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Willburger B, Chen Z, Mansfield KJ. Investigation of the quality and health literacy demand of online information on pelvic floor exercises to reduce stress urinary incontinence. Aust N Z J Obstet Gynaecol 2024. [PMID: 38686657 DOI: 10.1111/ajo.13830] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2023] [Accepted: 04/16/2024] [Indexed: 05/02/2024]
Abstract
BACKGROUND Many women are embarrassed to discuss pelvic floor exercises with health professionals during pregnancy; instead they search the internet for information on pelvic floor exercises. AIMS This project investigated the quality and health literacy demand in terms of readability, understandability and actionability of information available on the internet relating to pelvic floor exercises. MATERIALS AND METHODS An analysis was conducted on 150 websites and 43 videos obtained from three consecutive Google searches relating to pelvic floor exercises. Websites were assessed for Health on the Net certification. Readability was assessed using a readability calculator, and understandability/actionability of website and video information was assessed using the Patient Education Materials Assessment Tool (PEMAT) for Print or Audiovisual Materials. RESULTS Less than one-third (24%) of the websites were certified for quality. The median readability score for the websites was grade 9 and the websites and videos both rated highly for understandability and actionability. The median understandability score for the website information was 87%, and the median actionability score was 71%. The median understandability score of the video information was 95.5% and the median actionability score was 100%. The understandability and actionability of video information was also significantly greater than that for website information (P < 0.01). CONCLUSION Clinicians could consider directing patients to video-based resources when advising online pelvic floor exercise resources for women during pregnancy, especially those with lower health literacy.
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Affiliation(s)
- Brydie Willburger
- Graduate School of Medicine, University of Wollongong, Wollongong, New South Wales, Australia
- Illawarra Shoalhaven Local Health District, Wollongong, New South Wales, Australia
| | - Zhuoran Chen
- St George Hospital, University of New South Wales, Sydney, New South Wales, Australia
| | - Kylie J Mansfield
- Graduate School of Medicine, University of Wollongong, Wollongong, New South Wales, Australia
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2
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Passarelli E, Siddique M, Fry L, Hickman L, Propst K. Perineal lacerations and social media: can patients find reliable information on Instagram and TikTok? Int Urogynecol J 2024; 35:183-188. [PMID: 38032377 DOI: 10.1007/s00192-023-05690-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2023] [Accepted: 10/31/2023] [Indexed: 12/01/2023]
Abstract
INTRODUCTION AND HYPOTHESIS Social media content related to patient experiences and education continues to grow. Information on how obstetric perineal lacerations are represented on social media is limited. Our goal is to characterize available social media content on obstetric perineal lacerations. METHODS This is an IRB-exempt study using publicly available data on commonly searched topics about perineal lacerations to create a list of queries for Instagram and TikTok. The ten queries and "keyword" searches with the highest number of posts were identified from this list. The 50 most recent posts were reviewed for relevance, quality of content, and authorship. Topic-relevant posts were analyzed. RESULTS The search yielded 427 posts on Instagram and 500 on TikTok. Instagram yielded more topic-relevant posts than TikTok (94.1% vs 44.8%). Almost 50% of posts were categorized as educational. Instagram identified more patient experience-related posts (29.6%) whereas TikTok provided more humorous content (26.3%). Patients produced 27.6% of content on Instagram and 43.3% on TikTok. Physical therapists produced 18.9% of posts on Instagram and 21.9% on TikTok. They constituted the largest group of health professionals to post overall. Physician-created educational content accounted for 10.3% of posts on Instagram and 6.0% on TikTok. CONCLUSIONS Compared with TikTok, Instagram may be a more informative social media platform for educational or patient experience-related content. Given the paucity of physician-created content and given that only half of all posts are educational, providers should encourage social media engagement for community and networking purposes, while encouraging caution with regard to cosmetic products and advertisements.
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Affiliation(s)
- Emily Passarelli
- Obstetrics and Gynecology, Westchester Medical Center, Valhalla, NY, USA
| | - Moiuri Siddique
- Division of Female Pelvic Medicine and Reconstructive Surgery, Department of Obstetrics and Gynecology, NYU Langone Health, New York, NY, USA.
| | - Laura Fry
- Creator of Life After 4th Degree Tears Online Community, New York, NY, USA
| | - Lisa Hickman
- Division of Female Pelvic Medicine and Reconstructive Surgery, Department of Obstetrics & Gynecology, Ohio State University Wexner Medical Center, Columbus, OH, 43221, USA
| | - Katie Propst
- Division of Urogynecology & Reconstructive Pelvic Surgery, Department of Obstetrics and Gynecology, Morsani College of Medicine at the University of South Florida, Tampa, FL, 33602, USA
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Dong SM, Hickman LC. Current opinion: postpartum urinary disorders. Curr Opin Obstet Gynecol 2023; 35:510-516. [PMID: 37807921 DOI: 10.1097/gco.0000000000000919] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/10/2023]
Abstract
PURPOSE OF REVIEW The aim of this study was to describe the common postpartum urinary sequelae including urinary retention and incontinence, and to summarize the management of these conditions. RECENT FINDINGS Despite the high frequency of urinary disorders in obstetrics, screening and management protocols are rarely utilized by providers. Large variation exists in the literature regarding assessment of postpartum urinary retention, values of postvoid residuals and management of indwelling catheters in the immediate postpartum population. Recent expert guidance outlines a strategy for managing this condition.Research also highlights that screening for peripartum urinary incontinence is not a routine practice. The diagnosis is made more challenging by the fact that patients commonly understate and over-normalize their symptoms. Emerging studies have found that pelvic floor muscle training is cost-effective, preventive, and may improve symptoms in the postpartum setting. SUMMARY Increased awareness of urinary disorders in pregnancy and postpartum is imperative for appropriate diagnosis and management. Instituting standardized voiding protocols postpartum will allow providers to avoid undiagnosed postpartum urinary retention and its repercussions. Improved screening and education regarding urinary incontinence in the peripartum is important for early management, such as pelvic floor muscle training, and improved quality of life.
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Affiliation(s)
- Shirley M Dong
- Department of Obstetrics and Gynecology, Division of Female Pelvic Medicine and Reconstructive Surgery, The Ohio State University Wexner Medical Center, Columbus, Ohio, USA
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Bennett AT, Boniface ER, Spiers A, Gregory WT, Cichowski SB. A Randomized Trial of Social Media Versus Search Engine Advertising to Increase Awareness of Treatments for Female Stress Urinary Incontinence. Female Pelvic Med Reconstr Surg 2022; 28:293-299. [PMID: 35421015 DOI: 10.1097/spv.0000000000001187] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
IMPORTANCE Outreach based on user characteristics through social media advertising is significantly more effective than outreach based on user interests with search engine advertising for female stress urinary incontinence. OBJECTIVE The aim of the study was to compare the effectiveness of 2 online outreach platforms to engage women at risk of stress urinary incontinence with a high-quality patient education website. STUDY DESIGN A geographic randomized trial was performed comparing online advertising on Facebook, a social media site, versus Google Ads, a search engine, to direct viewers to VoicesForPFD.org. Advertisements were developed using health communication theory and pretested before the randomized trial. Counties in the Pacific Northwest were grouped into approximately equal populations, called "supercounties," and randomized to advertisement platforms. Educational website views resulting from each campaign, called sessions, were measured using Google Analytics; the primary outcome was the number of sessions per supercounty. County characteristics were obtained from national survey data. Effectiveness of the advertising platforms was compared between randomization arms using Welch's unequal variances t test, and crude and adjusted linear regression models. RESULTS Mean user sessions were significantly higher in areas randomized to Facebook advertising (470 sessions) compared with areas randomized to Google Ads advertising [44 sessions; mean, 426 session difference (95% confidence interval, 199-653 sessions); P = 0.001]. After accounting for adult female population and rurality, randomization to Facebook instead of Google Ads still resulted in 409 additional sessions (95% confidence interval, 317-501 sessions; P < 0.001). CONCLUSIONS Social media was 10 times more effective (470 versus 44 mean sessions per supercounty) than search engine outreach advertising and should be prioritized in outreach efforts. Future work is needed on engagement and behavior change with online outreach.
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Affiliation(s)
- Alaina T Bennett
- From the Division of Urogynecology and Reconstructive Pelvic Surgery, Department of Obstetrics and Gynecology
| | - Emily R Boniface
- Department of Obstetrics and Gynecology, Oregon Health & Science University, Portland, OR
| | - Alaina Spiers
- Department of Communication, Texas A&M University, College Station, TX
| | - W Thomas Gregory
- From the Division of Urogynecology and Reconstructive Pelvic Surgery, Department of Obstetrics and Gynecology
| | - Sara B Cichowski
- From the Division of Urogynecology and Reconstructive Pelvic Surgery, Department of Obstetrics and Gynecology
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Recognition and Management of Pelvic Floor Disorders in Pregnancy and the Postpartum Period. Obstet Gynecol Clin North Am 2021; 48:571-584. [PMID: 34416938 DOI: 10.1016/j.ogc.2021.05.009] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Abstract
Often considered a condition of aging women, pelvic floor disorders may initially present in pregnancy and postpartum, having a negative impact on quality of life during this important time in a woman's life. This review outlines the clinical approach to implementing pelvic health into obstetric care through education and promotion of pelvic health in pregnancy, screening for pelvic floor disorders routinely, and providing support through resources, treatment, and referrals if pelvic floor disorders develop during pregnancy and postpartum.
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Renbarger KM, Place JM, Schreiner M. The Influence of Four Constructs of Social Support on Pregnancy Experiences in Group Prenatal Care. WOMEN'S HEALTH REPORTS 2021; 2:154-162. [PMID: 34235502 PMCID: PMC8243703 DOI: 10.1089/whr.2020.0113] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Accepted: 04/27/2021] [Indexed: 11/12/2022]
Abstract
Objective: This study aimed to identify the influence of the four constructs of social support on positive pregnancy experiences in CenteringPregnancy, a group prenatal care (GPNC) model. Methods: Using a qualitative descriptive design, semi-structured interviews were conducted with 11 women who had participated in at least 6 of 10 GPNC sessions at a family practice medicine residency. Participants were asked to describe their experiences in GPNC. Results: Using a standard content analysis, four constructs of social support (emotional, informational, instrumental, and appraisal) were identified through three major themes: (1) informational support, offered by peers in GPNC settings, promotes learning and prepares women for motherhood; (2) emotional and appraisal support, offered by peers in GPNC, improves emotional well-being and helps women build lasting, supportive connections with peers, and (3) emotional, informational, instrumental, and appraisal support work in tandem to create positive relationships between women and health care providers. Conclusion: Social support provided a means to a positive prenatal health care experience that facilitated the attainment of new knowledge and the formation of positive relationships with health care providers and peers. The findings of this study can provide health care providers with a framework to examine and enhance their practice and care of women in the perinatal period.
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Affiliation(s)
| | - Jean Marie Place
- Department of Nutrition and Health Science, Ball State University, Muncie, Indiana, USA
| | - Melanie Schreiner
- IU Health Ball Memorial Family Medicine Residency Center, Muncie, Indiana, USA
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Woodley SJ, Hay-Smith EJC. Narrative review of pelvic floor muscle training for childbearing women-why, when, what, and how. Int Urogynecol J 2021; 32:1977-1988. [PMID: 33950309 DOI: 10.1007/s00192-021-04804-z] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2021] [Accepted: 04/12/2021] [Indexed: 02/06/2023]
Abstract
INTRODUCTION AND HYPOTHESIS Urinary incontinence (UI) is prevalent during pregnancy and postpartum. UI in pregnancy strongly predicts UI postpartum and later in life. UI reduces women's wellbeing and quality of life and presents a significant burden to healthcare resource. METHODS A narrative review summarizing quantitative and qualitative evidence about pelvic floor muscle training (PFMT) for prevention and treatment of UI for childbearing women. RESULTS There are clinically important reductions in the risk of developing UI in pregnancy and after delivery for pregnant women who start PFMT during pregnancy, and PFMT offers additional benefits preventing prolapse and improving sexual function. If women develop UI during pregnancy or postpartum then PFMT is an appropriate first-line treatment. For novice exercisers, a programme comprising eight contractions, with 8-s holds, three times a day, 3 days a week, for at least 3 months is a reasonable minimum and 'generic' prescription. All women need clear accurate verbal instruction in how to do PFMT. Incontinent women, and women who cannot do a correct contraction, require referral for pelvic floor rehabilitation. Behavioural support from maternity care providers (MCPs)-increasing women's opportunity, capability, and motivation for PFMT-is as important as the exercise prescription. CONCLUSION PFMT is effective to prevent and treat UI in childbearing women. All pregnant and postpartum women, at every contact with a MCP, should be asked if they are continent. Continent women need exercise prescription and behavioural support to do PFMT to prevent UI. Incontinent women require appropriate referral for diagnosis or treatment.
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Affiliation(s)
- Stephanie J Woodley
- Department of Anatomy, School of Biomedical Sciences, University of Otago, Dunedin, New Zealand
| | - E Jean C Hay-Smith
- Rehabilitation Teaching and Research Unit, Department of Medicine, University of Otago, Wellington, New Zealand.
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Li T, Wang J, Chen X, Chen L, Cai W. Obstetric Nurses' Knowledge, Attitudes, and Professional Support Related to Actual Care Practices About Urinary Incontinence. Female Pelvic Med Reconstr Surg 2021; 27:e377-e384. [PMID: 32925423 DOI: 10.1097/spv.0000000000000941] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
OBJECTIVES The objective of this study was to evaluate obstetric nurses' knowledge, attitudes, and practices (KAP) toward urinary incontinence (UI) during pregnancy and identify factors associated with their actual specific care practices for recommending pelvic floor muscle training (PFMT). METHODS A cross-sectional study was conducted among obstetric nurses attending an academic conference about perinatal care in China. Data were collected through a self-administered questionnaire, including demographic and professional information, professional supports included clinical protocol and learning experience, knowledge, attitudes, and practices of UI. RESULTS Four hundred and seven obstetric nurses completed the survey (89.8% response rate). The correct answer rates of the vast majority of knowledge items was more than 80%. The majority of participants strongly agreed that antenatal PFMT is effective in UI treatment and prevention (69.5% and 69.0% respectively). Although only less than 30% of participants always recommended PFMT to incontinent or continent pregnant women (29.5% and 25.3%, respectively), obstetric nurses with clinical protocol, learning experience, and positive attitudes were more likely to recommend PFMT for treating UI (odds ratio [OR], 2.165, P < 0.001; OR, 1.759; P = 0.014; OR, 2.326; P < 0.001, respectively). Obstetric nurses with clinical protocol and positive attitudes were more likely to recommend PFMT for preventing UI (OR, 2.252; P < 0.001; OR, 1.693; P = 0.005, respectively). CONCLUSIONS Most obstetric nurses have good knowledge and positive attitudes toward UI during pregnancy, but fail to deliver care for it. Clinical protocol, learning experience, and positive attitudes are facilitators of their actual specific care practices for recommending PFMT. This finding suggests the need for developing clinical protocols and education programs regarding UI during pregnancy.
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Affiliation(s)
- Tiantian Li
- From the Department of Nursing, Shenzhen Hospital, Southern Medical University, Shenzhen, and School of Nursing, Southern Medical University, Guangzhou
| | - Jia Wang
- From the Department of Nursing, Shenzhen Hospital, Southern Medical University, Shenzhen, and School of Nursing, Southern Medical University, Guangzhou
| | - Xiaomin Chen
- Department of Nursing, Shenzhen Hospital, Southern Medical University, Shenzhen, China
| | - Ling Chen
- Department of Nursing, Shenzhen Hospital, Southern Medical University, Shenzhen, China
| | - Wenzhi Cai
- From the Department of Nursing, Shenzhen Hospital, Southern Medical University, Shenzhen, and School of Nursing, Southern Medical University, Guangzhou
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Charrié M, Billecocq S. [Knowledge of pelvic floor disorders in peripartum women: A systematic review]. Prog Urol 2020; 31:204-214. [PMID: 33272785 DOI: 10.1016/j.purol.2020.10.009] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2020] [Revised: 10/05/2020] [Accepted: 10/20/2020] [Indexed: 11/28/2022]
Abstract
BACKGROUND Pregnancy and postpartum are periods of life during which pelvic floor disorders (PFD) can occur. PURPOSE The aim of this review is to make an inventory of what women in the perinatal period know about PFD, their risk factors and preventive measures. DOCUMENTARY SOURCES We performed a systematic review of the literature in PubMed, Cochrane Library, LISSA and Kinédoc databases by using the keywords "knowledge", "awareness", "beliefs", "pelvic floor", "postpartum" and "pregnancy". We included studies written in English or French, assessing women's knowledge using a questionnaire and published up to May 2020 with no restriction on start date. SELECTION OF STUDIES A total of 14 cross-sectional studies were selected from 240 studies, with a sample size of 3950 participants. RESULTS The topics covered in the questionnaires were anatomy, pelvic floor function, all PFD, risk factors and preventive measures. Overall, women's knowledge of the perinatal period is limited. It has also been shown that education of women on risk factors and preventive measures regarding the occurrence of PFD was incomplete. CONCLUSION To conclude, the knowledge of women in the perinatal period about PFD is limited.
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Affiliation(s)
- M Charrié
- La Châtaigneraie, centre de rééducation et de réadaptation fonctionnelle, 95180 Menucourt, France; Maternité Notre-Dame-de-Bon-Secours, groupe hospitalier Paris-Saint-Joseph, 75014 Paris, France.
| | - S Billecocq
- La Châtaigneraie, centre de rééducation et de réadaptation fonctionnelle, 95180 Menucourt, France; Maternité Notre-Dame-de-Bon-Secours, groupe hospitalier Paris-Saint-Joseph, 75014 Paris, France
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Prevalence and predictors of double incontinence 1 year after first delivery. Int Urogynecol J 2018; 29:1529-1535. [PMID: 29500515 DOI: 10.1007/s00192-018-3577-7] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2017] [Accepted: 01/26/2018] [Indexed: 10/17/2022]
Abstract
INTRODUCTION AND HYPOTHESIS Urinary (UI) and anal incontinence (AI) are common pelvic floor disorders (PFD), and postpartum women experiencing double incontinence (DI), the combination of UI and AI, tend to have more severe symptoms and a greater impact on quality of life. Our objective was to investigate the prevalence and predictors of postpartum DI and UI alone 1 year after first delivery. METHODS In this prospective cohort study, 976 women reported the prevalence of DI and UI alone 1 year after their first delivery in one of two hospitals in Norway using the St Marks score and the ICI-Q UI SF. RESULTS DI was significantly reduced from 13% in late pregnancy to 8% 1 year later, whereas 30% reported UI at both time points. Incontinence in late pregnancy predicted incontinence 1 year after delivery. Higher age was associated with UI alone. Compared with caesarean delivery, normal vaginal or instrumental delivery increased the risk of UI alone more than three and four times respectively. Obstetric anal sphincter injuries showed a four-fold increase in the risk of DI. CONCLUSIONS Nearly 50% reported incontinence symptoms 1 year after first delivery. Continence status during pregnancy was one of the main predictors of postpartum continence status. Mode of delivery increased the risk of postpartum UI, whereas obstetric anal sphincter injuries increased the risk of postpartum DI.
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