Conceptualization and Inventory of the Sexual and Psychological Burden of Women With Pelvic Floor Complaints; A Mixed-Method Study

Sexual Medicine - Tập 10 - Trang 100504 - 2022
Alma M. Brand1, Scott Rosas2, Wim Waterink1, Slavi Stoyanov3, Jacques J.D.M. van Lankveld1
1Faculty of Psychology, Open University of the Netherlands, Heerlen, The Netherlands
2Concept Systems, Inc., Ithaca, NY, USA
3Faculty of Educational Sciences, Open University of the Netherlands, Heerlen, The Netherlands

Tóm tắt

Abstract Introduction Despite the fact that the literature reports various restrictions and types of distress in women with pelvic floor complaints, a comprehensive overview of women's sexual and psychological burden emerging from these complaints is lacking, which compromises our ability to assess and grasp the impact to women. Aim This study was performed to conceptualize women's sexual and psychological burden and create a more comprehensive overview on this topic from both women's and health care providers’ perspectives. Furthermore, this research intended to identify items to populate a to-be-developed instrument to assess sexual and psychological burden. Methods In Group Concept Mapping, 125 statements were used about restrictions and distress that women with pelvic floor complaints experienced. Women with, and health care providers with and without pelvic floor complaints (13 women and 3 men) sorted the statements into comprehensive self-labeled clusters and rated their nature and severity. Multidimensional scaling and hierarchical cluster analyses were performed to identify a conceptual model of coherent clusters of statements. Item-total correlations of severity scores were calculated to identify statements that can be used in future research to represent women's sexual and psychological burden. Main Outcome Measure A conceptual model emerged, and outcomes of item-total correlations were then examined again using the conceptual model. Results Seven distress clusters were identified, namely, loss of control, sexual distress, feeling insecure, feeling wronged, feeling helpless, feeling angry, and feeling disappointed. Feeling insecure appeared more pervasive than other distresses. Furthermore, 33 statements were identified that can be used in future research to develop an instrument to assess sexual and psychological burden representing both women's and health care providers’ perspectives. Conclusion The conceptual model and list of statements may concisely represent the sexual and psychological burden of women with pelvic floor complaints from both women's and health care providers’ perspectives on this topic.

Tài liệu tham khảo

Nygaard, 2016, Physical activity and the pelvic floor, Am J Obstet Gynecol, 214, 164, 10.1016/j.ajog.2015.08.067 Brandt, 2019, Dysfunction, activity limitations, participation restriction and contextual factors in South African women with pelvic organ prolapse, S Afr J Physiother, 75, 10.4102/sajp.v75i1.933 Bazi, 2016, Prevention of pelvic floor disorders: International urogynecological association research and development committee opinion, Int Urogynecol J, 27, 1785, 10.1007/s00192-016-2993-9 de Mattos Lourenco, 2018, Urinary incontinence in female athletes: A systematic review, Int Urogynecol J, 29, 1757, 10.1007/s00192-018-3629-z Eliasson, 2008, Urinary incontinence in very young and mostly nulliparous women with a history of regular organised high-impact trampoline training: Occurrence and risk factors, Int Urogynecol J, 19, 687, 10.1007/s00192-007-0508-4 Elneil, 2009, Complex pelvic floor failure and associated problems, Best Pract Res Clin Gastroenterol, 23, 555, 10.1016/j.bpg.2009.04.011 Roos, 2014, Pelvic floor dysfunction: Women's sexual concerns unraveled, J Sex Med, 11, 743, 10.1111/jsm.12070 Yount, 2013, The impact of pelvic floor disorders and pelvic surgery on women's sexual satisfaction and function, J Midwifery Womens Health, 58, 538, 10.1111/jmwh.12030 Leclerc, 2015, Attachment, sexual assertiveness, and sexual outcomes in women with provoked vestibulodynia and their partners: A mediation model, Arch Sex Behav, 44, 1561, 10.1007/s10508-014-0295-1 Hayes, 2006, Original research—epidemiology: What can prevalence studies tell us about female sexual difficulty and dysfunction?, J Sex Med, 3, 589, 10.1111/j.1743-6109.2006.00241.x Ahmed, 2017, Assessment of sexually related personal distress accompanying premenopausal sexual dysfunction with an Arabic version of the female sexual distress scale, Int J Gynecol Obstet, 139, 65, 10.1002/ijgo.12255 Prather, 2009, Review of anatomy, evaluation, and treatment of musculoskeletal pelvic floor pain in women, PM&R, 1, 346, 10.1016/j.pmrj.2009.01.003 Rosenbaum, 2005, Physiotherapy treatment of sexual pain disorders, J Sex Marital Ther, 31, 329, 10.1080/00926230590950235 Stuge, 2012, The association between pelvic floor muscle function and pelvic girdle pain – A matched case control 3D ultrasound study, Man Ther, 17, 150, 10.1016/j.math.2011.12.004 Wang, 2012, Characteristics of patients seeking outpatient rehabilitation for pelvic-floor dysfunction, Phys Ther, 92, 1160, 10.2522/ptj.20110264 MHBdM, 2018, Profile and quality of life of women in pelvic floor rehabilitation, Rev Bras Enferm, 71, 2496, 10.1590/0034-7167-2017-0602 Buurman, 2013, Women's perception of postpartum pelvic floor dysfunction and their help-seeking behaviour: A qualitative interview study, Scand J Caring Sci, 27, 406, 10.1111/j.1471-6712.2012.01044.x Cichowski, 2014, Patients’ experience compared with physicians’ recommendations for treating fecal incontinence: A qualitative approach, Int Urogynecol J, 25, 935, 10.1007/s00192-013-2322-5 Jelovsek, 2006, Women seeking treatment for advanced pelvic organ prolapse have decreased body image and quality of life, Am J Obstet Gynecol, 194, 1455, 10.1016/j.ajog.2006.01.060 Lowder, 2011, Body image perceptions in women with pelvic organ prolapse: A qualitative study, Am J Obstet Gynecol, 204, 441, 10.1016/j.ajog.2010.12.024 Handelzalts, 2017, The impact of genital self-image on sexual function in women with pelvic floor disorders, Eur J Obstet Gynecol Reprod Biol, 211, 164, 10.1016/j.ejogrb.2017.02.028 Bergeron, 2014, Psychosexual aspects of vulvovaginal pain, Best Pract Res Clin Gastroenterol, 28, 991 Jawed-Wessel, 2017, The relationship between body image, female genital self-image, and sexual function among first-time mothers, J Sex Marital Ther, 43, 618, 10.1080/0092623X.2016.1212443 Bergeron, 2011, Genital pain in women: Beyond interference with intercourse, Pain, 152, 1223, 10.1016/j.pain.2011.01.035 Shallcross, 2018, Women's subjective experiences of living with vulvodynia: A systematic review and meta-ethnography, Arch Sex Behav, 47, 577, 10.1007/s10508-017-1026-1 Sadownik, 2017, The impact of a woman's dyspareunia and its treatment on her intimate partner: A qualitative analysis, J Sex Marital Ther, 43, 529, 10.1080/0092623X.2016.1208697 Rosand, 2011, Partner relationship satisfaction and maternal emotional distress in early pregnancy, BMC Public Health, 11, 10.1186/1471-2458-11-161 Vrijens, 2017, Prevalence of anxiety and depressive symptoms and their association with pelvic floor dysfunctions—A cross sectional cohort study at a Pelvic Care Centre, Neurourol Urodyn, 36, 1816, 10.1002/nau.23186 Kafri, 2013, Depressive symptoms and treatment of women with urgency urinary incontinence, Int Urogynecol J, 24, 1953, 10.1007/s00192-013-2116-9 Vrijens, 2014, Affective symptoms and the overactive bladder — A systematic review, J Psychosom Res, 78, 95, 10.1016/j.jpsychores.2014.11.019 Melotti, 2018, Severe depression and anxiety in women with overactive bladder, Neurourol Urodyn, 37, 223, 10.1002/nau.23277 Berghmans, 2018, Physiotherapy for pelvic pain and female sexual dysfunction: An untapped resource, Int Urogynecol J, 29, 631, 10.1007/s00192-017-3536-8 Westling, 2013, The association of dysmenorrhea with noncyclic pelvic pain accounting for psychological factors, Am J Obstet Gynecol, 209, 422, 10.1016/j.ajog.2013.08.020 Piontek, 2019, Somatic and psychosocial determinants of symptom severity and quality of life in male and female patients with chronic pelvic pain syndrome, J Psychosom Res, 120, 1, 10.1016/j.jpsychores.2019.02.010 Rosen, 2019, Genito-pelvic pain through a dyadic lens: Moving toward an interpersonal emotion regulation model of women's sexual dysfunction, J Sex Res, 56, 440, 10.1080/00224499.2018.1513987 Bond, 2012, A literature review on vulvodynia and distress, Sex Relatsh Ther, 27, 46, 10.1080/14681994.2012.664272 Skinner, 2018, Psychological consequences of pelvic floor trauma following vaginal birth: A qualitative study from two Australian tertiary maternity units, Arch Womens Ment Health, 21, 341, 10.1007/s00737-017-0802-1 Wuytack, 2015, Experiences of first-time mothers with persistent pelvic girdle pain after childbirth: Descriptive qualitative study, Phys Ther, 95, 1354, 10.2522/ptj.20150088 Trochim, 1989, An introduction to concept mapping for planning and evaluation, Eval Program Plann, 12, 1, 10.1016/0149-7189(89)90016-5 Kane, 2007, Concept mapping for planning and evaluation, 10.4135/9781412983730 Rosas, 2007, The use of concept mapping for scale development and validation in evaluation, Eval Program Plann, 30, 125, 10.1016/j.evalprogplan.2007.01.003 Trochim, 2017, Introduction to a special issue on concept mapping, Eval Program Plann, 60, 166, 10.1016/j.evalprogplan.2016.10.006 Rosas, 2017, The use of concept mapping in measurement development and evaluation: Application and future directions, Eval Program Plann, 60, 265, 10.1016/j.evalprogplan.2016.08.016 Morley, 2017, Essential public health competencies for medical students: Establishing a consensus in family medicine, Teach Learn Med, 29, 255, 10.1080/10401334.2016.1268964 Nunnally, 1978, Psychometric theory Rosas, 2016, Group concept mapping methodology: Toward an epistemology of group conceptualization, complexity, and emergence, Qual Quant, 51, 1403, 10.1007/s11135-016-0340-3 Rosas, 2012, Quality and rigor of the concept mapping methodology: A pooled study analysis, Eval Program Plann, 35, 236, 10.1016/j.evalprogplan.2011.10.003 Little, 1988, A test of missing completely at random for multivariate data with missing values, J Am Statist Assoc, 83, 1198, 10.1080/01621459.1988.10478722