Abstract:

Objective To construct a pelvic floor muscle training program for patients undergoing radical prostatectomy，and to provide a reference for clinical practice. Methods The evidence related to pelvic floor muscle training in patients undergoing radical prostatectomy was systematically searched and the quality was evaluated. The draft of pelvic floor muscle training program for patients undergoing radical prostatectomy was constructed based on the KAP theory and it was demonstrated and revised by expert meetings. From February to March 2023，Delphi method was used to determine the final scheme. 37 patients were selected as the control group and 38 patients as the experimental group to implement the scheme and evaluate the application effect. Results 2 rounds of Delphi consultations were conducted among 17 experts，and the recovery rate of the questionnaire was 100%. The expert authority coefficient was 0.89. The Kendall harmony coefficients of the importance and feasibility of the second round of consultation were 0.270 and 0.209（P<0.001）. The coefficient of variation of importance and feasibility of items were 0~0.18 and 0~0.20. The final program included 3 first-level items，8 second-level items and 29 third-level items. 1 month after surgery，there was no significant difference in urinary incontinence score（P=0.242） and there was significant difference in pelvic floor muscle training compliance（P=0.011） between 2 groups. Conclusion The program was applied preliminary in clinical practice and it was confirmed with scientific and practical meaning，so it can provide a reference for clinical nursing.

Key words: Radical Prostatectomy, Pelvic Floor Muscle Training, Delphi Technology, Nursing Care

摘要：

目的 构建前列腺癌根治术患者盆底肌训练方案并评价其应用效果，为临床实践提供参考。 方法 对前列腺癌根治术患者盆底肌训练相关证据进行系统检索和质量评价，以知信行理论为指导，拟订前列腺癌根治术患者盆底肌训练方案初稿，通过专家会议对方案初稿进行论证、修改，运用德尔菲法在2023年2月—3月进行专家函询，确定最终方案。选取2023年4月—9月在浙江省某三级甲等医院泌尿外科B病区行前列腺癌根治术的38例患者为试验组，实施该方案并评价应用效果；A病区37例患者为对照组，采取常规护理。 结果 17名专家参加了2轮德尔菲专家函询，问卷回收率100%，函询专家权威系数0.89。第2轮函询条目重要性、可行性的肯德尔和谐系数分别为0.270、0.209（P<0.001）；条目重要性、可行性评分的变异系数分别为0~0.18、0~0.20；最终形成的前列腺癌根治术患者盆底肌训练方案包括3个一级条目、8个二级条目、29个三级条目。两组术后1个月尿失禁评分差异无统计学意义（P=0.242）。试验组术后1个月盆底肌训练依从性评分（10.89±4.67）分，高于对照组（8.16±4.38）分，差异有统计学意义（P=0.011）。 结论 该研究构建的前列腺癌根治术患者盆底肌训练方案具有较好的科学性和实用性，可提高患者的盆底肌训练依从性，为临床护理实践提供参考。

关键词: 前列腺癌根治术, 盆底肌训练, 德尔菲技术, 护理