Factors influencing long-term adherence to pelvic floor exercises in women with urinary incontinence

Abstract

Background and ObjectivesTo ensure the effectiveness of Physical Therapy for urinary incontinence (UI), it is crucial that patients adhere to treatment in both the long and the short term. Treatment adherence may prevent symptom progression and the need for surgery, which is associated with higher costs and potential complications. Adherence is defined as carrying out a recommended behavioral modification or change. The World Health Organization (WHO) has established that adherence is a multifactorial phenomenon determined by the interaction of five dimensions, which include diverse factors that affect long-term adherence on many levels.

AimTo identify the factors that influence long-term adherence to pelvic floor exercises in women with UI.

MethodsObservational, descriptive, cross-sectional study. The sample was recruited from the Centro Integral de Reeducacion de Piso Pelvico (CIREP), and included 61 women treated for UI at the center in 2014 and 2015. Participants completed a self-administered, 28-item questionnaire developed for this study based on the WHO five dimensions. Data analysis was performed using STATA 13.0 software.

ResultsHaving performed pelvic floor home exercises after discharge from Physical Therapy was significantly associated with self-rated treatment adherence (P<0.001). Patient-related factors were significantly associated with long-term adherence to the pelvic floor exercise program (P<0.001).

ConclusionPatient-related factors, exerted the strongest influence on long-term adherence to pelvic floor exercises in women with UI; forgetting to do the exercises and boredom with the exercises were the factors most strongly related to low treatment adherence, while motivation and commitment were associated with high adherence in this population.