Factors motivating women to commence and adhere to pelvic floor muscle exercises following a perineal tear at delivery: the influence of experience

Author(s): S. Gillard & D. Shamley - Pages: 5–18

Abstract

Childbirth is one of the main causes of urinary incontinence (UI) in women. Pelvic floor muscle exercises (PFMEs) have been used clinically as a method of restoring muscle function, and preventing and treating postnatal UI for over 60 years. The success of PFME programmes is reliant on patient adherence and self-motivation, but 20–50% of postnatal women do not perform PFMEs on a daily basis. This study investigates the experiences determining the factors that motivate women to commence and adhere to PFMEs following a perineal tear at delivery. A crosssectional, retrospective, qualitative study was carried out using purposive sampling. Ten postnatal women were recruited from a single UK hospital. The approach was based on the principles of Heidegger’s hermeneutic interpretative phenomenology. Data were collected using semi-structured interviews that used questions based on the framework of the Health Belief Model. These transcripts were validated and the data were then thematically analysed. Seven themes emerged: (1) knowledge and understanding; (2) personal experience of symptoms; (3) fear of experiencing symptoms; (4) perceived self-efficacy; (5) belief in the effectiveness of the exercises; (6) experience of the actual exercises; and (7) triggers for action. Motivation to commence and adhere to PFMEs was affected when these areas were not addressed. The subjects identified their experience of UI or faecal incontinence, their fear of experiencing incontinence, and their perceived self-efficacy as key motivating factors.

Keywords: Health Belief Model, hermeneutics, motivation, pelvic floor muscle exercises, perineal tear.