Application Of Continuous Nursing Based On Reinforcement Theory In Home Rehabilitation Of Patients Undergoing Radical Prostatectomy

Research Purpose:Based on the reinforcement theory,a continuous nursing intervention plan for home rehabilitation of patients after radical prostate cancer surgery was formulated.To investigate the effects of this regimen on exercise adherence,severity of urinary incontinence,and mental health in postoperative patients with prostate cancer.Research Methods:Using the research method of rehabilitation diary combined with online intervention.There are 40 patients who undergone prostatectomy in control group and 40 in trial group.The steps of the intervention were divided into preoperative and postoperative interventions,and the preoperative intervention distributed exercise videos and manuals within 24 hours before the operation of the two groups of patients,ensuring that each patient learned the method of pelvic floor muscle exercise before surgery.The postoperative intervention begins within 3 days of the patient’s catheter removal,the control group exercised in accordance with the requirements of the video and manual;the experimental group needed to record the daily exercise and urination,submit a record punch card once a week,the researcher evaluated according to the punch content and gave feedback to the patient,and adopted a positive incentive policy to encourage the patient to adhere to the standardized exercise.The duration of the intervention was 2 months,and the patients were assessed for outcome measures before the intervention,at the end of month 1 and at the end of month 2,respectively,including exercise adherence（average daily exercise time）,urinary incontinence severity（nonwetting use,prostate symptoms,incontinence impact scores）,and mental health（self-management effectiveness,anxiety,depression scores）.Research Results:71 patients completed the trial,37 in the experimental group and 34 in the control group.There was no statistic difference in the general data between the two groups of patients before intervention（P>0.05）.At one month after the intervention,the median average daily exercise time in the experimental and control groups was 45.00 and 30.00,respectively,with a statistically significant difference（P<0.05）.At the second month,the median of the experimental group was 30.00 and the control group was 37.50,and the difference was not statistically significant（P>0.05）.The number of patients in the experimental group who did not wet with diapers was 13 at the first month and 3 at the second month;patients who without diapers in control group was 22 and 10,and the difference were both statistically significant（P<0.05）.The median prostate symptoms scores of the patients in the experimental group was 12 and 7 points,and the control group was 20 and 15 points,respectively,and the difference were both statistically significant（P<0.001）.There was no statistically significant difference in the incontinence impact scores between the two groups at month 1 of the postoperative intervention（13.38±2.24 VS 14.03±2.15,P>0.05）,and at month 2 of the intervention,there was a statistically significant difference between the two groups（9.67±1.531 VS 10.65±2.54,P<0.05）.Comparing the self-management effectiveness scores of the two groups at different time points before and after the intervention,there was no interaction effect between the intervention method and time（P>0.05）,and the same to anxiety scores.There is an interaction effect between the depression scoring intervention factors and time at different points in time（P<0.001）.Separate effects analysis of the intervention in depression scores showed no significant difference between the two groups before the intervention and at the second month of intervention（P>0.05）,and a significant difference between the two groups at the first month（P<0.001）.Separate effects analysis of time factors in depression scores showed no significant difference in trial group at the 1st month compared with pre-intervention（P>0.05）,and the difference in depression scores between the second month and pre-intervention,and the difference between the second month and the first month of the intervention（P<0.05）.There were significant differences between the 1st month and pre-intervention in the control group（P<0.001）,and the same to second month VS preintervention and the 2nd month VS 1st month（P<0.001）.Research Conclusion:The continuous nursing intervention program based on the reinforcement theory can effectively improve the compliance and mental health level of pelvic floor muscle exercise in patients,reduce the severity of urinary incontinence,and deserve further clinical promotion and application.