The Impact Of An Intervention Based On Health Empowerment Theory On The Health Seeking Behavior Of Elderly Women With Urinary Incontinence In Community

ObjectivesTo explore the impact of an intervention based on health empowerment theory on the health seeking behavior of elderly women with urinary incontinence in the community,so that it can help drive the health seeking behavior and improve the quality of life of elderly women with urinary incontinence.MethodsThe first part:Constructing an intervention based on health empowerment theory on the health seeking behavior of elderly women incontinent patients in the community,conducting two rounds of expert consultation to refine the intervention,followed by selecting five cases of incontinent patients to conduct a pre-test to further modify and improve the intervention to form the final intervention.The second Part:Evaluate the effectiveness of the intervention based on health empowerment theory on the health seeking behavior of elderly women incontinent patients in the community.Eighty cases of elderly women urinary incontinence patients from two communities in Lanzhou City were selected and divided into an intervention group(n=40)and a control group(n=40)to conduct a class experimental study.The intervention group implemented a health empowerment theory-based health seeking behavior intervention once a week for a total of 5 sessions,while the control group implemented conventional health education once a week for a total of 5 sessions.Changes in patients’health seeking intention,health seeking attitude and health seeking behavior were measured using the Health Seeking Intention Scale and the Health Seeking Attitude Scale,the Health Seeking Behavior Questionnaire for Patients with Women Urinary Incontinence immediately after the intervention,in the first month after the intervention and in the third month after the intervention.SPSS 26.0 was used for statistical analysis and descriptive statistical analysis,chi-square test,Fisher’s exact probability method,independent sample t-test,generalized estimating equation and repeated measures ANOVA were applied.Results1.5 cases were lost in the intervention group and 1 case was lost in the control group during the follow-up of this study,so there were 74 valid cases finally.There were no statistically significant differences between the two study groups in terms of age,BMI,ethnicity,marital status,education level,work status,menstrual status,history of gynaecological surgery,number of spontaneous deliveries,history of caesarean section,primary family caregiver,monthly family income and type of health insurance(P>0.05).No statistically significant differences existed between the two groups in terms of health seeking behavior,intention to seek health care and attitude towards health care(P>0.05).2.There was no interaction effect between time and group for intention to seek health care during both before and after the intervention(F=0.625,P=0.561).There was a significant between-group effect(F=8.778,P=0.004),which indicates that the intervention programme based on health empowerment theory was effective in improving patients’intention to seek care.The time effect was significant(F=4.695,P=0.007),which indicates that patients’intention to seek care scores decreased with time point in both groups.3.A significant time and group interaction effect(F=3.442,P=0.033)was found between pre-and post-intervention attitudes to health care,which indicates that changes in scores of attitudes towards health care at different time points in the intervention group were significantly inconsistent with changes in scores of attitudes towards health care at different time points in the control group.The between-group effect was significant(F=8.082,P=0.006),which indicates that the intervention programme based on health empowerment theory was effective in improving patients’attitudes towards health care.There was a significant time effect(F=16.175,P<0.001),which indicates that patients’attitudes to healthcare scores decreased over time in both groups.The scores of medical attitude of patients in the two groups at different time points were compared within group,and the results showed that in the intervention group,differences in intervention group and attitudes towards medical treatment before and immediately after the intervention,and at the first month after the intervention were statistically significant(P<0.05),differences in attitudes towards medical treatment immediately after the intervention and at the third month after the intervention were statistically significant(P<0.05),and differences in attitudes towards medical treatment at the first and third month after the intervention were statistically significant(P<0.05).4.Patients in the intervention group had a higher attendance rate than the control group,with a statistically significant comparison between groups(Waldx~2=9.676,P=0.002);there was no significant change in the visit rate between the two groups at month 1 and month 3 post-intervention compared to the immediate post-intervention period,and the time comparison was not statistically significant(Waldx~2=0.804,P=0.669).Patients in the intervention group had more visits than those in the control group and the comparison between the groups was statistically significant(Waldx~2=16.333,P<0.001);there was no significant change in the number of visits in the first and third months after the intervention compared to the immediate post-intervention period and the time comparison was not statistically significant(Waldx~2=2.124,P=0.346).Patients in the intervention group were better at complying with medical advice and treatment on time than those in the control group,with a statistically significant comparison between the groups(Waldx~2=8.900,P=0.003);there was no significant change in compliance with medical advice and treatment on time at month 1 and month 3 post-intervention compared to the immediate post-intervention period,with no statistically significant comparison between the two groups(Waldx~2=0.481,P=0.786).There was no significant difference between the intervention group and the control group in terms of whether patients stopped treatment when their symptoms improved,and the comparison between the groups was not statistically significant(Waldx~2<0.001,P=0.993);compared to the immediate post-intervention period,there was no significant change in whether patients stopped treatment when their symptoms improved at month 1 and month 3 after the intervention,and the comparison between the two groups was not statistically significant(Waldx~2=0.005,P=0.998).There was no significant difference between the intervention group and the control group in terms of whether patients complied with medical advice for regular check-ups when their symptoms improved,and the comparison between the groups was not statistically significant(Waldx~2=0.008,P=0.930).Compared to the immediate post-intervention period,there was no statistically significant change in compliance with medical advice for regular review at month 1 and month 3 post-intervention in the two groups,and the time comparison was not statistically significant(Waldx~2<0.001,P=1.000).ConclusionsInterventions based on health empowerment theory can help improve intention to seek health care,attitudes towards care and health seeking behavior among elderly women with urinary incontinence in the community.