Background To assess the feasibility and acceptability of in-person support groups as a potential intervention for female patients with urinary incontinence. Methods Women over the age of 18 seeking treatment for UI were randomized to standard care with support group participation or to standard care alone. All participants completed validated questionnaires at the beginning and conclusion of the study. Questionnaires were analyzed with repeated measures of ANOVA models in an intention-to-treat manner. Three moderated support group sessions were held and audio recorded. Recordings were transcribed and categorized by frequency into themes using grounded theory methodology. Results A total of 10 control and 8 intervention participants agreed to participate. Seven women attended all three support group sessions and were included in the final analysis. Transcripts from support group sessions observed women identified most with (1) urinary incontinence (UI) as a chronic disease, (2) shame managing UI, and (3) social constraints of toileting. Support participants self-reported appreciation of support group participation and desire for on-going sessions. Analysis of the questionnaires did not demonstrate statistically significant differences. Conclusion Data ascertained from questionnaires was unable to demonstrate a meaningful effect in improved treatment outcomes for control and intervention participants. Grounded theory analysis of transcripts identified four primary themes: (1) appreciation of the support group, (2) UI as a gendered issue, (3) lack of public awareness, and (4) history of negative provider interactions. All support group participants self-reported interest in attending future support group sessions.
INTRODUCTION AND OBJECTIVE: Pain catastrophizing has been found to be correlated with worse outcomes following treatment for patients with CPP. Despite this association, there is scant evidence regarding catastrophication as a dynamic trait. We studied whether an improvement in pain catastrophizing during specialized pelvic floor physical therapy (PT) would portend better outcomes.METHODS: A retrospective chart review was performed among patients with CPP undergoing pelvic floor PT. Patients are given validated survey instruments three times over their treatment period, including the short-form Pain Catastrophizing Scale (PCS), Genitourinary Pain Index (GUPI), and Pelvic Floor Disability Index (PFDI-20). Patients were separated into catastrophication improvers (CI) and non-catastrophication improvers (NCI) based on their net change in PCS scores between weeks 0 and 6. Patients' changes on their GUPI and PFDI scores were compared utilizing unpaired two sample t-tests.RESULTS: CI patients (n[37, 74%) had a mean decrease in GUPI score of 5.16 compared to a mean decrease of only 0.46 points in the NCI group (n[13, 26%) after six weekly PT appointments (p [0.026). The CI group had improved scores for the urinary symptoms and quality of life subsections of the GUPI specifically (p<0.05). There was a nonsignificant difference in the mean PFDI score change between the two groups of 28.29 (p[0.143) with CI patients improving their PFDI score by 17.35 whereas the NCI group had a mean increase in PFDI score by 10.94.CONCLUSIONS: This is the first study to evaluate whether changes in pain catastrophication can affect outcomes in patients with CPP undergoing pelvic floor physical therapy. Preliminary data suggests patients who catastrophize less throughout treatment have improved pain symptoms, specifically in regard to urinary complaints and quality of life measures.
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