A 24 month longitudinal qualitative study of women's experience of electromyography biofeedback pelvic floor muscle training (PFMT) and PFMT alone for urinary incontinence: adherence, outcome and context.

Bugge, Carol; Hay-Smith, Jean; Grant, Aileen; Taylor, Anne; Hagen, Suzanne; McClurg, Doreen; Dean, Sarah

Abstract

Aims of study: To investigate women’s experiences of electromyography (EMG) biofeedback pelvic floor muscle training (PFMT) and PFMT alone for stress or mixed urinary incontinence (UI) to explain the contextual factors that influence intervention adherence and outcome within a randomised controlled trial. Study design, materials and methods: The study design was a two-tailed, longitudinal, qualitative case study (1) carried out in parallel to a randomised controlled trial (2). The ‘tails’ were the biofeedback PFMT group and PFMT alone group. Following ethical approval, purposive maximum variation sampling (based on difference in treatment centre, UI type, and therapist type) was used to invite a subsample of women, who had consented to the trial, to take part in the case study. Interested women were sent written information about, and asked to consent to, the case study specifically. The data from each recruited women formed one case. Women were interviewed at baseline, six, 12 and 24 months after randomisation. Interviews were semi-structured, digitally recorded and transcribed. Where possible, baseline and six month interviews were face to face and either at the participant’s home or in the clinic, and 12 and 24 month interviews were by telephone. Interviews explored women’s experiences of the social contexts within which they experienced UI, the intervention they received, adherence and outcome. Data analysis principally followed case study analytic traditions (1) whereby all data from a case were analysed and findings collected together to form a case summary with a focus on understanding a woman’s experience of UI, intervention, adherence and outcome and how these factors interacted. Case summaries within a ‘tail’ were collated, the cases compared, and the two tails were then compared to one another. Results: Sample: Forty women, 20 per group, were recruited as planned; 24 had data at all four time points (10 biofeedback PFMT and 14 PFMT alone), with 2856 minutes of interview data recorded. There was a wide age range in both groups (20 to 76 years). Eleven women had stress UI and 29 Mixed UI with similar proportions in the groups. Six women were treated in community clinics, 16 in University hospitals and 18 in District General Hospitals with similar proportions in the groups. Most women were treated by specialist women’s health physiotherapists (n=36) and four by continence nurses.

Citation

BUGGE, C., HAY-SMITH, J., GRANT, A., TAYLOR, A., HAGEN, S., MCCLURG, D. and DEAN, S. 2019. A 24 month longitudinal qualitative study of women’s experience of electromyography biofeedback pelvic floor muscle training (PFMT) and PFMT alone for urinary incontinence: adherence, outcome and context. Presented at the 49th International Continence Society conference 2019 (ICS 2019), 3-6 September 2019, Gothenburg, Sweden. Bristol: ICS [online], abstract 473. Available from: https://www.ics.org/2019/abstract/473

• Presentation Conference Type: Lecture
• Conference Name: 49th International Continence Society conference 2019 (ICS 2019)
• Conference Location: Gothenburgh, Sweden
• Start Date: Sep 3, 2019
• End Date: Sep 6, 2019
• Deposit Date: Sep 24, 2019
• Publicly Available Date: Sep 24, 2019
• Keywords: Electromyography biofeedback; (EMG); Pelvic floor muscle training (PFMT); Urinary incontinence
• Public URL: https://rgu-repository.worktribe.com/output/350776
• Publisher URL: https://www.ics.org/2019/abstract/473