摘要
本研究目的在探討以不同的衛教方式進行骨盆底肌肉運動之成效。研究對象為立意選取自2006年3月9日至同年7月8日研究者的年滿20歲以上女性複診病人，並自填過去一年曾經發生過應力性尿失禁者。研究方法分兩部分：實驗一以「單樣本前後測設計」，全體研究樣本接受三分鐘動機式晤談，並立即評估其成效。實驗二以「實驗組對照組前後測設計」，實驗組接受研究者設計之個別衛教方式，對照組則比照一般門診衛教方式，分別進行骨盆底肌肉運動衛教，12週後比較不同衛教方式之成效。所得的重要結果如下：(一)三分鐘動機式晤談對增強動機有成效。 (二)若知識的前測得分在7分（含）以下時，個別衛教的教學方法達顯著的差異，且前測分數越低的成效越好。(三)但當前測漏尿量大於0.12公克時，以陰道指診法教導骨盆底肌肉運動達到顯著的成效，且前測漏尿量越大的成效越好。 (四)個別衛教組中，「人際支持策略--電話連絡成功次數超過八次者」具有顯著的效果。(五) 個別衛教組中，當「一小時棉墊試驗前測的漏尿量」大於0.44公克時，「行動提示策略--記錄及繳回運動日誌」具有顯著的效果。(六)全體研究樣本之「一小時棉墊試驗後測的漏尿量」除了前測的漏尿量以外，可由“實驗組別”及“晤談後之動機得分”來預測。(七)實驗組之「一小時棉墊試驗後測的漏尿量」除了前測的漏尿量之外，可由來行動提示策略來預測。
在一般門診中有不少被疏忽的輕、中度應力性尿失禁婦女，建議家庭醫師應主動詢問漏尿議題，忙碌的門診工作中可以用三分鐘進行動機式晤談來增強病人進行骨盆底肌肉運動的動機，運用行為科學的跨理論模式來設計衛教內容，缺少生理回饋儀的設備時可以用最方便和可近性的陰道指診法教導骨盆底肌肉收縮技巧，讓尿失禁婦女走出尿失禁的陰影及提升其生活品質。

Abstract
The purpose of the research is to compare the effects of different types of health education on the pelvic floor muscle exercise. The subjects in this research are over-20-year-old female patients chosen by purposive sampling from those who, coming to the outpatient clinic for the other disease between March 9 and July 8, 2006, stated they experienced stress incontinence in the year before. Two methods are used. In one of them, called the Pretest-Posttest Single Group Design, all the samples take a three-minute motivation interview and the results are assessed right after the interview. In the other, referred to as the Pretest-Posttest Control Group Design, the experimental group receives health education on the pelvic floor muscle exercise specifically designed for each different subject while the control group accepts the similar health education commonly given in the out patient clinic. Twelve weeks later, the effects of the two different types of health education are assessed. The results are as follows. First, all samples are more motivated after a three-minute motivation interview. Second, the experimental group is more impressive in helping increase the scores of understanding stress incontinence. Third, the experimental group shows remarkable progress in reducing urine leakage in the one hour pad test. Fourth, in the experimental group, interpersonal support strategy shows great force in helping reducing urine leakage in the one hour pad test. Fifth, in the experimental group, action hint strategy plays a big role in helping reducing urine leakage when urine leakage is higher than 0.443 grams in the one hour pad test. In addition to pretest urine leakage, posttest urine leakage for all samples can be predicted based on experimental group categories and the motivation scores after the interviews. Seventh, in addition to pretest urine leakage, posttest urine leakage for the experimental group can be predicted based on patient’s adherence.
For numerous women whose slight stress incontinence is often neglected, busy family physicians are advised to actively ask them about urine leakage and to help them with the clinic health education flowchart. The three-minute motivation interview can help patients become more motivated to do the pelvic floor muscle exercise; the education based on Transtheoretical Model can increase the knowledge of stress incontinence; the convenient and accessible digital vaginal palpation for pelvic floor muscle training helps reduce urine leakage; can help women walk out of the shadow of urinary incontinence.

一、 中文部份
于漱、夏萍絗（1999）。衛生教育介入對社區婦女骨質疏鬆症知識、態度與行為之影響。公共衛生，26(3)，157-170。
內政部戶政司(2003)。中華民國臺閩地區人口統計。台北：內政部。
王英偉（2001）。醫療場所中的衛生教育與健康促進。健康促進暨衛生教育雜誌，21，37-53。
王雅瑩、王誠、柴惠敏、洪秀娟（2003）。婦女泌尿科門診接受物理治療之尿失禁病例分析。物理治療，28(1)，27-34。
行政院衛生署中部辦公室統計科（2001）。醫師衛教特別門診調查報告。台中：行政院衛生署。
江碧玉（2002）。婦女尿失禁生活品質之探討。中國醫學大學醫學研究所碩士論文。全國博碩士論文摘要，090CSMU0534020。
余宏政、季瑋珠、丘祖毅（1994）。台北地區社區成年婦女尿失禁的盛行率及危險因子的評估。中華民國泌尿科醫學會雜誌，5(1)，24-31。
李玉嬋（2002）。內科護理實習學生健康諮商技巧訓練之成效研究。國立臺灣師範大學教育心理與輔導研究所博士論文。全國博碩士論文摘要，088NTNU0328009。
李秋香（2003）。尿失禁婦女骨盆底肌肉運動介入之成效及其相關因素探討。中山醫學大學醫學研究所碩士論文。全國博碩士論文摘要，091CSMU0534003。
李從業、左如梅、蔣美蘭（1997）。團體衛教對女性老師乳房自我檢查率之影響。榮總護理，14(3)，241-250。
H.S.Ross and P.R.Mico(1985），衛生教育的理論與實際（呂槃、姚克明、黃松元譯）。台北：中華民國衛生教育學會。
吳佩蓉、許淑蓮、蔡敦仁、黃秀梨（1997）。個別衛教對慢性腎衰竭患者疾病認知、態度、自我照顧之成效。台灣醫學，1(1)，23-34。
吳嘉玲（1991）。《醫院病人衛生教育》。台北：大洋出版社。
吳銘斌、林鏡川、邱文祥、黃國峰（2003）。以基本門診評估項目建立婦女尿失禁的臨床診斷。臺灣醫界，46(4)，25-30。
吳銘斌、蘇聰賢、邱文祥、黃國峰（2003）：復發性應力性尿失禁。臺灣醫學，7(1)，115-122。
林志商、吳銘斌、黃名揚、楊順德、蔡篤俊、黃國峰（2002）。電刺激治療儀在婦女尿失禁之臨床應用。臺灣醫界，45(1)，22-24。
林清山（1992）。《心理與教育統計學》。台北：東華書局。
林淑媛（2001）：南丁格爾的煩惱--談老年婦女尿失禁及行為治療。護理雜誌，48(5)，16-21。
林淑燕、簡淑真、陳淑月（2003）。應力性尿失禁及其對婦女心理社會層面之影響。中臺學報醫護卷，14，81-93。
林登龍 (1997)。當代女性應力性尿失禁之診斷與手術治療。臨床醫學，40(5)， 263-266。
林獻鋒、賴世偉、張靖梅、劉秋松（2001）。老年人尿失禁。基層醫學，16(7)，171-176。
林鶴雄（1997）。尿路動力學在診斷婦女尿失禁之角色。臺灣醫學，1(6)，774-778。
林鶴雄（2001）。以電極刺激治療女性應力性尿失禁。中華民國泌尿科醫學會雜誌，12(1)，16-19。
林鶴雄（2005）。婦女尿失禁。台灣醫學，9(4)，502-507。
洪志秀、曾英芬、鄭綉絨（1995）。團體衛教對產後住院婦女壓力之影響。高雄醫學科學雜誌，11(4)，205-212。
晏涵文（1994），《健康教育─健康教學與研究》。台北：心理出版社。
張淑紅、黃璉華、李源德（1996）。個別衛生教育介入對高脂血個案知識、健康信念、自我效能、行為的影響。中華公共衛生雜誌，15(3)，188-196。
張淑娟（1992）。C型肝炎防治衛生教育介入對其門診患者之知識、態度與自我照顧行為的效果。台灣大學醫學院護理學研究所碩士論文。全國博碩士論文摘要，081NTU00563005。
張道遠（1998）。尿道注射膠原蛋白及其它充填劑治療應力性尿失禁。臺灣醫學，2(4)，418-423。
張道遠（2000）。女性尿失禁的治療。臺北市醫師公會會刊，44(2)，36-44。
陳春森、廖國盟（2005）。個別衛教對糖尿病人血糖控制之效果。北市醫學雜誌，2(5)，454-464。
陳美玲、林麗嬋、卓俊辰、白璐（1997）。漸進性骨盆底肌肉運動對應力性尿失禁婦女之影響--前驅性研究。護理研究，5(4)，353-365。
陳淑月、林隆堯、林淑姿、陳進典（2000）。婦女尿失禁骨盆底肌肉收縮運動遵從行為及其相關因素。醫學教育，4(4)，483-493。
陳瑛治（1993）。健康諮商--諮商新領域。學生輔導雙月刊，26，74-81。
陳慧毅、張維君、林武周、葉聯舜、徐泰彥、蔡鴻德等（1999）。應力性尿失禁之骨盆底肌復健的臨床療效。臺灣醫學會雜誌，98(4)，271-276。
黃世聰（2000）。婦女應力性尿失禁的影像及尿路動力學檢查。中華民國泌尿科醫學會雜誌，12(3)，111-116。
黃美涓、裴育晟、黃彬彬、鄭鴻衛、周適偉、李佳穎（2002）。年青女性運動員尿失禁探討。復健醫學會雜誌，30(4)，201-206。
黃鈺雯、余宏政、賴明坤、陳擇銘、謝豐舟、黃秀梨（1997）。應力性尿失禁婦女的心理社會衝擊與因應策略之探討。慈濟醫學雜誌，9(3)，207-217。
黃翠媛、黃秀梨（1997）。團體衛教對冠狀動脈疾病病人認知、態度與自我照顧行為之影響。護理研究，5(1)，88-98。
黃懷恩、余宏政、陳淳、季瑋珠（2002）。大台北地區台灣婦女尿失禁之危險因子。中華民國泌尿科醫學會雜誌，13(1)：32-37。
程惠鳳、鄧新棠、牛素珍、雷青熒、廖繼洲（2004）。比較團體衛教與個別指導對定量噴霧劑使用的影響。臺灣臨床藥學雜誌，11(4)，75-84。
葉美玉、康清雲（2003）。醫師衛教門診評價研究--病人觀點。臺灣公共衛生雜誌，22(2)，141-146。
鄒頡龍（2001）。骨盆底肌肉運動。中華民國泌尿科醫學會雜誌，12(1)，9-15。
蔡娟秀（2002）。生理回饋於骨盆底肌肉運動之應用。中華民國泌尿科醫學會雜誌，13(1)，1-7。
廖媛美、劉玉秀、魏玲玲（1999）。探討影響社區婦女尿失禁之相關因素及尿失禁對社區婦女身心之影響。新台北護理期刊，1(1)，69-79。
蕭伃伶、苗迺芳、周雨樺（2002）。以健康信念模式分析臺北市老年婦女對應力性尿失禁執行骨盆底肌肉運動之預防行為。新臺北護理期刊，4(1)，37-51。
羅美芳、于博芮、胡文郁、黃貴薰（1996）。罹患應力性尿失禁對婦女之影響。慈濟醫學雜誌，8(2)，137-143。

二、英文部份
Abrams, P., Blaivas, J. G., Stanton, S. L., & Andersen, J. T. (1988). The standardisation of terminology of lower urinary tract function. The International Continence Society Committee on Standardisation of Terminology. Scand J Urol Nephrol Suppl, 114, 5-19.
Abrams, P., Cardozo, L., Fall, M., Griffiths, D., Rosier, P., Ulmsten, U., et al. (2003). The standardisation of terminology in lower urinary tract function: report from the standardisation sub-committee of the International Continence Society. Urology, 61(1), 37-49.
al-Shahri, M. Z., al-Almaei, S. M., & Mian, M. H. (1997). Promotion of healthy lifestyle: knowledge and attitudes of primary care physicians. Patient Educ Couns, 31(2), 125-130.
Arya, L. A., Myers, D. L., & Jackson, N. D. (2000). Dietary caffeine intake and the risk for detrusor instability: a case-control study. Obstet Gynecol, 96(1), 85-89.
Balde, A., Figueras, J., Hawking, D. A., & Mill, J. R. (2003). Physician advice to the elderly about physical activity. Journal of aging and physical activity, 11, 90-97.
Bardsley, A. (2004). Key trends in the management and treatment of stress urinary incontinence. Prof Nurse, 19(10), 30-32.
Benvenuti, F., Caputo, G. M., Bandinelli, S., Mayer, F., Biagini, C., & Sommavilla, A. (1987). Reeducative treatment of female genuine stress incontinence. Am J Phys Med, 66(4), 155-168.
Beutel, M. E., Hessel, A., Schwarz, R., & Brahler, E. (2005). [Prevalence of urinary incontinence in the German population]. Urologe A, 44(3), 232-238.
Bidmead, J., & Cardozo, L. (2000). Short cut to continence? Lancet, 355(9222), 2183-2184.
Blaivas, J. G., Appell, R. A., Fantl, J. A., Leach, G., McGuire, E. J., Resnick, N. M., et al. (1997). Definition and classification of urinary incontinence: recommendations of the Urodynamic Society. Neurourol Urodyn, 16(3), 149-151.
Bo, K., & Talseth, T. (1996). Long-term effect of pelvic floor muscle exercise 5 years after cessation of organized training. Obstet Gynecol, 87(2), 261-265.
Bo, K., Talseth, T., & Holme, I. (1999). Single blind, randomised controlled trial of pelvic floor exercises, electrical stimulation, vaginal cones, and no treatment in management of genuine stress incontinence in women. Bmj, 318(7182), 487-493.
Brown, J. M., & Miller, W. R. (1993). Impact of motivational interviewing on participation and outcome in residential alcoholism treatment. Psychology of addictive behaviors, 7, 211-218.
Brown, J. S., Sawaya, G., Thom, D. H., & Grady, D. (2000). Hysterectomy and urinary incontinence: a systematic review. Lancet, 356(9229), 535-539.
Brown, J. S., Subak, L. L., Gras, J., Brown, B. A., Kuppermann, M., & Posner, S. F. (1998). Urge incontinence: the patient's perspective. J Womens Health, 7(10), 1263-1269.
Bump, R. C., Hurt, W. G., Fantl, J. A., & Wyman, J. F. (1991). Assessment of Kegel pelvic muscle exercise performance after brief verbal instruction. Am J Obstet Gynecol, 165(2), 322-327; discussion 327-329.
Bump, R. C., & McClish, D. M. (1994). Cigarette smoking and pure genuine stress incontinence of urine: a comparison of risk factors and determinants between smokers and nonsmokers. Am J Obstet Gynecol, 170(2), 579-582.
Bump, R. C., Sugerman, H. J., Fantl, J. A., & McClish, D. K. (1992). Obesity and lower urinary tract function in women: effect of surgically induced weight loss. Am J Obstet Gynecol, 167(2), 392-397; discussion 397-399.
Burgio, K. L., & Goode, P. S. (1997a). Behavioral interventions for incontinence in ambulatory geriatric patients. Am J Med Sci, 314(4), 257-261.
Burgio, K. L., & Goode, P. S. (1997b). The role of biofeedback in Kegel exercise training for stress urinary incontinence. The American journal of the medical sciences, 314(4), 257-261.
Burgio, K. L., Robinson, J. C., & Engel, B. T. (1986). The role of biofeedback in Kegel exercise training for stress urinary incontinence. Am J Obstet Gynecol, 154(1), 58-64.
Burkhart, K. S. (2000). Urinary incontinence in women: assessment and management in the primary care setting. Nurse Pract Forum, 11(4), 192-204.
Burns, P. A., Pranikoff, K., Nochajski, T., Desotelle, P., & Harwood, M. K. (1990). Treatment of stress incontinence with pelvic floor exercises and biofeedback. J Am Geriatr Soc, 38(3), 341-344.
Cammu, H., & Van Nylen, M. (1998). Pelvic floor exercises versus vaginal weight cones in genuine stress incontinence. Eur J Obstet Gynecol Reprod Biol, 77(1), 89-93.
Cammu, H., Van Nylen, M., & Amy, J. J. (2000). A 10-year follow-up after Kegel pelvic floor muscle exercises for genuine stress incontinence. BJU Int, 85(6), 655-658.
Cardozo, L. D., Abrams, P. D., Stanton, S. L., & Feneley, R. C. (1978). Idiopathic bladder instability treated by biofeedback. Br J Urol, 50(7), 521-523.
Chen, G. D., Hu, S. W., Chen, Y. C., Lin, T. L., & Lin, L. Y. (2003). Prevalence and correlations of anal incontinence and constipation in Taiwanese women. Neurourol Urodyn, 22(7), 664-669.
Chen, S. Y., Lin, F. S., Shen, K. H., Chen, K. C., & Xiang, P. (2005). [Non-invasive therapeutics in female urinary incontinence by extracorporeal magnetic innervation (ExMI)]. Hu Li Za Zhi, 52(3), 53-58.
Colling, J., McCreedy, M., & Owen, T. (1994). Urinary tract infection rates among incontinent nursing home and community dwelling elderly. Urol Nurs, 14(3), 117-119.
Cooney, L. M., Jr. (1997). Pressure sores and urinary incontinence. J Am Geriatr Soc, 45(10), 1278-1279.
Culligan, P. J., & Heit, M. (2000). Urinary incontinence in women: evaluation and management. Am Fam Physician, 62(11), 2433-2444, 2447, 2452.
Dellas, A., & Drewe, J. (1995). Conservative therapy of female genuine stress incontinence with vaginal cones. Eur J Obstet Gynecol Reprod Biol, 62(2), 213-215.
Dickey, L. L., Gemson, D. H., & Carney, P. (1999). Office system interventions supporting primary care-based health behavior change counseling. Am J Prev Med, 17(4), 299-308.
Ding, Y. Y., & Jayaratnam, F. J. (1994). Urinary incontinence in the hospitalised elderly--a largely reversible disorder. Singapore Med J, 35(2), 167-170.
Diokno, A., & Yuhico, M., Jr. (1995). Preference, compliance and initial outcome of therapeutic options chosen by female patients with urinary incontinence. J Urol, 154(5), 1727-1730; discussion 1731.
Diokno, A. C., Burgio, K., Fultz, N. H., Kinchen, K. S., Obenchain, R., & Bump, R. C. (2004). Medical and self-care practices reported by women with urinary incontinence. Am J Manag Care, 10(2 Pt 1), 69-78.
Dougherty, M. C. (1998). Current status of research on pelvic muscle strengthening techniques. J Wound Ostomy Continence Nurs, 25(2), 75-83.
DuBeau, C. E. (2002). The continuum of urinary incontinence in an aging population. Geriatrics, 57 Suppl 1, 12-17.
DuBeau, C. E., & Resnick, N. M. (1995). Urinary incontinence and dementia: the perils of guilt by association. J Am Geriatr Soc, 43(3), 310-311.
Dugan, E., Cohen, S. J., Bland, D. R., Preisser, J. S., Davis, C. C., Suggs, P. K., et al. (2000). The association of depressive symptoms and urinary incontinence among older adults. J Am Geriatr Soc, 48(4), 413-416.
Duong, T. H., & Korn, A. P. (2001). A comparison of urinary incontinence among African American, Asian, Hispanic, and white women. Am J Obstet Gynecol, 184(6), 1083-1086.
Elia, G., & Bergman, A. (1993). Pelvic muscle exercises: when do they work? Obstet Gynecol, 81(2), 283-286.
Elia, G., Bergman, J., & Dye, T. D. (2002). Familial incidence of urinary incontinence. Am J Obstet Gynecol, 187(1), 53-55.
Elia, G., Dye, T. D., & Scariati, P. D. (2001). Body mass index and urinary symptoms in women. Int Urogynecol J Pelvic Floor Dysfunct, 12(6), 366-369.
Emmons, K. M., & Rollnick, S. (2001). Motivational interviewing in health care settings. Opportunities and limitations. Am J Prev Med, 20(1), 68-74.
Farghaly, S. A., Hindmarsh, J. R., & Worth, P. H. (1986). Post-hysterectomy urethral dysfunction: evaluation and management. Br J Urol, 58(3), 299-302.
Ferguson, K. L., McKey, P. L., Bishop, K. R., Kloen, P., Verheul, J. B., & Dougherty, M. C. (1990). Stress urinary incontinence: effect of pelvic muscle exercise. Obstet Gynecol, 75(4), 671-675.
Fultz, N., Girts, T., Kinchen, K., Nygaard, I., Pohl, G., & Sternfeld, B. (2005). Prevalence, management and impact of urinary incontinence in the workplace. Occup Med (Lond), 55(7), 552-557.
Gallo, M. L., & Staskin, D. R. (1997). Cues to action: pelvic floor muscle exercise compliance in women with stress urinary incontinence. Neurourol Urodyn, 16(3), 167-177.
Galloway, N. T., El-Galley, R. E., Sand, P. K., Appell, R. A., Russell, H. W., & Carlan, S. J. (1999). Extracorporeal magnetic innervation therapy for stress urinary incontinence. Urology, 53(6), 1108-1111.
Galuska, D. A., Will, J. C., Serdula, M. K., & Ford, E. S. (1999). Are health care professionals advising obese patients to lose weight? Jama, 282(16), 1576-1578.
Gray, M. L. (2003). Gender, race, and culture in research on UI: sensitivity and screening are integral to adequate patient care. Am J Nurs, Suppl, 20-25.
Green, L. W., & Ottoson, J. M. (1999). Community and Population Health (8th ed.). Boston, MA: WCB/McGraw-Hill.
Haase, P., & Skibsted, L. (1988). Influence of operations for stress incontinence and/or genital descensus on sexual life. Acta Obstet Gynecol Scand, 67(7), 659-661.
Hahn, I., Milsom, I., Fall, M., & Ekelund, P. (1993). Long-term results of pelvic floor training in female stress urinary incontinence. Br J Urol, 72(4), 421-427.
Han, M. O., Lee, N. Y., & Park, H. S. (2006). Abdominal obesity is associated with stress urinary incontinence in Korean women. Int Urogynecol J Pelvic Floor Dysfunct, 17(1), 35-39.
Hannestad, Y. S., Rortveit, G., Daltveit, A. K., & Hunskaar, S. (2003). Are smoking and other lifestyle factors associated with female urinary incontinence? The Norwegian EPINCONT Study. Bjog, 110(3), 247-254.
Harland, J., White, M., Drinkwater, C., Chinn, D., Farr, L., & Howel, D. (1999). The Newcastle exercise project: a randomised controlled trial of methods to promote physical activity in primary care. Bmj, 319(7213), 828-832.
Herschorn, S. (2001). Current status of injectable agents for female stress urinary incontinence. Can J Urol, 8(3), 1281-1289.
Herschorn, S. (2003). Injectables for the treatment of female stress urinary incontinence. In S. L. Stanton & P. E. Zimmern (Eds.), Female pelvic reconstructive surgery (pp. 85-92). London: Springer-Verlag.
Hilton, P. (1988). Urinary incontinence during sexual intercourse: a common, but rarely volunteered, symptom. Br J Obstet Gynaecol, 95(4), 377-381.
Holroyd-Leduc, J. M., & Straus, S. E. (2004). Management of urinary incontinence in women: clinical applications. Jama, 291(8), 996-999.
Hu, T. W. (1990). Impact of urinary incontinence on health-care costs. J Am Geriatr Soc, 38(3), 292-295.
Hu, T. W., Wagner, T. H., Bentkover, J. D., Leblanc, K., Zhou, S. Z., & Hunt, T. (2004). Costs of urinary incontinence and overactive bladder in the United States: a comparative study. Urology, 63(3), 461-465.
Hunskaar, S., Lose, G., Sykes, D., & Voss, S. (2004). The prevalence of urinary incontinence in women in four European countries. BJU Int, 93(3), 324-330.
Jackson, S. L., Scholes, D., Boyko, E. J., Abraham, L., & Fihn, S. D. (2005). Urinary incontinence and diabetes in postmenopausal women. Diabetes Care, 28(7), 1730-1738.
Jorgensen, L., Lose, G., & Andersen, J. T. (1987). One-hour pad-weighing test for objective assessment of female urinary incontinence. Obstet Gynecol, 69(1), 39-42.
Julian, T. M. (1998). Physical examination and pretreatment testing of the incontinent woman. Clin Obstet Gynecol, 41(3), 663-671.
Kegel, A. H. (1948). Progressive resistance exercise in the functional restoration of the perineal muscles. American journal of obstetrics and gynecology, 56, 238-248.
Keilman, L. J. (2005). Urinary incontinence: basic evaluation and management in the primary care office. Prim Care, 32(3), 699-722.
Keller, S. L. (1999). Urinary incontinence: occurrence, knowledge, and attitudes among women aged 55 and older in a rural Midwestern setting. J Wound Ostomy Continence Nurs, 26(1), 30-38.
Klarskov, P., Nielsen, K. K., Kromann-Andersen, B., & Maegaard, E. (1991). Long-term results of pelvic floor training and surgery for female genuine stress incontinence. International urogynecology journal and pelvic floor dysfunction, 2, 132-135.
Ko, Y., Lin, S. J., Salmon, J. W., & Bron, M. S. (2005). The impact of urinary incontinence on quality of life of the elderly. Am J Manag Care, 11(4 Suppl), S103-111.
Kocak, I., Okyay, P., Dundar, M., Erol, H., & Beser, E. (2005). Female urinary incontinence in the west of Turkey: prevalence, risk factors and impact on quality of life. Eur Urol, 48(4), 634-641.
Kumm, S., Hicks, V., Shupe, S., & Hagemaster, J. (2002). You can help your clients change. Dimens Crit Care Nurs, 21(2), 72-77.
Kushner, R. F. (1995). Barriers to providing nutrition counseling by physicians: a survey of primary care practitioners. Prev Med, 24(6), 546-552.
Lagro-Janssen, A. L., Smits, A. J., & van Weel, C. (1994). [Beneficial effect of exercise therapy in urinary incontinence in family practice depends largely on therapy compliance and motivation]. Ned Tijdschr Geneeskd, 138(25), 1273-1276.
Lam, G. W., Foldspang, A., Elving, L. B., & Mommsen, S. (1992). Social context, social abstention, and problem recognition correlated with adult female urinary incontinence. Dan Med Bull, 39(6), 565-570.
Lewis, F. M. (1990). Perspective on models of interpersonal health behavior. In K. Glanz, F. M. Lewis & B. K. Rimer (Eds.), Health Behavior and Health Education (pp. 242-251). California: Jossey-Bass.
Lin, S. Y., & Dougherty, M. C. (2003). Incontinence impact, symptom distress and treatment-seeking behavior in women with involuntary urine loss in Southern Taiwan. Int J Nurs Stud, 40(3), 227-234.
Luber, K. M. (2003). Risks, comorbidities, complications and quality of life in patients with urinary incontinence. Director, 11(4), 166, 169-172; quiz 173.
Macaulay, A. J., Stern, R. S., Holmes, D. M., & Stanton, S. L. (1987). Micturition and the mind: psychological factors in the aetiology and treatment of urinary symptoms in women. Br Med J (Clin Res Ed), 294(6571), 540-543.
Manonai, J., Poowapirom, A., Kittipiboon, S., Patrachai, S., Udomsubpayakul, U., & Chittacharoen, A. (2006). Female urinary incontinence: a cross-sectional study from a Thai rural area. Int Urogynecol J Pelvic Floor Dysfunct, 17(4), 321-325.
Maral, I., Ozkardes, H., Peskircioglu, L., & Bumin, M. A. (2001). Prevalence of stress urinary incontinence in both sexes at or after age 15 years: a cross-sectional study. J Urol, 165(2), 408-412.
Marcus, B. H., Goldstein, M. G., Jette, A., Simkin-Silverman, L., Pinto, B. M., Milan, F., et al. (1997). Training physicians to conduct physical activity counseling. Prev Med, 26(3), 382-388.
Mariappan, P., Ballantyne, Z., N'Dow, J. M., & Alhasso, A. A. (2005). Serotonin and noradrenaline reuptake inhibitors (SNRI) for stress urinary incontinence in adults. Cochrane Database Syst Rev(3), CD004742.
McCormack, P. L., & Keating, G. M. (2004). Duloxetine: in stress urinary incontinence. Drugs, 64(22), 2567-2573; discussion 2574-2565.
Melville, J. L., Katon, W., Delaney, K., & Newton, K. (2005). Urinary incontinence in US women: a population-based study. Arch Intern Med, 165(5), 537-542.
Meyer, S., Schreyer, A., De Grandi, P., & Hohlfeld, P. (1998). The effects of birth on urinary continence mechanisms and other pelvic-floor characteristics. Obstet Gynecol, 92(4 Pt 1), 613-618.
Mhurchu, C. N., Margetts, B. M., & Speller, V. (1998). Randomized clinical trial comparing the effectiveness of two dietary interventions for patients with hyperlipidaemia. Clin Sci (Lond), 95(4), 479-487.
Miller, W. R. (1996). Motivational interviewing: research, practice, and puzzles. Addict Behav, 21(6), 835-842.
Miller, W. R., & Rollnick, S. (2002). Motivational Interviewing: Preparing People for Change (2nd ed.). New York: Guilford Press.
Moore, K. H., Simons, A., Dowell, C., Bryant, C., & Prashar, S. (1999). Efficacy and user acceptability of the urethral occlusive device in women with urinary incontinence. J Urol, 162(2), 464-468.
Moore, K. N., Saltmarche, B., & Query, A. (2003). Urinary incontinence. Non-surgical management by family physicians. Can Fam Physician, 49, 602-610.
Morisky, D. E., Levine, D. M., Green, L. W., Shapiro, S., Russell, R. P., & Smith, C. R. (1983). Five-year blood pressure control and mortality following health education for hypertensive patients. Am J Public Health, 73(2), 153-162.
Mouritsen, L., Frimodt-Moller, C., & Moller, M. (1991). Long-term effect of pelvic floor exercises on female urinary incontinence. Br J Urol, 68(1), 32-37.
Moyers, T. B., & Yahne, C. E. (1998). Motivational interviewing in substance abuse treatment: negotiating. Journal of substance abuse misuse for nursing health and social care, 3(1 ), 30-33.
Newman, D. K. (1996). Aging and the problem of urinary incontinence: AHCPR's 1996 clinical practice guidance. Urol Nurs, 16(4), 121-122.
Newman, D. K. (2000). New technology for women for stress incontinence. Contemporary Ob/Gyn, 15, 69-70, 74-15, 79-83.
Noonan, W. C., & Moyers, T. B. (1997). Motivational interviewing: A review. Journal of Substance Misuse, 2, 8-16.
Norton, P. A., Zinner, N. R., Yalcin, I., & Bump, R. C. (2002). Duloxetine versus placebo in the treatment of stress urinary incontinence. Am J Obstet Gynecol, 187(1), 40-48.
Nygaard, I., Girts, T., Fultz, N. H., Kinchen, K., Pohl, G., & Sternfeld, B. (2005). Is urinary incontinence a barrier to exercise in women? Obstet Gynecol, 106(2), 307-314.
Nygaard, I. E., Kreder, K. J., Lepic, M. M., Fountain, K. A., & Rhomberg, A. T. (1996). Efficacy of pelvic floor muscle exercises in women with stress, urge, and mixed urinary incontinence. Am J Obstet Gynecol, 174(1 Pt 1), 120-125.
Nygaard, I. E., Thompson, F. L., Svengalis, S. L., & Albright, J. P. (1994). Urinary incontinence in elite nulliparous athletes. Obstet Gynecol, 84(2), 183-187.
O'Neil, B., & Gilmour, D. (2003). Approach to urinary incontinence in women. Diagnosis and management by family physicians. Can Fam Physician, 49, 611-618.
Oskay, U. Y., Beji, N. K., & Yalcin, O. (2005). A study on urogenital complaints of postmenopausal women aged 50 and over. Acta Obstet Gynecol Scand, 84(1), 72-78.
Ostergard, D. R. (2002). The epochs and ethics of incontinence surgery: is the direction forward or backwards? Int Urogynecol J Pelvic Floor Dysfunct, 13(1), 1-3.
Paick, J. S., Ku, J. H., Shin, J. W., Park, K., Son, H., Oh, S. J., et al. (2005). Significance of pad test loss for the evaluation of women with urinary incontinence. Neurourol Urodyn, 24(1), 39-43.
Palmer, M. H. (1994). A health-promotion perspective of urinary continence. Nurs Outlook, 42(4), 163-169.
Pang, M. W., Leung, H. Y., Chan, L. W., & Yip, S. K. (2005). The impact of urinary incontinence on quality of life among women in Hong Kong. Hong Kong Med J, 11(3), 158-163.
Papanicolaou, S., Hunskaar, S., Lose, G., & Sykes, D. (2005). Assessment of bothersomeness and impact on quality of life of urinary incontinence in women in France, Germany, Spain and the UK. BJU Int, 96(6), 831-838.
Prochaska, J. O., & DiClemente, C. C. (1983). Stages and processes of self-change of smoking: toward an integrative model of change. J Consult Clin Psychol, 51(3), 390-395.
Prochaska, J. O., & Velicer, W. F. (1997). The transtheoretic Model and Stage of Change. In K. Glanz, F. M. Lewis & B. K. Rimer (Eds.), Health Behavior and Health Education (pp. 60-80).
Rakel, R. E., & Pisacano, N. J. (2002). The family physician. In R. E. Rakel. (Ed.), Textbook of family practice (6th ed ed., pp. 3-11). Philadelphia, PA W.B. Saunders.
Resnick, N. M., & Yalla, S. V. (1985). Management of urinary incontinence in the elderly. N Engl J Med, 313(13), 800-805.
Roberts, C., & Banning, M. (1998). Managing risk factors for hypertension in primary care. Nurs Stand, 12(23), 39-43.
Roe, B., & Doll, H. (1999). Lifestyle factors and continence status: comparison of self-report data from a postal survey in England. J Wound Ostomy Continence Nurs, 26(6), 312-313, 315-319.
Romanzi, L. J. (2001). Urinary incontinence in women and men. J Gend Specif Med, 4(3), 14-20.
Sampselle, C. M. (2003). Behavioral interventions in young and middle-age women: simple interventions to combat a complex problem. Am J Nurs, Suppl, 9-19.
Scarpa, K. P., Herrmann, V., Palma, P. C., Riccetto, C. L., & Morais, S. S. (2006). Prevalence and correlates of stress urinary incontinence during pregnancy: a survey at UNICAMP Medical School, Sao Paulo, Brazil. Int Urogynecol J Pelvic Floor Dysfunct, 17(3), 219-223.
Schnelle, J. F., Adamson, G. M., Cruise, P. A., al-Samarrai, N., Sarbaugh, F. C., Uman, G., et al. (1997). Skin disorders and moisture in incontinent nursing home residents: intervention implications. J Am Geriatr Soc, 45(10), 1182-1188.
Secker-Walker, R. H., Solomon, L. J., Flynn, B. S., Skelly, J. M., & Mead, P. B. (1998). Reducing smoking during pregnancy and postpartum: physician's advice supported by individual counseling. Prev Med, 27(3), 422-430.
Seim, A., Hermstad, R., & Hunskaar, S. (1998). Female urinary incontinence: long-term follow-up after treatment in general practice. Br J Gen Pract, 48(436), 1731-1734.
Shinitzky, H. E., & Kub, J. (2001). The art of motivating behavior change: the use of motivational interviewing to promote health. Public Health Nurs, 18(3), 178-185.
Simpson, L. (2000). Stress incontinence in younger women: prevention and treatment. Nurs Stand, 14(36), 49-54; quiz 56, 58.
Sims, J. M. (1998). On the treatment of vesico-vaginal fistula. 1852. Int Urogynecol J Pelvic Floor Dysfunct, 9(4), 236-248.
Sirls, L. T., Foote, J. E., Kaufman, J. M., Lightner, D. J., Miller, J. L., Moseley, W. G., et al. (2002). Long-term results of the FemSoft urethral insert for the management of female stress urinary incontinence. Int Urogynecol J Pelvic Floor Dysfunct, 13(2), 88-95; discussion 95.
Siu, L. S., Chang, A. M., Yip, S. K., & Chang, A. M. (2003). Compliance with a pelvic muscle exercise program as a causal predictor of urinary stress incontinence amongst Chinese women. Neurourology and urodynamics, 22(7), 659-663.
Smith, D. E. (1997). Motivational interviewing to improve adherence to a behavioral weight-control program for order obse women with NIDDM: A pilot study. Diabetes care, 20, 53-54.
Smith, J. J., 3rd. (1996). Intravaginal stimulation randomized trial. J Urol, 155(1), 127-130.
Song, Y. F., Zhang, W. J., Song, J., & Xu, B. (2005). Prevalence and risk factors of urinary incontinence in Fuzhou Chinese women. Chin Med J (Engl), 118(11), 887-892.
Subak, L. L., Johnson, C., Whitcomb, E., Boban, D., Saxton, J., & Brown, J. S. (2002). Does weight loss improve incontinence in moderately obese women? Int Urogynecol J Pelvic Floor Dysfunct, 13(1), 40-43.
Sutherland, S. E., & Goldman, H. B. (2004). Treatment options for female urinary incontinence. Med Clin North Am, 88(2), 345-366.
Sutherst, J., & Brown, M. (1980). Sexual dysfunction associated with urinary incontinence. Urol Int, 35(6), 414-416.
Sutherst, J. R. (1979). Sexual dysfunctional and urinary incontinence. Br J Obstet Gynaecol, 86(5), 387-388.
Swami, S., Batista, J. E., & Abrams, P. (1997). Collagen for female genuine stress incontinence after a minimum 2-year follow-up. Br J Urol, 80(5), 757-761.
Swanson, J. G. (2001). Urinary incontinence causes negative outlook of overall health. American family physician, 63(6 ), 1167.
Tannenbaum, C., Perrin, L., DuBeau, C. E., & Kuchel, G. A. (2001). Diagnosis and management of urinary incontinence in the older patient. Arch Phys Med Rehabil, 82(1), 134-138.
Thom, D. H., Nygaard, I. E., & Calhoun, E. A. (2005). Urologic diseases in America project: urinary incontinence in women-national trends in hospitalizations, office visits, treatment and economic impact. J Urol, 173(4), 1295-1301.
Thyssen, H., Bidmead, J., Lose, G., Moller Bek, K., Dwyer, P., & Cardozo, L. (2001). A new intravaginal device for stress incontinence in women. BJU Int, 88(9), 889-892.
Timmerman, G. M., Reifsnider, E., & Allan, J. D. (2000). Weight management practices among primary care providers. J Am Acad Nurse Pract, 12(4), 113-116.
Tries, J. (1990). Kegel exercises enhanced by biofeedback. J Enterostomal Ther, 17(2), 67-76.
Tseng, I. J., Chen, Y. T., Chen, M. T., Kou, H. Y., & Tseng, S. F. (2000). Prevalence of urinary incontinence and intention to seek treatment in the elderly. J Formos Med Assoc, 99(10), 753-758.
Turkan, A., Inci, Y., & Fazli, D. (2005). The short-term effects of physical therapy in different intensities of urodynamic stress incontinence. Gynecol Obstet Invest, 59(1), 43-48.
Ueda, T., Tamaki, M., Kageyama, S., Yoshimura, N., & Yoshida, O. (2000). Urinary incontinence among community-dwelling people aged 40 years or older in Japan: prevalence, risk factors, knowledge and self-perception. Int J Urol, 7(3), 95-103.
Unsal, A., Saglam, R., & Cimentepe, E. (2003). Extracorporeal magnetic stimulation for the treatment of stress and urge incontinence in women--results of 1-year follow-up. Scand J Urol Nephrol, 37(5), 424-428.
Urinary incontinence in adults. Agency for Health Care Policy and Research. (1992). Clin Pract Guidel Quick Ref Guide Clin(2), QR1-27.
Vandoninck, V., Bemelmans, B. L., Mazzetta, C., Robertson, C., Keech, M., Boyle, P., et al. (2004). The prevalence of urinary incontinence in community-dwelling married women: a matter of definition. BJU Int, 94(9), 1291-1295.
Viera, A. J., & Larkins-Pettigrew, M. (2000). Practical use of the pessary. Am Fam Physician, 61(9), 2719-2726, 2729.
Viktrup, L., & Lose, G. (2001). The risk of stress incontinence 5 years after first delivery. Am J Obstet Gynecol, 185(1), 82-87.
Wagner, T. H., & Hu, T. W. (1998). Economic costs of urinary incontinence in 1995. Urology, 51(3), 355-361.
Walters, M. D. (1999). Evaluation of urinary incontinence: History, physical examination, and office tests. In M. D. Walters & M. M. Karram (Eds.), Urogynecology and reconstructive pelvic surgery (pp. 45-53). St Louis Missouri: Mosby Inc.
Weidner, A. C., Myers, E. R., Visco, A. G., Cundiff, G. W., & Bump, R. C. (2001). Which women with stress incontinence require urodynamic evaluation? Am J Obstet Gynecol, 184(2), 20-27.
Whitlock, E. P., Orleans, C. T., Pender, N., & Allan, J. (2002). Evaluating primary care behavioral counseling interventions: an evidence-based approach. Am J Prev Med, 22(4), 267-284.
Wilson, L., Brown, J. S., Shin, G. P., Luc, K. O., & Subak, L. L. (2001). Annual direct cost of urinary incontinence. Obstet Gynecol, 98(3), 398-406.
Wyman, J. F. (2000). Management of urinary incontinence in adult ambulatory care populations. Annu Rev Nurs Res, 18, 171-194.
Yamanishi, T., & Yasuda, K. (1998). Electrical stimulation for stress incontinence. Int Urogynecol J Pelvic Floor Dysfunct, 9(5), 281-290.
Yang, X., Zheng, H., Liao, Q. P., Tao, R. X., Fu, C., Peng, X. L., et al. (2004). [Mode of delivery on urinary incontinence]. Zhonghua Fu Chan Ke Za Zhi, 39(10), 662-665.
Yip, S. K., & Chung, T. K. (2003). Treatment-seeking behavior in Hong Kong Chinese women with urinary symptoms. Int Urogynecol J Pelvic Floor Dysfunct, 14(1), 27-30; discussion 30.
Yokoyama, T., Nishiguchi, J., Watanabe, T., Nose, H., Nozaki, K., Fujita, O., et al. (2004). Comparative study of effects of extracorporeal magnetic innervation versus electrical stimulation for urinary incontinence after radical prostatectomy. Urology, 63(2), 264-267.
Zorn, B. H., Montgomery, H., Pieper, K., Gray, M., & Steers, W. D. (1999). Urinary incontinence and depression. J Urol, 162(1), 82-84.