Background The awareness and practice of pelvic floor muscle exercise (PFME) in the prevention and reduction of the rate of urinary incontinence among pregnant women was considerably poor, despite the increased prevalence of urinary incontinence during pregnancy across Malaysia. There healthcare providers do not give adequate attention to the potential impact of PFME on urinary incontinence and there is limited local intervention addressed urinary incontinence during pregnancy. The objective of this study was to determine the effectiveness of a newly developed PFME intervention in terms of knowledge, attitude, practice, self-efficacy, and urinary symptoms.
Methods A single-blinded, two-armed, randomized control trial was included pregnant women from 18 to 20 weeks of gestation and was conducted at the Maternity Hospital of Kuala Lumpur. The intervention group received PFME in addition to the usual perinatal care. The data were collected using validated questionnaires at 4 time points: baseline, post-intervention in the early third trimester, late third trimester, and early postnatal period. The intervention effects were analyzed using a generalized estimating equation.
Results The primary analysis included pregnant women who had at least one follow-up; 122 women (71.8%) in the intervention group had significant improvement in knowledge, attitude, practice, and self-efficacy, as well as in the severity of urinary incontinence over time. However, improvement was not observed in self-reported urinary incontinence.
Conclusion PFME can be considered an effective initial intervention to provide information about urinary incontinence prevention to pregnant women.
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Background The patient’s intention to engage in diabetes care is the hallmark of role acceptance as a health manager and implies one’s readiness to change. The study aimed to understand the process of having the intention to engage in diabetes care.
Methods A qualitative study using narrative inquiry was conducted at a public primary care clinic. Ten participants with type 2 diabetes of more than a 1-year duration were selected through purposive sampling. In-depth interviews were conducted using a semi-structured protocol guide and were audio-taped. The interviews were transcribed and the texts were analyzed using a thematic approach with the Atlas.ti ver. 8.0 software (Scientific Software Development GmbH, Berlin, Germany).
Results Three themes emerged from the analysis. The first theme, “Initial reactions toward diabetes,” described the early impression of diabetes encompassing negative emotions, feeling of acceptance, a lack of concern, and low level of perceived efficacy. “Process of discovery” was the second overarching theme marking the journey of participants in finding the exact truth about diabetes and learning the consequences of ignoring their responsibility in diabetes care. The third theme, “Making the right decision,” highlighted that fear initiated a decision-making process and together with goal-setting paved the way for participants to reach a turning point, moving toward engagement in their care.
Conclusion Our findings indicated that fear could be a motivator for change, but a correct cognitive appraisal of diabetes and perceived efficacy of the treatment as well as one’s ability are essentially the pre-requisites for patients to reach the stage of having the intention to engage.
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Background Despite growing knowledge of the importance of the management of diet and physical activity in the prevention of obesity in adolescence, a better understanding of social psychological influences could assist efforts in family, school and community settings. Methods: Among the 3,653 adolescents who were randomly selected from seven separate school districts in Busan, 2,938 (83.9%) completed the questionnaire. The students who agreed to participate in this study were given a questionnaire which included social support as the Child and Adolescent Social Support Scale, self-efficacy as the physical self-efficacy questionnaire, self-concept as the Song and Hattie Test, physical activity as a Leisure-Time Exercise Questionnaire and eating habits as the Harris questionnaire. Results: The support from parents, teachers, classmates, close friends and other people in the community predicted the level of adolescents' self-concept and physical activity, while only the support from teachers and other people in the community predicted adolescents' dietary self-efficacy. Adolescents' self-concept and physical activity self-efficacy significantly predicted the level of physical activity. Self-concept and dietary self-efficacy also predicted healthier eating habits. Only the support from close friends predicted adolescents' healthy eating habits. The support from parents, teachers, close friends, classmates and other people in the community predicted the level of physical activity through increasing the level of self- concept or physical activity self-concept. Conclusion: Although adolescents' behavior are ultimately individualized, they are formed through cognitive processes which are affected by social support. These social levels, therefore, should be supportive of adolescents' physical activity and healthier eating habits by providing frequent support and encouragement to establish positive self-concept and self-efficacy.
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