in personal factors (including demographic characteristics, body mass index, locus of control, medication use, personal histories of labor, diseases, surgeries, and medical treatment), knowledge, attitude (including three dimensions: seeking treatment, self-acceptance, and perceived acceptance and support from significant others), behavior, and the severity of UI (measuring by one 1-hour period extended pad test, self-rated severity, and self-rated impacts on daily living). Regarding the effects of intervention, this approach significantly improved the subjects' knowledge and behaviors (p < .001) however did not significantly change their attitudes. As to the severity, significant decrease in urine volume measuring by 1-hour period extended pad test was found in experimental group. Based on our findings, health education needs assessment and instruction, and Kegel's exercise training are effective to improve SUI women's knowledge, behavior, and the severity of UI. However, more effective intervention still should be developed in future to significantly change attitude and then to build a more active and positive attitude toward UI.