【作者】 刘妍；

【导师】 王克芳；

【作者基本信息】 山东大学 ， 护理学， 2013， 硕士

【摘要】 目的1.修订中文版女性排尿行为量表,并在女性护士中检验其信、效度；2.调查女性护士下尿路症状现况,并探讨其与排尿行为的关系。方法1.采用多阶段分层整群调查法从济南市三甲医院女性护士中分两次随机抽取2个样本。样本1(n=235)进行项目分析,样本2(n=401)用于对修订后的量表进行信度和效度分析。随机抽取样本2中41名护十(样本2的10%)两周后接受重测,采用SPSS17.0进行项目分析和信度分析,采用AMOS19.0对量表进行验证性因素分析。2.采用儆断面调查的方法,选取济南市某三家三甲医院女性护士401例(样本2)作为研究对象,分别选用国际尿失禁咨询委员会女性下尿路症状问卷(ICIQ-FLUTS)、修订版女性排尿行为量表调查女性护士的下尿路症状和排尿行为。数据经收集整理后,采用户SPSS17.0软件进行统计学分析。结果1.中文版女性排尿行为量表在临床护士中的信效度检验(1)效度：项目分析后最终保留17个条目、5个因子,各条目的门载荷量在0.423～0.899,均>0.4。验证性因子分析显示,结构方程模型各拟合指数良好,模型的绝对适配指标GFI值(0.949)、AGFI值(0.920)均大于0.9,RMSEA值为0.027<0.05；(2)信度：修订后的中文版女性排尿行为量表内部一致性系数为0.802,除排尿姿势外,各维度Cronbach’s a系数均大于0.7,量表的重测信度为0.929。2.女性护士下尿路症状现况及其与排尿行为的关系(1)济南市三甲医院女性护士排尿行为总分为42.86+9.38分,各维度条目平均分由高至低依次为憋尿3.14+0.77分,排尿地点选择倾向2.90+0.85分,排尿姿势倾向2.50+1.09分,无尿意排尿2.31±0.93分,用力排尿1.91+0.86分。(2)84.3%的女性护士至少患有一种下尿路症状,其中储尿症状总患病率(63.8%)高于排尿症状总患病率(17.5%)。不同下尿路症状患病率从高到低依次为夜尿(63.8%)、尿失禁(44.6%)、尿急(24.2%)、膀胱过度活动症(20.2%)、排尿踌躇(13.5%)、尿频(6.5%)、排尿中断(4.2%)、排尿费力(3.2%)。(3)多元Logistic回归分析显示,年龄、尿路感染病史、饮水量、剖宫产：是尿失禁的独立影响因素；不良排尿行为和月经不规律是膀胱过度活动症的独立影响因素。结论1.修订后的中文版女性排尿行为量表在护士中具有较好的信、效度,适用于我国临床护士排尿行为的评估。2.女性护士的不良排尿行为发生率高,以憋尿为主要表现。3.LUTS在女性护士中患病率较高,储尿期症状患病率高于排尿期症状,夜尿最常见。4.年龄、尿路感染病史是UI发生的危险因素,饮水量>2000m1和剖宫产生是UI发生的保护因素。5.女性护士的不良排尿行为和月经不规律OAB发生的危险因素更多还原

【Abstract】 Objectives1. To revise the Chinese version Women’s Toileting Behavior Scale(WTBS-Chinese). and to explore its reliability and validity in female nurses.2. To investigate the prevalence of lower urinary tract symptoms(LUTS) among female nurses, and to explore the relationship between LUTS toileting behavior.Methods1. The Chinese version of Women’s Toileting Behavior Scale was administered to235clinical nurses (sample1)for item analysis while confirmatory factor analysis and reliability analysis were conducted from a sample of401clinical nurses (sample2) in Grade Ⅲ-A hospitals in Jinan by multistage stratified cluster sampling method.40nurses were randomly selected from sample2to be retested two weeks later to evaluate the test-retest reliability. Item analysis and reliability were analysed by SPSS17.0. confirmatory factor analysis was analysed by AMOS19.0.2. A cross-sectional study was employed.401nurses(sample2) were recruited from three Grade Ⅲ-A hospitals in Jinan. International Consultation on Incontinence Questionnaire-Femal Lower Urinary Tract Symptoms(ICIQ-FLUTS) and revised Women’s Toileting Behavior Scale(WTBS) were used to investigate the prevalence of lower urinary tract symptoms and toileting behaviors in female nurses respectively. The collected data was analysed by SPSS17.0.Results1. Reliability and validity of WTBS-Chinese in clinical nurses(1) Validity of WTBS-Chinese:Seventeen items were left using item analysis in5factors and each item loading is over0.4(0.423～0.899). The fitness of such model was perfect (GFI=0.949>0.9, AGFI=0.920>0.9, RMSEA=0.027<0.05)(2) Reliability of WTBS-Chinese:The Cronbach’s a of WTBS-Chinese was0.802and Cronbach’s a of factors were all above0.7except the posture preference for voiding. The test-retest reliability of WTBS-Chinese was0.929.2. The prevalence of LUTS among female nurses, and the relationship between LUTS and toileting behavior.(1) The total score of TB of female nurses in Grade Ⅲ-A hospitals in Jinan was42.86±9.38, and the entries average of each demension were deplayed voiding(3.14±0.77). place preference for voiding(2.90±0.85). posture preference for voiding(2.50±1.09), premature voiding(2.31±0.93). and straining voiding(1.91±0.86) in the descending order.(2) Eighty-four point three percent of the nurses reported at least one LUTS. The prevalence of storage LUTS(63.8%) was greater than that for voiding(17.5%). The prevalence of LUTS was in sequence of nocturia(63.8%).urinary incontinence(UI)(44.6%). urgency(24.2%). overactive bladder(OAB)(20.2%), hesilancy(13.5%). increased daytime frequency(6.5%). intermittent stream(4.2%).straining(3.2%).(3) Multivariate logistic analysis indicated that age. history of urinary infection, fluid intake>2000ml, and cesarean section were independent influencing factors for UI. Poor toileting behaviors and irregular menstruation were independent influencing factors for OAB.Conclusion 1.The revised WTBS-Chinese shows good validity and reliability to estimate the toileting behaviors among clinical nurses.2. The prevalence of poor toileting behaviors is high, especially for delayed voiding.3. LUTS are highly prevalent in female nurses, and prevalence of storage symptoms is greater than that for voiding symptoms in which nocturia is the most common LUTS.4. Age and history of urinary infection are the risk factors for UI while fluid intake>2000ml and cearean section are the protective factors.5. Poor toileting behaviors and irregular menstruation are the risk factors for OAB.更多还原