Predictors for adherence to a home-based pelvic floor muscle exercise program for treating female urinary incontinence in Brazil.

Autor: Sacomori C PT, PhD; School of Kinesiology, Universidad Bernardo O'Higgins, Santiago de Chile, Chile., Berghmans B PT, MSc, PhD; Pelvic care Centre Maastricht, Maastricht University Medical Centre, Maastricht, The Netherlands., de Bie R PT, PhD; Department of Epidemiology, Maastricht University, Maastricht, The Netherlands., Mesters I PhD; Department of Epidemiology, Maastricht University, Maastricht, The Netherlands., Cardoso FL PhD; Department of Health Sciences, Centre of Health and Sports Sciences, Universidade do Estado de Santa Catarina, Florianópolis, SC, Brazil.
Jazyk: angličtina
Zdroj: Physiotherapy theory and practice [Physiother Theory Pract] 2020 Jan; Vol. 36 (1), pp. 186-195. Date of Electronic Publication: 2018 Jun 04.
DOI: 10.1080/09593985.2018.1482583
Abstrakt: Objective : To assess predictors for adherence to a home-based pelvic floor muscle exercise (PFME) program supplemented with three physical therapy sessions in women with urinary incontinence (UI). Design : Secondary analysis of a randomized controlled trial of interventions to enhance self-efficacy with respect to PFME. Setting : Patients were referred from public primary or secondary care providers in Florianópolis, Brazil. Participants : Adult women with UI. Intervention : Three supervised physiotherapy sessions for the treatment of UI combined with home-based PFME program. Treatment groups were combined for predictive modelling because there was no difference after intervention between groups regarding UI and adherence rates. Main Outcome Measures : Adherence to PFME at 3-month follow-up (structured questionnaire). Baseline Predictors: self-efficacy and outcome expectation scales; severity of UI (ICIQ-SF), pelvic floor muscle strength, age, body mass index (BMI), and educational level. Results : 86 women with UI of whom 72 completed the study. An intention-to-treat analysis was performed. Forty-three women reported carrying out PFME every day. Adherence was correlated to: baseline self-efficacy ( r  = 0.299); age ( r  = 0.242); and educational level ( r  = -0.273). Hierarchical regression analyses incorporating treatment group, age, education, disease-related factors (severity of UI; pelvic floor muscle strength; BMI), and outcome expectations and self-efficacy showed that only baseline self-efficacy predicted adherence ( R 2  = 0.217). Conclusions : Adherence to home-based PFME is a complex phenomenon. Assessing self-efficacy may help physiotherapists to detect patients' confidence in performing home-based exercises and, when necessary, give patients additional incentives.
Databáze: MEDLINE
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