Üriner İnkontinansı Olan Kadınlarda Sağlığı Geliştirme Modeline Dayalı Eğitim ve Danışmanlık Programının Benlik Saygısı, Cinsel Doyum ve Yaşam Kalitesine Etkisi

Abstract

Başkaya, E. The Effect of Education and Counseling Program Based on the Health Promotion Model on Self-Esteem, Sexual Satisfaction and Quality of Life in Women with Urinary Incontinence. Hacettepe University, Graduate School of Health Sciences, Obstetrics and Gynecology Nursing Doctoral Program, Doctoral Thesis, Ankara, 2023. The study was carried out in two stages to determine the prevalence and risk factors of urinary incontinence in non-menopausal women over the age of 18 who were registered in a Family Health Center in cross-sectional design, and examine the effects of the training and counseling program based on 'Pender's Health Promotion Model' on women's self-esteem, sexual satisfaction and quality of life in women with urinary incontinence in a randomized controlled experimental research design. The research has been conducted in two stages. The first stage of the research has been conducted in a cross-sectional research design to determine the prevalence and risk factors of urinary incontinence in nonmenopausal women over 18 years of age registered in a Family Health Center; and the second stage has been conducted in a pre-test-post-test randomized controlled experimental research design to evaluate the effect of the training and counseling program based on Pender's Health Promotion Model on women's self-esteem, sexual satisfaction and quality of life in women with urinary incontinence. In the first stage of the research, 1042 non-menopausal women over the age of 18 enrolled in the Family Health Center were included. In the first stage, data have been collected between 18 January 2021 and 31 May 2021 by using the 'Question Form on Descriptive Characteristics', 'International Incontinence Inquiry Form' and 'Incontinence Severity Index'. The second phase of the research has been continued with 46 women who met the sample selection criteria for the second phase. After the pre-test was completed, 46 women stratified blocks were stratified according to the severity of urinary incontinence (mild, moderate) by randomization and assigned to the intervention and control groups (M:23, F:23). In the second phase of the research, the data were collected between 24 September 2021 and 13 January 2022 using the ‘International Consultation on Incontinence Questionnaire Short Form’, 'Incontinence Severity Index', ‘Information Form Based on Pender's Health Promotion Model', 'Self-Esteem Subscale', 'Golombok-Rust Inventory of Sexual Satisfaction-Women Form', 'Incontinence Quality of Life Scale', ’Self-Efficacy Scale'. In the second stage of the research, 'Training and Consultancy Program Based on Pender's Health Promotion Model‘prepared according to Pender's Health Promotion Model was applied to the intervention group. During the three-month period, the intervention group received 3 home visits one, two, and three months after the training program, and 3 phone calls 15 days after the training program, the first and the second home visit. The control group did not receive any intervention, data collection forms were applied simultaneously with the intervention group. In both stages of the research, the forms and scales were filled by the women themselves and the women were guided during this period. Frequency, percentage and descriptive statistics, Shapiro-Wilk Test, Independent Samples T-Test, Repeated Measurements Anova Test, Chi-square Independence Test, Fisher’s Exact Test, Cochran-Q Test, Mann-Whitney U Test, McNemar Test, Friedman Test and Marginal Homogeneity Test have been used in the evaluation of the data. In the first stage of the research, urinary incontinence was determined in 32.9% of the women and it has been found that while the age, the recurrence of urinary system infection increased the risk of urinary incontinence, the increase in the level of education decreased the risk of incontinence. In the second stage of the research, it has been found that the frequency, amount, and severity of urinary incontinence of the women in the intervention group were lower than the control group one month and three months after the training, and the sexual satisfaction and quality of life of the women in the intervention group were higher than the control group one month and three months after the training (p<0,05). The training and consultancy program given according to Pender's Health Promotion Model improves the frequency, amount, severity, sexual satisfaction and quality of life of urinary incontinence in women. In this direction, it is recommended to eliminate the risk factors before the problem arises in women who are at risk for urinary incontinence, to identify the problem at an early stage and to implement behavior and lifestyle changes, to integrate behavior and lifestyle changes into primary health care services, and to expand training programs for prevention and risk reduction in women who have problems.