Organising a clinical service for patients with pelvic floor disorders

Chatoor, D; Soligo, Marco; Emmanuel, Anton

doi:10.1016/j.bpg.2009.06.004

Cited by 18 publications

(13 citation statements)

References 13 publications

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“…Historically, pelvic floor disorders were divided into anterior, middle and posterior dysfunction leading to fragmented assessment and care . Although algorithms exist to tackle each type of dysfunction patients often present with symptoms attributable to all compartments . The joint pelvic floor clinic was first reported in 1997 and gave high levels of patient satisfaction .…”

Section: Discussionmentioning

confidence: 99%

“…The evolution of the multidisciplinary approach to the management of chronic disease reflects an understanding of the complexity of such conditions . The pelvic floor multidisciplinary meeting (MDM) encourages best evidence led practice and standardization of patient care.…”

Section: Introductionmentioning

confidence: 99%

“…It improves management and patient satisfaction . These considerations should not be confined to tertiary referral centres but should be adapted to the local expertise available .…”

Section: Introductionmentioning

confidence: 99%

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The future of pelvic floor services in the UK

et al. 2016

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The provision of pelvic floor services includes local, regional and tertiary centres. The overall response rate was low (38%) and biased to centres with a consultant who was a member of the Pelvic Floor Society. Not all regional or tertiary centres held an MDM or a pelvic floor clinic. Given the nature of pelvic floor pathology an integrated service should be aimed at linking different centres and specialities.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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The future of pelvic floor services in the UK

et al. 2016

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“…This approach is supported by Chatoor et. al (2009) [51] who states: “The multidisciplinary team approach is a means of synchronising treatment between various specialities and streamlining the patient pathway [51], p. 614.…”

Section: Discussionmentioning

confidence: 99%

“A patchwork of services” – caring for women who sustain severe perineal trauma in New South Wales – from the perspective of women and midwives

Priddis

Schmied

Kettle

et al. 2014

BMC Pregnancy Childbirth

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BackgroundCurrent research into severe perineal trauma (3rd and 4th degree) focuses upon identification of risk factors, preventative practices and methods of repair, with little focus on women’s experiences of, and interactions with, health professionals following severe perineal trauma (SPT). The aim of this study is to describe current health services provided to women in New South Wales (NSW) who have experienced SPT from the perspective of Clinical Midwifery Consultants (CMC) and women.MethodsThis study used a descriptive qualitative design and reports on the findings of a component of a larger mixed methods study. Data were collected through a semi-structured discussion group using a variety of non-directive, open-ended questions leading CMCs of NSW. A survey was distributed prior to the discussion group to collect further information and enable a more comprehensive understanding of services provided. Data from individual interviews with twelve women who had experienced SPT during vaginal birth is used to provide greater insight into their interactions with, and ease of access to, health service providers in NSW. An integrative approach was undertaken in reporting the findings which involved comparing and analysing findings from the three sets of data.ResultsOne overarching theme was identified: A Patchwork of Policy and Process which identified that current health services operate in a ‘patchwork’ manner when caring for women who sustain SPT. They are characterised by lack of consistency in practice and standardisation of care. Within the overarching theme, four subthemes were identified: Falling through the gaps; Qualifications, skills and attitudes of health professionals; Caring for women who have sustained SPT; and Gold standard care: how would it look?ConclusionThe findings from this study suggest that current health services in NSW represent a ‘patchwork’ of service provision for women who have sustained SPT. It appeared that women seek compassionate and supportive care based upon a clear exchange of information, and this should be considered when reflecting upon health service design. This study highlights the benefits of establishing multi-disciplinary collaborative specialist clinics to support women who experience SPT and associated morbidities, with the aim of providing comprehensive physiological and psychological support.

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“…For example, correcting rectal prolapse can thus induce or unmask cystocele and/or UI . Therefore, unidisciplinary treatment might be suboptimal, as relevant literature and current clinical practice increasingly show the importance of holistic assessment and evaluation of pelvic functional disorders, and advocate multidisciplinary treatment . However, objective data to support the multidisciplinary approach are scarce .…”

Section: Introductionmentioning

confidence: 99%

Patient‐reported outcome after treatment of urinary incontinence in a multidisciplinary pelvic care clinic

et al. 2015

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Abbreviations & Acronyms COPD = chronic obstructive pulmonary disease FI = fecal incontinence FP = fecal problems; obstipation and/or fecal incontinence M&S = menstruation and/or sexual problems MUI = mixed urinary incontinence P&M = prolapse and/or micturition problems PcC = pelvic care center POP = pelvic organ prolapse PRO = patient-reported outcome SUI = stress urinary incontinence UI = urinary incontinence UUI = urgency urinary incontinence Correspondence: Desiree MJ Objectives: To assess patient-reported outcome and satisfaction regarding urinary incontinence 1 year after the end of treatment in a multidisciplinary pelvic care clinic. Methods: A total of 647 patients with urinary incontinence seen in an academic multidisciplinary pelvic care clinic were prospectively included in a specific triage system. Patient-reported improvement of urinary incontinence and patient satisfaction were assessed by telephone survey 1 year after the end of treatment. Results: Just 15.6% of patients presented with one single pelvic floor problem, most had two or three pelvic functional disorders simultaneously, such as urinary incontinence, pelvic organ prolapse and constipation or fecal incontinence. One year after the end of treatment, of 440 responders (68%), 18.2% reported no remaining complaints, and 33.4% reported only one complaint. Patients reported a significant improvement of the mean severity (scale 0-10) of urinary incontinence from 7.2 AE1.6 pretreatment (=T0) to 4.3 AE 3.0 1 year after the end of treatment (P < 0.001). A total of 20.6% of patients reported no urinary incontinence after 1 year (P < 0.001), and 27.6% (P < 0.001) stopped using incontinence pads. Patients claimed high satisfaction with the clinic and care received, with 35.8% being "satisfied" and 45.5% "very satisfied." Conclusion: At 1 year after the end of treatment, one out of five patients with urinary incontinence recovered completely, and more than one out of four stopped using incontinence absorption pads. One out of three patients went from having a multifactorial health problem to a monofactorial health problem. High satisfaction rates were reported by more than four out of five patients.

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Organising a clinical service for patients with pelvic floor disorders

Cited by 18 publications

References 13 publications

The future of pelvic floor services in the UK

The future of pelvic floor services in the UK

“A patchwork of services” – caring for women who sustain severe perineal trauma in New South Wales – from the perspective of women and midwives

Patient‐reported outcome after treatment of urinary incontinence in a multidisciplinary pelvic care clinic

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