5E rehabilitation model for self-management in women with stress urinary incontinence: a randomised mixed methods study

To evaluate the effectiveness and feasibility of a self-management intervention based on the 5E rehabilitation model for female patients with stress urinary incontinence (SUI) using an explanatory sequential mixed methods design. Eligible patients were randomized to intervention ( n = 41) or control ( n = 41) groups. The control group received routine care; the intervention group additionally received the 5E model-based self-management intervention. Outcomes—72 h incontinence episodes, BPMSES scores, and PFMT adherence—were assessed at baseline, week 8, and week 12. Qualitative interviews were conducted with 10 intervention participants. Seventy-seven participants completed the study (attrition 6.1%). 72 h incontinence episodes decreased more in the intervention group (from 7.69 ± 1.99 to 4.87 ± 1.36) than in the control group (7.66 ± 1.74 to 6.16 ± 1.55), with significant time × group interaction ( P < 0.05). BPMSES scores increased more in the intervention group (94.56 ± 16.61 to 130.30 ± 17.08) than in controls (93.87 ± 13.51 to 105.58 ± 15.08), with significant group differences at weeks 8 and 12 ( P < 0.05 and P < 0.001, respectively). PFMT adherence was higher in the intervention group at week 12 (74.4% vs. 31.6%, P < 0.001). Qualitative findings revealed enhanced self-efficacy, improved adherence, and acceptability. In this single-centre randomised trial, the 5E-based self-management intervention was associated with greater reduction in self-reported incontinence episodes and higher PFMT adherence and self-efficacy at 12 weeks; its scalability requires confirmation in multicentre studies with longer follow-up. Chinese Clinical Trial Registry (ChiCTR2300071673, registered on 22 May 2023).