Randomized control trial of a values-based motivational interview support to promote attendance at pelvic floor muscle training physiotherapy treatment

Author(s): L. A. Osborne et al. - Pages: 38–46

Abstract

The recommended first-line treatment for pelvic floor disorders is pelvic floor muscle training (PFMT), which is effective, acceptable to patients and cost-effective. However, PFMT outcomes are mediated by patient variables such as depression, anxiety, motivation and health values. This study examined whether provision of an adjunct values-based motivational interview support for moderately depressed and/or anxious patients would improve attendance at PFMT group sessions. In total, 67 consecutive female patients who were referred for PFMT were screened for signs of depression and anxiety using the Hospital Anxiety and Depression Scale, and 31 were identified as having moderate levels of both conditions. The average age of the women was 50 years (range = 32–72 years), and they suffered from a variety of pelvic floor problems. The participants were randomly divided into two groups: (1) PFMT treatment as usual (n = 15); and (2) PFMT plus motivational support (n = 16). The patients then received 6 months of outpatient physiotherapy treatment. Those in group 2 (PFMT plus motivational support) received three, 30-min group sessions of support after PFMT sessions 2, 3 and 4, which involved an intervention focused on motivation and values. Significantly more patients (approximately twice as many) in group 2 (PFMT plus motivational support) completed the course, compared to those in group 1 (treatment as usual). These results suggest that adjunct motivational support during PFMT intervention treatment may help some patients by enhancing their motivation to attend sessions and their treatment compliance.

Keywords: attendance, motivational support, pelvic floor dysfunction, pelvic floor muscle training, treatment compliance.