Researchers and health professionals in Swansea have revealed the value women put on their own health can have a direct effect on the success of medical treatment for pelvic floor problems.
Pelvic floor dysfunction affects more than a quarter of all women in the UK. It can involve incontinence and prolapse, and can be treated by physiotherapy.
However, according to the research carried out by Swansea University and Swansea Bay University Health Board, many women do not put their own health first. As a result, they do not benefit from the treatment, and end up having to have surgical intervention instead.
Professor Phil Reed and health professionals carried out a study of 218 women who had been referred for physiotherapy to treat their pelvic floor dysfunction. The researchers discovered the strength of the women's health-related values predicted their attendance, but only those patients who valued health for themselves - rather than because of what it allowed them to do for others - showed improvement.
Professor Reed said:
The fact that holding strong health values is an important predictor of treatment attendance is no surprise, but the data show that many ladies place this aspect of their life lower than many other areas - and we need to help empower them to value their own health."
Health values influence outcomes in several healthcare contexts, but the impact of these values on physiotherapy was previously unknown.
The team's motivation in conducting the study was to gain a better understanding of the views of patients and the kinds of things that they regard as important, in order to develop appropriate support for women undergoing pelvic floor physiotherapy, and to enhance treatment attendance and outcomes.
Pelvic floor dysfunction causes substantial reductions in women's quality of life and impacts ability to work, as well as involving substantial costs to the NHS. Pelvic floor muscle training (PFMT) is effective, safe, and cost-efficient relative to alternative treatments, such as surgery. However, many psychological factors are associated with its outcome and with patient adherence to treatment.
One implication of these new findings is that supporting patients to develop the sorts of health values that aid better outcomes might enhance their attendance at PFMT sessions and help them recover their pelvic floor function without the need for operations.
Professor Reed added: "Physiotherapy treatment for this very common problem can be so effective and safe for the patients, and it is really important that the ladies who attend have their needs fully recognised and supported."
"If we do that, then we will enhance attendance and outcomes for these patients, and stop them having to go for operations, which will also have the benefit of saving the NHS much-needed money that can then be used to help other patients."
The team has previously shown that supporting the motivation of women to attend PFMT, through short group-based sessions, improves attendance by around 60%, and it says the current findings will help to tailor this support to the needs of the women even more closely.
The study, conducted by Dr Lisa A. Osborne, Research Psychologist, C. Mair Whittall, Clinical Physiotherapy Specialist in Women's Health, Professor Simon Emery, Consultant Gynaecologist/Urogynaecologist, all from Swansea Bay University Health Board, and Professor Phil Reed, Chair in Psychology at Swansea University, was published in the journal Urology
A short animated video, developed by Clare Lehane, Impact Support Officer in Swansea University's College of Human and Health Sciences, aims to illustrate research findings and help patients and health professionals approach this issue.
Reed, P., et al. (2019) Impact of Strength and Nature of Patient Health Values on Compliance and Outcomes for Physiotherapy Treatment for Pelvic Floor Dysfunction. Urology. doi.org/10.1016/j.urology.2019.11.017.