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The mediating effect of self-efficacy on adherence to pelvic floor muscle training: an analysis based on the COM-B
Jianning Wang1, Liping Wu2, Guorong Fan3
1Department of Nursing, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing 100730, China.
Objective:
Numerous studies have shown that pelvic floor muscle training (PFMT) adherence in women with pelvic floor dysfunction (PFD) is low and influenced by many factors. However, most previous studies have ignored the pathways between factors. Based on the COM-B model, this study hypothesised that self-efficacy is a mediating variable in the causes of PFMT adherence.
Methods:
A total of 315 women with PFD who visited the pelvic floor rehabilitation centre of a Grade A tertiary hospital in Beijing, China between October 2022 and August 2023 were selected. PFMT adherence, severity of PFD, knowledge of PFD, social support and self-efficacy of PFMT were measured when patients were treated or reviewed. The mediation analysis was used to validate mediating effect of self-efficacy on PFMT adherence using SPSS 25.0 software.
Results:
The score of PFMT adherence in patients with PFD was 11.30 ± 4.17. The mediation effect of self-efficacy between knowledge (β = 0.046, 95 % CI [0.068, 0.229]), social support (β = 0.058, 95 % CI [0.068, 0.229]) and adherence were significant, and all were fully mediated effects.
Conclusion:
PFMT adherence in women with PFD is at a moderate level. Self-efficacy had a direct effect on PFMT adherence. Social support and knowledge of PFD had an indirect effect on PFMT adherence through self-efficacy.
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