基于COM-B模型的产妇居家盆底肌锻炼依从性影响因素的质性研究

Drivers of Adherence to Home-Based Pelvic Floor Muscle Training in Postpartum Women: A COM-B Informed Qualitative Study

摘要: 目的：探讨产妇居家盆底肌锻炼的真实体验，为制定临床干预策略提供依据。方法：基于能力、机会、动机–行为(capability, opportunity and motivation-behavior, COM-B)模型，采用描述性质性研究方法，通过目的抽样法选取2024年12月~2025年3月湖南省衡阳市某三级甲等综合医院盆底专科门诊12例分娩后的产妇进行半结构式访谈，采用定向内容分析法进行资料分析。结果：共归纳出3个主题及8个亚主题，即能力因素(盆底康复知识缺乏、知识获取途径有限、知行转化不足)、机会因素(育儿责任削弱锻炼的持续性、配偶支持不足、专业指导赋能产妇坚持锻炼)、动机因素(盆底肌锻炼价值认同感的内在驱动、盆底肌锻炼效果增加锻炼动力)。结论：产妇居家盆底肌锻炼依从性受多重因素影响。医护与家属需协同强化宣教指导、优化居家锻炼环境，创造便利化锻炼条件，让每一位产妇都能认识并享受到盆底肌锻炼带来的长期益处。

Abstract: Objective: To explore the real experiences of postpartum women in performing pelvic floor muscle exercises at home and provide a basis for formulating clinical intervention strategies. Methods: Based on the Capability, Opportunity and Motivation-Behavior (COM-B) model, a descriptive qualitative research method was adopted. Through purposive sampling, 12 postpartum women from the pelvic floor specialist outpatient department of a tertiary general hospital in Hengyang City, Hunan Province from December 2024 to March 2025 were selected for semi-structured interviews. Directed content analysis was used for data analysis. Results: A total of 3 themes and 8 sub-themes were identified, namely capability factors (lack of pelvic floor rehabilitation knowledge, limited knowledge acquisition channels, insufficient knowledge-to-action conversion), opportunity factors (weakened exercise persistence due to childcare responsibilities, insufficient support from spouses, professional guidance empowering women to adhere to exercises), and motivation factors (intrinsic drive from recognizing the value of pelvic floor muscle exercises, increased exercise motivation from exercise effects). Conclusion: The compliance of postpartum women with home pelvic floor muscle exercises is influenced by multiple factors. Medical staff and family members need to collaborate to strengthen educational guidance, optimize the home exercise environment, and create convenient exercise conditions to enable every postpartum woman to recognize and enjoy the long-term benefits of pelvic floor muscle exercises.