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Implementing pelvic floor muscle training in women's childbearing years : a critical interpretive synthesis of individual, professional, and service issues

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Salmon, Victoria E., Hay‐Smith, E. J. C, Jarvie, Rachel, Dean, Sarah, Terry, Rohini, Frawley, Helena, Oborn, Eivor, Bayliss, Susan E., Bick, Debra, Davenport, Clare, MacArthur, Christine and Pearson, Mark (2020) Implementing pelvic floor muscle training in women's childbearing years : a critical interpretive synthesis of individual, professional, and service issues. Neurourology and Urodynamics, 39 (2). pp. 863-870. doi:10.1002/nau.24256

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Official URL: http://dx.doi.org/10.1002/nau.24256

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Abstract

Aims:
Antenatal pelvic floor muscle training (PFMT) may be effective for the prevention and treatment of urinary and fecal incontinence both in pregnancy and postnatally, but it is not routinely implemented in practice despite guideline recommendations. This review synthesizes evidence that exposes challenges, opportunities, and concerns regarding the implementation of PFMT during the childbearing years, from the perspective of individuals, healthcare professionals (HCPs), and organizations.

Methods:
Critical interpretive synthesis of systematically identified primary quantitative or qualitative studies or research syntheses of women's and HCPs attitudes, beliefs, or experiences of implementing PFMT.

Results:
Fifty sources were included. These focused on experiences of postnatal urinary incontinence (UI) and perspectives of individual postnatal women, with limited evidence exploring the views of antenatal women and HCP or wider organizational and environmental issues. The concept of agency (people's ability to effect change through their interaction with other people, processes, and systems) provides an over‐arching explanation of how PFMT can be implemented during childbearing years. This requires both individual and collective action of women, HCPs, maternity services and organizations, funders and policymakers.

Conclusion:
Numerous factors constrain women's and HCPs capacity to implement PFMT. It is unrealistic to expect women and HCPs to implement PFMT without reforming policy and service delivery. The implementation of PFMT during pregnancy, as recommended by antenatal care and UI management guidelines, requires policymakers, organizations, HCPs, and women to value the prevention of incontinence throughout women's lives by using low‐risk, low‐cost, and proven strategies as part of women's reproductive health.

Item Type: Journal Article
Subjects: H Social Sciences > HQ The family. Marriage. Woman
R Medicine > RC Internal medicine
R Medicine > RG Gynecology and obstetrics
Divisions: Faculty of Medicine > Warwick Medical School > Health Sciences > Clinical Trials Unit
Faculty of Social Sciences > Warwick Business School > Entrepreneurship, Innovation & Management
Faculty of Medicine > Warwick Medical School > Health Sciences
Faculty of Social Sciences > Warwick Business School
Faculty of Medicine > Warwick Medical School
Library of Congress Subject Headings (LCSH): Urinary stress incontinence -- Exercise therapy, Urinary incontinence -- Exercise therapy, Fecal incontinence -- Exercise therapy, Maternal health services -- Great Britain, Pelvic floor, Pelvic floor -- Diseases -- Exercise therapy, Pregnant women , Pregnant women -- Services for
Journal or Publication Title: Neurourology and Urodynamics
Publisher: John Wiley & Sons, Inc.
ISSN: 0733-2467
Official Date: February 2020
Dates:
DateEvent
February 2020Published
17 December 2019Available
3 December 2019Accepted
Date of first compliant deposit: 17 December 2019
Volume: 39
Number: 2
Page Range: pp. 863-870
DOI: 10.1002/nau.24256
Status: Peer Reviewed
Publication Status: Published
Access rights to Published version: Open Access
RIOXX Funder/Project Grant:
Project/Grant IDRIOXX Funder NameFunder ID
RP‐PG‐0514‐20002[NIHR] National Institute for Health Researchhttp://dx.doi.org/10.13039/501100000272

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