Motivations, psychosocial burdens, and decision-making modes of post-partum women with stress urinary incontinence engaging in pelvic floor physical therapy: a qualitative research

Li, Jie; Li, Tiantian; Huang, Shurong; Chen, Ling; Cai, Wenzhi

doi:10.1007/s00192-023-05466-9

Cited by 3 publications

(5 citation statements)

References 36 publications

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“…PPUI affects women's physical well‐being, psychology, and social economy 5 . PFPT is a recommended first‐line treatment, 6,7 but patients must consider individual factors and make choices 8 . SDM enhances patient participation and communication 10 .…”

Section: Discussionmentioning

confidence: 99%

“…A literature review on SDM theory and existing measurement tools was conducted. An exploratory qualitative study 8 with 22 women with PPUI was conducted using semistructured questionnaires.…”

Section: Methodsmentioning

confidence: 99%

“…To address PPUI, pelvic floor physical therapy (PFPT) is considered a conservative, first‐line treatment 6,7 . However, patients often need to consider various factors and make choices based on their individual situations and expectations 8 . Shared decision‐making (SDM) theory framework is a theoretical approach that recognizes the importance of incorporating patients' values, preferences, and individual circumstances into the healthcare decision‐making process.…”

Section: Introductionmentioning

confidence: 99%

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Development and validation of a Decision‐Making Ability Scale for postpartum urinary incontinence women engaging in pelvic floor physical therapy

Li,

Zhao

et al. 2023

Neurourology and Urodynamics

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ObjectiveThis study aimed to develop and validate a Decision‐Making Ability Scale (DMA‐S) for postpartum urinary incontinence (PPUI) women engaging in pelvic floor physical therapy (PFPT).MethodsItems were created in line with a review of the literature and exploratory qualitative study with 22 women. The items were submitted for expert opinion and a pilot implementation was made with 58 women with PPUI. Furthermore, the construct validity of the scale was tested with exploratory factor analysis (EFA) (n = 220) and confirmatory factor analysis (CFA) (n = 240). Internal consistency for the Chronbach's α and test–retest reliability for the intraclass correlation coefficient (ICC) were also investigated for the DMA‐S in the study.ResultsThe results of the EFA indicated a Kaiser–Meyer–Olkin value of 0.85 and Bartlett's test of sphericity showed a χ2 value of 8352.101, p < 0.001. After removing one item with factor loading values below 0.50, the resulting factor structure accounted for 83.38% of the total variance. The fit indices of the scale model tested in the CFA were determined as χ2/df = 1.08 < 3, root mean square error of approximation = 0.018 < 0.08, comparative fit index = 0.996 > 0.90, Tucker–Lewis index = 0.995 > 0.90, goodness‐of‐fit index (GFI) = 0.933 > 0.90, adjusted GFI = 0.916 > 0.90, and incremental fit index = 0.996 > 0.90. The Cronbach's α values were 0.95–0.97 for the subdimensions of the scale and 0.93 for the total scale. Data also showed a good test–retest stability (ICC = 0.984).ConclusionThe DMA‐S is a reliable and valid tool for assessing the decision‐making ability for PPUI women engaging in PFPT.

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Section: Discussionmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Development and validation of a Decision‐Making Ability Scale for postpartum urinary incontinence women engaging in pelvic floor physical therapy

Li,

Zhao

et al. 2023

Neurourology and Urodynamics

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“…The prevalence of stress incontinence during the first pregnancy and 12 years after delivery was significantly higher in women who developed it during the first pregnancy (56%) and shortly after delivery (78%) than in women without initial symptoms (30%), indicating an increased risk of long-term symptoms of stress incontinence occurring during the first pregnancy or puerperal period ( 9 ). This disease not only seriously affects the quality of life of patients, but also increases the psychological burden and economic burden of patients ( 10 , 11 ). In order to allow the body to recover from pregnancy and childbirth, surgical treatment is usually delayed after delivery.…”

Section: Introductionmentioning

confidence: 99%

Acupuncture combined with pelvic floor rehabilitation training for postpartum stress urinary incontinence: protocol for a systematic review and meta-analysis

Wenming,

Xiaoman,

Ling

et al. 2023

Front. Med.

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IntroductionThe purpose of this study is to systematically evaluate the efficacy and safety of acupuncture combined with pelvic floor rehabilitation training in the treatment of postpartum stress urinary incontinence, and to promote the further promotion and application of acupuncture in the field of rehabilitation.Methods and analysisRandomized controlled trials (RCTs) of acupuncture combined with pelvic floor rehabilitation in the treatment of postpartum stress urinary incontinence will be searched in PubMed, Web of Science (WOS), Cochrane Library, EMBASE, China National Knowledge Infrastructure (CNKI), Chinese Biomedical Literature Database (CBM), Wanfang (WF), and VIP databases. The clinical trial Registry (ClinicalTrials.gov and Chinese clinical trial Registry) will also be searched. The search period is limited to July 1, 2023, and the language limit of this systematic review is Chinese and English. The primary outcome is clinical effective rate. International Consultation on Incontinence Questionnaire-Short Form (ICI-Q-SF), 1-h pad test, pelvic floor muscle potential value, incidence of adverse events are secondary outcomes. A meta-analysis will be performed using RevMan 5.4 statistical software. If feasible, subgroup analysis and sensitivity analysis will be performed to address potential causes of inconsistency and heterogeneity. The risk of bias will be assessed using the approach recommended by Cochrane Handbook for Systematic Reviews of Interventions, and the quality of evidence will be assessed using GRADE. This Protocol has been developed in accordance with the guideline of Preferred Reporting Items for Systematic review and Meta-Analysis Protocols (PRISMA-P) 2015.DiscussionAcupuncture combined with pelvic floor rehabilitation training can effectively promote the rehabilitation of postpartum stress urinary incontinence patients, and provide a reference for the clinical application of integrated Chinese and Western medicine treatment in the field of rehabilitation.Systematic review registrationPROSPERO CRD42023455801.

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“…The postpartum period is a time of significant transition with obvious obstacles to attending PFPT. Current qualitative research, primarily from international populations, indicates there are psychosocial burdens and specific motivations that affect engagement with postpartum PFPT, such as financial stress, worries about the baby, and effects on quality of life 6 . The ability to further characterize and understand attendance and adherence patterns to postpartum PFPT could help with realistic expectations for postpartum patients.…”

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confidence: 99%

Pelvic Floor Physical Therapy Attendance Among High-Risk Postpartum Patients

Toal,

Goodman,

Durst

et al. 2024

UROGC

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Importance Limited data describe attendance to pelvic floor physical therapy (PFPT) in a postpartum patient population. Objectives The objective was describe attendance to PFPT in a cohort of postpartum women at high-risk of pelvic floor concerns. We secondarily compared attendance between patients with and without evaluation in a postpartum pelvic floor healing clinic (PPFHC). Study Design This was a retrospective cohort study of 2 convenience samples from an academic hospital. The PPFHC cohort comprised all postpartum vaginal delivery patients evaluated in the PPFHC from July 2021 to July 2022. The historical pre-PPFHC cohort comprised patients with third/fourth-degree obstetrical lacerations from December 2019 to January 2021. We abstracted attendance to PFPT, number of visits, Pelvic Floor Distress Inventory-20 (PFDI-20) scores, Pelvic Floor Impact Questionnaire (PFIQ) scores, and discharge status. Results Our cohort contained 464 patients, 195 (42.0%) from pre-PPFHC and 269 (58.0%) from PPFHC. Among all patients 302 (65.1%) were referred to PFPT and 170 (56.3%) attended at least 1 visit, 82 (48.2%) were discharged from PFPT with goals met, and the median number of visits was 6 (3–10). The majority of patients (97.0%, n = 261) seen in the PPFHC were referred to PFPT, compared with 22.0% (n = 41) of pre-PPFHC patients (P < 0.01). More patients in the pre-PPFHC cohort attended PFPT than in those the PPFHC cohort (75.6% vs 53.5%, P ≤ 0.01). Most patients exhibited improved PFDI and PFIQ scores after PFPT (n = 88, 80.0%, and n = 89, 81.7% respectively). Conclusions Patients attending postpartum PFPT demonstrated high therapy completion rates. A dedicated PPFHC had more referrals, however, lower PFPT attendance rates, when compared with a historical cohort.

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Motivations, psychosocial burdens, and decision-making modes of post-partum women with stress urinary incontinence engaging in pelvic floor physical therapy: a qualitative research

Cited by 3 publications

References 36 publications

Development and validation of a Decision‐Making Ability Scale for postpartum urinary incontinence women engaging in pelvic floor physical therapy

Development and validation of a Decision‐Making Ability Scale for postpartum urinary incontinence women engaging in pelvic floor physical therapy

Acupuncture combined with pelvic floor rehabilitation training for postpartum stress urinary incontinence: protocol for a systematic review and meta-analysis

Pelvic Floor Physical Therapy Attendance Among High-Risk Postpartum Patients

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