Does self-motivation improve success rates of pelvic floor muscle training in women with urinary incontinence in a secondary care setting?
Rent the article at a discountRent now
* Final gross prices may vary according to local VAT.Get Access
Introduction and hypothesis
Pelvic floor muscle training (PFMT) is the recommended first-line treatment for women with urinary incontinence (UI). Success rates are variable and dependent on a number of factors. The development of an incontinence treatment motivation questionnaire (ITMQ) provides us with a tool to assess patient self-motivation with respect to PFMT and UI. The aim of this study was to determine the effect of women’s self-motivation to perform PFMT on outcome.
Women with stress predominant UI completed an ITMQ and a 24-h pad test and then underwent a 12-week course of supervised PFMT. At the end of their treatment they completed a patient global impression of improvement questionnaire (PGI-I) and a second 24-h pad test. The PGI-I scores and the difference in pad test weight correlated with the ITMQ according to Spearman’s correlation coefficient.
Sixty-five women were recruited. Thirty-two (49 %) patients perceived themselves as having improved, 28 women (43 %) did not experience any change in symptoms and 5 women (8 %) felt that their symptoms deteriorated following treatment. When correlating the PGI-I with the ITMQ, 3 of the 5 domains: MQS1 (positive attitude for treatment; p = 0.003), MQS3 (frustration of living with incontinence; p = 0.002) and MQS4 (desire for treatment; p = 0.002) correlated significantly with outcome. Desire for treatment was the only domain to correlate with change in pad weight (p = 0.001).
Self-motivation is essential in order to determine improved success rates with PFMT.
- Haylen, BT, Ridder, D, Freeman, RM, Swift, SE, Berghmans, B, Lee, J, Monga, A, Petri, E, Rizk, DE, Sand, PK, Schaer, GN (2010) An International Urogynecological Association (IUGA)/International Continence Society (ICS) joint report on the terminology for female pelvic floor dysfunction. Int Urogynecol J 21: pp. 5-26 CrossRef
- Kelleher, CJ, Cardozo, LD, Khullar, V, Salvatore, S (1997) A new questionnaire to assess the quality of life of urinary incontinent women. Br J Obstet Gynaecol 104: pp. 1374-1379 CrossRef
- Dumoulin C, Hay-Smith J (2010) Pelvic floor muscle training versus no treatment, or inactive control treatments, for urinary incontinence in women. Cochrane Database Syst Rev. 20(1):
- National Institute of Clinical Excellence (2009) Guidelines on urinary incontinence
- Kondo, A, Yamada, Y, Morishige, R, Niijima, R (1996) An intensive programme for pelvic floor muscle exercises: short- and long-term effects on those with stress urinary incontinence. Hinyokika Kiyo 42: pp. 853-859
- Mørkved, S, Bø, K, Fjørtoft, T (2002) Effect of adding biofeedback to pelvic floor muscle training to treat urodynamic stress incontinence. Obstet Gynecol 100: pp. 730-739 CrossRef
- Moore, KH, O’Sullivan, RJ, Simons, A, Prashar, S, Anderson, P, Louey, M (2003) Randomised controlled trial of nurse continence advisor therapy compared with standard urogynaecology regimen for conservative incontinence treatment: efficacy, costs and two year follow up. BJOG 110: pp. 649-657 CrossRef
- Sarma, S, Hawthorne, G, Thakkar, K, Hayes, W, Moore, KH (2009) The development of an incontinence treatment motivation questionnaire for patients undergoingpelvic floor physiotherapy in the treatment of stress incontinence. Int Urogynecol J Pelvic Floor Dysfunct 20: pp. 1085-1093 CrossRef
- Bronken BA, Kirkevold M, Martinsen R, Wyller TB, Kvigne K (2012) Psychosocial well-being in persons with aphasia participating in a nursing intervention after stroke. Nurs Res Pract 568242
- Miller, JM, Sampselle, C, Ashton-Miller, J, Hong, GR, DeLancey, JO (2008) Clarification and confirmation of the Knack maneuver: the effect of volitional pelvic floor muscle contraction to preempt expected stress incontinence. Int Urogynecol J Pelvic Floor Dysfunct 19: pp. 773-782 CrossRef
- Yalcin, I, Bump, R (2003) Validation of two global impression questionnaires for incontinence. Am J Obstet Gynecol 189: pp. 98-101 CrossRef
- Slack, A, Hill, A, Jackson, S (2007) Is there a role for a specialist physiotherapist in the multidisciplinary management of women with stress incontinence referred from primary care to a specialist continence clinic?. J Obstet Gynaecol 28: pp. 410-412 CrossRef
- Zanetti, MR, Castro Rde, A, Rotta, AL, Santos, PD, Sartori, M, Girao, MJ (2007) Impact of supervised physiotherapeutic pelvic floor exercise for treating female stress urinary incontinence. Sao Paulo Med J 6: pp. 265-269 CrossRef
- Tsai, YC, Liu, CH (2009) The effectiveness of pelvic floor exercises, digital vaginal palpation and interpersonal support on stress urinary incontinence: an experimental study. Int J Nurs Stud 46: pp. 1181-1186 CrossRef
- Williams, KS, Assassa, RP, Gillies, CL, Abrams, KR, Turner, DA, Shaw, C, Haslam, J, Mayne, C, McGrother, CW (2006) Leicestershire MRC incontinence study team. A randomized control trial of the effectiveness of pelvic floor therapies for urodynamic stress and mixed incontinence. BJU Int 98: pp. 1043-1050 CrossRef
- Castro, RA, Aruda, RM, Zanetti, MR, Santos, PD, Sartori, MG, Girao, MJ (2008) Single-blind, randomized controlled trial of pelvic floor muscle training, electrical stimulation, vaginal cones, and no active treatment in the management of stress urinary incontinence. Clinics (Sao-Paulo) 63: pp. 465-472 CrossRef
- Kusurkar, RA, Croiset, G, Mann, KV, Custers, E, Ten Cate, O (2012) Have motivation theories guided the development and reform of medical education curricula? A review of the literature. Acad Med 87: pp. 735-743 CrossRef
- Fromer, L (2011) Implementing chronic care for COPD: planned visits, care coordination, and patient empowerment for improved outcomes. Int J Chron Obstruct Pulmon Dis 6: pp. 605-614 CrossRef
- Ogedegbe, G, Schoenthaler, A, Richardson, T, Lewis, L, Belue, R, Espinosa, E, Spencer, J, Allegrante, JP, Charlson, ME (2007) An RCT of the effect of motivational interviewing on medication adherence in hypertensive African Americans: rationale and design. Contemp Clin Trials 28: pp. 169-181 CrossRef
- Cockle-Hearne, J, Faithfull, S (2010) Self-management for men surviving prostate cancer: a review of behavioural and psychosocial interventions to understand what strategies can work, for whom and in what circumstances. Psychooncology 19: pp. 909-922 CrossRef
- Huffman, M (2007) Health coaching: a new and exciting technique to enhance patient self-management and improve outcomes. Home Health Nurse 25: pp. 271-274 CrossRef
- Aujoulat, I, d’Hoore, W, Deccache, A (2007) Patient empowerment in theory and practice: polsemy or cacophony. Patient Educ Couns 66: pp. 13-20 CrossRef
- Jerant, A, Moore, M, Loring, K, Franks, P (2008) Perceived control moderated the self-efficacy enhancing effects of a chronic illness self-management intervention. Chronic Illn 4: pp. 173-182 CrossRef
- Franks, P, Chapman, B, Deberstein, P, Jerant, A (2009) Five factor model personality factors moderated the effects of an intervention to enhance chronic disease management self-efficacy. Br J Health Psychol 14: pp. 473-487 CrossRef
- Does self-motivation improve success rates of pelvic floor muscle training in women with urinary incontinence in a secondary care setting?
International Urogynecology Journal
Volume 24, Issue 11 , pp 1947-1951
- Cover Date
- Print ISSN
- Online ISSN
- Springer London
- Additional Links
- Pelvic floor muscle training
- Incontinence treatment motivation questionnaire
- Industry Sectors
- Author Affiliations
- 1. Department of Urogynaecology, Kings College Hospital NHS Foundation Trust, Denmark Hill, London, SE5 9 RS, UK
- 3. King’s College Hospital, Denmark Hill, London, SE5 9RS, UK
- 2. Department of Obstetrics and Gynaecology, Medway NHS Foundation Trust, Windmill Road, Gillingham, Kent, ME7 5NY, UK