Exploring the application of an integrated health behavior change-based nursing model in pelvic floor muscle self-training

To examine the effect of the Integrated Theory of Health Behavior Change (ITHBC) model on self-efficacy, adherence, and rehabilitation outcomes in pelvic floor muscle training among postpartum women. This study recruited primiparas who underwent vaginal delivery at five medical institutions in China between January 2020 and January 2025. Participants were randomly assigned to either the ITHBC nursing model combined with conventional care group (observation group) or the conventional care group (control group). Outcomes included compliance with pelvic floor muscle training, self-efficacy, pelvic floor function, muscle strength, surface electromyography, ultrasound parameters, quality of life, and nursing satisfaction. The observation group showed better performance than the control group in terms of compliance, self-efficacy, and nursing satisfaction. Statistically significant differences were observed in pelvic floor function and quality of life pre- and post-intervention, with the observation group outperforming the control group post-intervention. For pelvic floor muscle strength, statistically significant changes occurred pre- and post-intervention; however, no significant difference was found in type I muscle fiber fatigue degree between groups. Surface electromyography showed significant improvements pre- and post-intervention, with the observation group performing better across most indicators except endurance contraction variability. Ultrasound parameters revealed no significant differences in bladder detrusor muscle thickness, residual urine volume, or bladder neck initial position but showed significant differences in other parameters, with the observation group performing better overall except for the right anal angle. The ITHBC model shows promise for improving adherence and short-term pelvic floor function, but further validation in diverse populations is needed.Clinical Trial Number: www.chictr.org.cn, ID: ChiCTR2300070607. Registered on 18/4/2023.