A Study of the Development of a Nursing Model to Support Women with Urinary Incontinence, So as to Promote Sexual Health.

本研究旨在建立一套综合/系统的护理模式，以支持尿失禁（UI）妇女，从而促进其有效的应对行为，促进其性健康。在基础研究中，我们调查了77名患有尿失禁的门诊患者，了解尿失禁对其性行为的影响。结果显示，25%的受试者表示他们的性生活受到了影响。将尿失禁对性生活的影响分为“性交时大小便失禁”、“性交困难（性交困难或性交疼痛）”、“性活动焦虑”、“引语怕漏”、“尴尬”等。在研究结果和文献回顾的基础上，建立了干预性担忧的护理模式。在几个目的中，它旨在(1)促进有效的准备，可以获得与性行为相关的满足感和成就感；(2)支持公认的女性内在价值。在临床上，将该模型的实验应用应用于5名认识到其性作用的UI女性。结果，在使用护理模型后，观察到行为变化，即，一方面，在模型应用后。患有尿失禁的女性获得了有效的性生活应对行为，能够更积极地接受尿失禁的诊断。另一方面，有人指出了一些问题，使我们重新考虑这种干预的重点和形式。其中一点是要仔细考虑女性的性观念和价值，这是由日本性的历史和文化背景形成和定义的。接下来，我们将重复该模型的临床应用，以完善其作为实际护理模型的使用。

The purpose of this study is to develop a comprehensive/systematic nursing model to support women with urinary incontinence (UI), so as to promote effective coping behaviors for their sexual health. For the basic study, seventy-seven out-patients with UI were surveyed for the effect of urinary incontinence on their sexuality. The results showed that twenty-five percent of the subjects stated an effect on their sexual life. The effects of UI on the sexual life were classified into "micturation incontinence during sexual intercourse", "dyspareunia (difficult or painful intercourse) ", "anxiety with sexual activity", "citing fear of leakage", "embarrassment", etc.On the basis of the results and the review of the literature, a nursing model of intervention for sexual concerns was developed. Among several purposes, it aimed (1) to promote effective preparation which can achieve feelings of satisfaction and fulfilllment associated with sexual behavior and (2) to support the recognized intrinsic value of a female. Clinically, the experimental application of the model was applied to 5 women with UI who recognized its sexual effects. As aresults, behavioral changes were observed following the use of the nursing model, That is, on one hand, after the applications of the model. women with UI acquired effective coping behaviors for sexual life and could more positively accept their diagnosis of UI.On the other hand, some points were noted that cause us to reconsider this focus and form of intervention. One such point is to carefully consider a women's concept and value of sexuality which has been formed and defined by the historical and cultural backgrounds of sexuality in Japan.Hereafter, we will repeat the clinical application of the model to refine it's use as a practical nursing model.