婦女執行骨盆底肌運動之阻礙因素質性研究

Women’s Perceived Barriers to Performing A Pelvic Floor Muscle Exercise: A Qualitative Approach

目的：本研究之目的在探討接受骨盆底肌運動醫囑治療尿失禁之婦女執行骨盆底肌運動之經驗。方法： 以深度訪談法訪問八位接受骨盆底肌運動醫囑治療其尿失禁並已執行該運動至少六週之婦女，年齡介於30至64歲。訪談指引為：(1)請問您做骨盆底肌運動的經驗？(2) 有些什麼會阻礙您做骨盆底肌運動？ 它們是什麼？ 到什麼程度？ 您如何克服它們？ 克服它們有多困難？ 以及(3)骨盆底肌運動對您和您的性伴侶關係有什麼影響？ 訪談內容錄音並寫成逐字稿，再以內容分析法整理歸納之。結果： 研究結果顯示婦女執行骨盆底肌運動之經驗可歸納為三個主題：(1)其他優先事項轉移對運動的專注，(2)運動時處於是否執行正確的不確定性，(3)運動對尿失禁的療效只是部份改善。此外，研究對象中有五位願意分享她們運用骨盆底肌運動於性生活的經驗。結論： 婦女骨盆底肌運動經驗三大主題皆為執行該運動的阻礙因素，這些阻礙因素助長「不遵從骨盆底肌運動使尿失禁益形惡化」之惡性循環。未來在執行骨盆底肌訓練之後續追蹤，應注意此一循環現象，並進一步研究如何打破此一惡性循環。

Purpose: The study aimed to obtain feedback about the experiences of women who performed a pelvic floor muscle exercise (PFME) prescribed for treating urinary incontinence. Methods: A qualitative inquiry method with in-depth interviews was used to collect data. Eight women (30-64 years) were recruited. All of them were given proper instruction and they performed the PFME daily for six weeks. The interview questions were: (1) What is your typical experience when doing the PFM exercise? (2) Do any events prevent you from doing the PFM exercise? To what extent do they interfere with your PFM exercise performance? How do you manage those obstacles? and (3) How does the PFM exercise influence your relationship with your partner? The interviews were audiotaped and transcribed verbatim. Content analysis was used to examine the data. Results: The findings showed that the narrative data on women's experiences of performing the PFME revealed three themes: (1) shifting attention to other priorities, (2) uncertainty about the exercise procedure, and (3) partially benefiting from the PFME. Five of the eight women also shared their expectations and experiences acquired after performing the PFME during sex. Conclusions: The three themes are all related to perceived barriers to performing the PFME, and lead to an exacerbation of the urinary incontinence symptoms when the exercise is not performed. Regular follow-ups after pelvic floor muscle training for monitoring progress and giving positive feedback are suggested in order to encourage women to continue long-term use of the PFME for maximum effectiveness.