Analysis Of Influential Factors Of Urinary Incontinence During Pregnancy And Qualitative Study On Women's Experience With Urinary Incontinence

ObjectiveThe aim of this study is to determine the prevalence of urinary incontinence and in pregnant women,characterize UI subtype,and identify characteristics associated with UI,further explore pregnancy women's perception of urinary incontinence,experience and health needs,in order to provide scientific evidence for risk factors of urinary incontinence and effective prevention strategies;To provide effective and feasible suggestions for clinical perinatal nursing intervention,and enhance women's pelvic floor health care and promote the development of the women's health in China.MethodsThis study used method of combining of quantitative and qualitative research.1.Qualitative research“Study on Prevalence and Influencing Factors of Urinary Incontinence during Pregnancy”.Through a convenient sampling method,pregnant women from March to September 2017 in a routine inspection of top three hospitals in Guangzhou,were selected as research subjects.The self-designed questionnaire and International Consultation on Incontinence Questionnaire Urinary Incontinence Short Form Chinese was used to screen and evaluate UI symptoms,Survey contents mainly include sociodemographic characteristics,history of pregnancy delivery,chronic medical history,urinary incontinence,and problems with life,etc.The analysis of all data was performed by SPSS version 20.0,including descriptive statistical analysis,two independent sample t-test,One-way ANOVA,chi-square,unconditioned multivariable Logistic regression analysis method.2.Qualitative research“Study on self-coping strategies and experience with urinary incontinence during pregnancy”.Purposive sampling and face-to-face semi-structured in-depth qualitative interviews were carried out with 11 female incontinent pregnant women in the top three hospitals in Guangzhou.All interviews were audio-taped were and transcribed into word-by-word texts,memorandums were written after the interview.Using Colaizzi content analysis method in phenomenology to encode,classify,summarize,and finally refine a thematic.ResultsA total of 1036 valid questionnaires were collected in this study,of which601 were nulliparous and 435 were maternity.In the mid-term pregnancy(13~27 weeks)352 people,384 people in the late pregnancy(28 weeks).The average age of pregnant women was 29.59±4.77 years.The mean pre-pregnancy BMI was 24.05±3.25kg/m~2,and the BMI during pregnancy was24.05±3.25 kg/m2.The mean gestational age 29.13±7.72 weeks;the average number of pregnancies was1.73±0.88,and the average number of delivery was0.27±0.58.2.The overall prevalence of UI during pregnancy was 36.9%(382/1036),SUI,UUI,MUI and other types of urinary incontinence was 27.6%(286/1036)?4.2%?3.7%and 1.4%,respectively.In addition,the SUI is the most common type of urinary incontinence,accounting 74.9%of female UI composition ratio.3.The maternal UI prevalence rate was 43.4%(189/435),the nulliparous UI prevalence was 32.1%.The prevalence of maternity UI was higher than nulliparous,and the difference was statistically significant(?~2=13.929,P<0.001).4.The UI degree are mainly composed of mild and moderate the UI.The severity of UI is mainly light and moderate UI,among which 216 are mild UI,accounting for 56.5%,and 147 are moderate UI,accounting for 38.5%.There was a significant difference between maternity and nulliparous in terms of severity of UI with chi-square(Z=0.942,P>0.942).5.In single factor analysis,the two factors of maternal pre-pregnancy BMI and gestational age were significantly related to UI(P<0.05);the delivery,diabetes,and constipation of maternal were related to the occurrence of UI during pregnancy(P<0.05).6.The childbirth way,BMI during pre-pregnancy,gestational age,diabetes,constipation were independent risk factors for UI during pregnancy of the using multivariate unconditioned Logistic regression analysis.7.Through in-depth interviews,UI pregnant women's self-coping style and experience can be summarized into five themes:(1)Insufficiency of cognition:lack of understanding of the basic knowledge of diseases and limited knowledge sources;(2)coping approach:passive avoidance and positive response;(3)psychological experience:changes in comfort,mental distress,and decreased self-efficacy;(4)Health needs;(5)Change in health concept.Conclusions1.The prevalence of UI during pregnancy is higher in Guangzhou,SUI is one of the most common type.The incidence of multipara UI is higher than nulliparous.The severity of UI during pregnancy is mainly mild and moderate,similar to that of other regions in China.Therefore,medical staff should be attach the importance to UI during pregnancy and take measures during pregnancy.2.Multipara are more likely to develop UI than nulliparous,the incidence of UI increases with the increase of gestational weeks,third trimester women are more likely to occur UI.Pre-pregnancy BMI overweight pregnant women relatively low BMI pregnant women,pregnant women with diabetes,compared with normal blood glucose pregnant women,and often constipated pregnant women,compared with non-constipated pregnant women,UI prevalence is higher.Therefore,medical personnel should focus on the impact factors of gestational period,targeted to carry out early prevention and management work,reduce the incidence of gestational UI,thereby reducing the overall prevalence of UI in China.3.When lack of knowledge and coping capacity for pregnant women with UI,to some extent,the quality of life is affected.Therefore,health education and psychological support of pregnant women should be strengthened,and more targeted and humanized nursing model should be created to improve the basic knowledge and quality of life among the pregnant women with UI.