Sağlık Profesyonellerinin Pelvik Taban Hakkında Bilgi ve Farkındalık Düzeylerinin Değerlendirilmesi
Yıl 2021,
Cilt: 8 Sayı: 3, 591 - 607, 31.12.2021
Şeyda Toprak Çelenay
,
Elif Sena Düşgün
,
Büşra Okumuş
,
Maviye Nur Çolakoğlu
Melike Güngör
Öz
Amaç: Sağlık profesyonellerinin pelvik taban hakkındaki bilgi ve farkındalığının incelenmesiydi.
Gereç ve Yöntem: Çalışmaya 96 hekim, 225 fizyoterapist, 186 hemşire ve 106 ebe olmak üzere toplam 613 sağlık profesyoneli dahil edildi. Pelvik taban bilgi ve farkındalığı araştırmacılar tarafından hazırlanan bir anket ile hem yüz yüze görüşme ile hem de çevrimiçi platform üzerinden toplandı.
Bulgular: Pelvik tabanı içeren yapılara doğru yanıt verenlerin yüzdesi hekimlerde (%78.1) ve fizyoterapistlerde (%77.8) en yüksekti. Pelvik taban kaslarının bütün meslek gruplarında en iyi bilinen fonksiyonları üriner kontinansı sağlamak ve pelvik organlara destek olmak iken; en az bilinen fonksiyonları lumbopelvik stabilitede önemli olduğu ve solunum sistemi ile ilişkili olduğu idi. Hastalara pelvik taban kas egzersizi öğreten sağlık profesyoneli oranı fizyoterapist (%68.9) ve ebelerde (%62.3) en yüksekti. Bütün meslek gruplarında pelvik taban kas eğitiminin en çok bilinen faydası üriner/anal kontinansın sağlanmasında önemli olduğu iken; en az bilinen faydası bel ağrısında önemli olduğu idi.
Sonuç: Sağlık profesyonellerinin, pelvik tabanı oluşturan yapıları, vücuttaki yeri, pelvik taban kaslarının fonksiyonu ve pelvik taban kas egzersizleri ile ilgili bilgi ve farkındalık düzeylerin de yeterli düzeyde olmadığı görüldü. Ayrıca, fizyoterapistlerin diğer meslek gruplarına göre pelvik taban ile ilgili daha fazla bilgiye sahip olduğu bulundu. Bu alanda çalışan sağlık profesyonellerinde pelvik taban ve pelvik taban egzersizleri konusundaki eğitimlerinin artırılması gerekmektedir.
Kaynakça
- Ashton-Miller, J. A., & DeLancey, J. O. (2007). Functional anatomy of the female pelvic floor. Annals of the new york academy of sciences, 1101:266-96.
- Aydur, E., & Şimşir, A. (2011). Pelvik organ prolapsusunun anatomisi ve patofizyolojisi. Kadın ve İşlevsel üroloji bülteni, 1(2): 5-8.
- Berzuk, K., & Shay, B. (2015). Effect of increasing awareness of pelvic floor muscle function on pelvic floor dysfunction: a randomized controlled trial. International urogynecology journal, 26(6), 837-844.
- Bø, K., Berghmans, B., Morkved, S., & Van Kampen, M. (2014). Evidence-Based physical therapy for the pelvic floor-E-book: bridging science and clinical practice. Elsevier health sciences, pp. 113-119.
- Bø, K., & Stien, R. (1994). Needle EMG registration of striated urethral wall and pelvic floor muscle activity patterns during cough, Valsalva, abdominal, hip adductor, and gluteal muscle contractions in nulliparous healthy females. Neurourology and urodynamics, 13(1), 35-41.
- Bump, R. C., Hurt, W. G., Fantl, J. A., & Wyman, J. F. (1991). Assessment of Kegel pelvic muscle exercise performance after brief verbal instruction. American journal of obstetrics and gynecology, 165(2), 322-329.
- Chen, Z., Wang, X., Jin, Y., & Feng, S. (2021). Knowledge, attitude and practice of pelvic floor dysfunction among obstetrical healthcare workers in China: A cross-sectional study. Journal of Gynecology Obstetrics and Human Reproduction, 50(8), 102068.
- de Freitas, L. M., Bø, K., Fernandes, A. C. N. L., Uechi, N., Duarte, T. B., & Ferreira, C. H. J. (2019). Pelvic floor muscle knowledge and relationship with muscle strength in Brazilian women: a cross-sectional study. International urogynecology journal, 30(11), 1903-1909.
- Eickmeyer, S. M. (2017). Anatomy and physiology of the pelvic floor. Physical medicine and rehabilitation clinics of north america, 28(3), 455-60.
- Eliasson, K., Elfving, B., Nordgren, B., & Mattsson, E. (2008). Urinary incontinence in women with low back pain. Manual therapy, 13(3), 206-212.
- Fuentes-Márquez, P., Cabrera-Martos, I., & Valenza, M. C. (2019). Physiotherapy interventions for patients with chronic pelvic pain: a systematic review of the literature. Physiotherapy theory and practice, 35(12), 1131-1138.
- Geoffrion, R., Robert, M., Ross, S., van Heerden, D., Neustaedter, G., Tang, S., & Milne, J. (2009). Evaluating patient learning after an educational program for women with incontinence and pelvic organ prolapse. International Urogynecology Journal, 20(10), 1243-1252.
- Haylen, B. T., De Ridder, D., Freeman, R. M., Swift, S. E., Berghmans, B., Lee, J., ... & Schaer, G. N. (2010). An International Urogynecological Association (IUGA)/International Continence Society (ICS) joint report on the terminology for female pelvic floor dysfunction. Neurourology and Urodynamics: Official Journal of the International Continence Society, 29(1), 4-20.
- Hill, A. M., McPhail, S. M., Wilson, J. M., & Berlach, R. G. (2017). Pregnant women’s awareness, knowledge and beliefs about pelvic floor muscles: a cross-sectional survey. International urogynecology journal, 28(10), 1557-1565.
- Hodges, P. W., & Gandevia, S. C. (2000). Changes in intra-abdominal pressure during postural and respiratory activation of the human diaphragm. Journal of applied Physiology, 89(3), 967-976.
- Hodges, P. W., Sapsford, R., & Pengel, L. H. M. (2007). Postural and respiratory functions of the pelvic floor muscles. Neurourology and urodynamics, 26(3), 362-371.
- Kavalcı, K. B., Oskay, K., & Toprak Celenay, S. (2021). Comparison of lumbopelvic stability, low back pain and well-being of women who have overactive bladder syndrome to asymptomatic controls: cut-off points. Somatosensory and motor research, doi: 10.1080/08990220.2021.1961722.
- Laycock, J., & Haslam, J. (2002) Pelvic floor muscle exercise in the treatment of urinary incontinence. Therapeutic management of incontinence and pelvic pain pelvic organ disorders. London: springer-verlag, pp.63-72.
- Li, C., Gong, Y., & Wang, B. (2016). The efficacy of pelvic floor muscle training for pelvic organ prolapse: a systematic review and meta-analysis. International urogynecology journal, 27(7), 981-992.
- Liu, B., Wang, L., Huang, S. S., Wu, Q., & Wu, D. L. (2014). Prevalence and risk factors of urinary incontinence among Chinese women in Shanghai. International journal of clinical and experimental medicine, 7(3), 686-96.
- Mamuk, R., Dişsiz, M., & Dinç, H. (2018). Sağlık Profesyonellerinin Pelvik Taban Kas Egzersizlerini Uygulama ve Öğretme Konusundaki Bilgi Tutum ve Davranışlarının Değerlendirilmesi. JAREN/Hemşirelik Akademik Araştırma Dergisi, 4(1), 15-20.
- Mandimika, C. L., Murk, W., McPencow, A. M., Lake, A., Wedderburn, T., Collier, C. H., ... & Guess, M. K. (2014). Knowledge of pelvic floor disorders in a population of community-dwelling women. American journal of obstetrics and gynecology, 210(2), 165-e1.
- Martinho, N. M., Silva, V. R., Marques, J., Carvalho, L. C., Iunes, D. H., & Botelho, S. (2016). The effects of training by virtual reality or gym ball on pelvic floor muscle strength in postmenopausal women: a randomized controlled trial. Brazilian journal of physical therapy, 20(3), 248-257.
- Mateus-Vasconcelos, E. C. L., Ribeiro, A. M., Antônio, F. I., Brito, L. G. D. O., & Ferreira, C. H. J. (2018). Physiotherapy methods to facilitate pelvic floor muscle contraction: a systematic review. Physiotherapy theory and practice, 34(6), 420-432.
- Messelink, B., Benson, T., Berghmans, B., Bo, K., Corcos, J., Fowler, C., ... & Nijeholt, G. A. (2005). Standardization of terminology of pelvic floor muscle function and dysfunction: report from the pelvic floor clinical assessment group of the International Continence Society. Neurourology and urodynamics, 24(4), 374-80.
- Neels, H., Tjalma, W. A., Wyndaele, J. J., De Wachter, S., Wyndaele, M., & Vermandel, A. (2016). Knowledge of the pelvic floor in menopausal women and in peripartum women. Journal of physical therapy science, 28(11), 3020-3029.
- Panjabi, M. M. (1992). The stabilizing system of the spine. Part I. Function, dysfunction, adaptation, and enhancement. Journal of spinal disorders, 5(4), 383-389.
- Rivalta, M., Sighinolfi, M. C., Micali, S., De Stefani, S., & Bianchi, G. (2010). Sexual function and quality of life in women with urinary incontinence treated by a complete pelvic floor rehabilitation program (biofeedback, functional electrical stimulation, pelvic floor muscles exercises, and vaginal cones). The journal of sexual medicine, 7(3), 1200-1208.
- Salvesen, K. Å., & Mørkved, S. (2004). Randomised controlled trial of pelvic floor muscle training during pregnancy. Bmj, 329(7462), 378-380.
- Toprak Celenay, S., Coban, O., Korkut, Z., & Alkan, A. (2021). Do community-dwelling pregnant women know about pelvic floor disorder?. Women & Health, 61(6), 609-616.
- Toprak Celenay, S., Dusgun, E. S., & Degirmendereli, A. R. (2021). High-impacts Sport Athletes’ Pelvic Floor Knowledge, Awareness, and Lower Urinary Tract Symptoms: A Cross Sectional Pilot Study. Turkiye klinikleri journal of sports sciences, doi: 10.5336/sportsci.2021-82598.
- Voorham-van der Zalm, P. J., à Nijeholt, G. A. L., Elzevier, H. W., Putter, H., & Pelger, R. C. (2008). “Diagnostic investigation of the pelvic floor”: a helpful tool in the approach in patients with complaints of micturition, defecation, and/or sexual dysfunction. The journal of sexual medicine, 5(4), 864-871.
Evaluation of the Knowledge and Awareness Levels of Health Professionals about Pelvic Floor
Yıl 2021,
Cilt: 8 Sayı: 3, 591 - 607, 31.12.2021
Şeyda Toprak Çelenay
,
Elif Sena Düşgün
,
Büşra Okumuş
,
Maviye Nur Çolakoğlu
Melike Güngör
Öz
Objectives: To investigation knowledge and awareness of health professionals about pelvic floor.
Materials and Methods: A total of 613 healthcare professionals, 96 physicians, 225 physiotherapists, 186 nurses and 106 midwives, were included in the study. Pelvic floor knowledge and awareness with a questionnaire prepared by the researchers were collected via both face-to-face and the online platform.
Results: The percentage of correct responders to structures containing the pelvic floor was highest in physicians (78.1%) and physiotherapists (77.8%). While the most well-known functions of the pelvic floor muscles in all groups are to provide urinary continence and to support the pelvic organs; its least known functions were that it was important in lumbopelvic stability and was associated with the respiratory system. The rate of healthcare professionals who taught pelvic floor muscle exercises to patients was highest in physiotherapists (68.9%) and midwives (62.3%). While the most well-known benefit of pelvic floor muscle training in all groups is that it is important in providing urinary/anal continence; its least known benefit was that it was important in low back pain.
Conclusion: It was seen that the knowledge and awareness levels of health professionals about the structures forming the pelvic floor, their location in the body, the function of the pelvic floor muscles and pelvic floor muscle exercises were not enough. However, physiotherapists were found to have more information about the pelvic floor than other groups. It is necessary to increase trainings on pelvic floor and pelvic floor exercises in health professionals working in this field.
Kaynakça
- Ashton-Miller, J. A., & DeLancey, J. O. (2007). Functional anatomy of the female pelvic floor. Annals of the new york academy of sciences, 1101:266-96.
- Aydur, E., & Şimşir, A. (2011). Pelvik organ prolapsusunun anatomisi ve patofizyolojisi. Kadın ve İşlevsel üroloji bülteni, 1(2): 5-8.
- Berzuk, K., & Shay, B. (2015). Effect of increasing awareness of pelvic floor muscle function on pelvic floor dysfunction: a randomized controlled trial. International urogynecology journal, 26(6), 837-844.
- Bø, K., Berghmans, B., Morkved, S., & Van Kampen, M. (2014). Evidence-Based physical therapy for the pelvic floor-E-book: bridging science and clinical practice. Elsevier health sciences, pp. 113-119.
- Bø, K., & Stien, R. (1994). Needle EMG registration of striated urethral wall and pelvic floor muscle activity patterns during cough, Valsalva, abdominal, hip adductor, and gluteal muscle contractions in nulliparous healthy females. Neurourology and urodynamics, 13(1), 35-41.
- Bump, R. C., Hurt, W. G., Fantl, J. A., & Wyman, J. F. (1991). Assessment of Kegel pelvic muscle exercise performance after brief verbal instruction. American journal of obstetrics and gynecology, 165(2), 322-329.
- Chen, Z., Wang, X., Jin, Y., & Feng, S. (2021). Knowledge, attitude and practice of pelvic floor dysfunction among obstetrical healthcare workers in China: A cross-sectional study. Journal of Gynecology Obstetrics and Human Reproduction, 50(8), 102068.
- de Freitas, L. M., Bø, K., Fernandes, A. C. N. L., Uechi, N., Duarte, T. B., & Ferreira, C. H. J. (2019). Pelvic floor muscle knowledge and relationship with muscle strength in Brazilian women: a cross-sectional study. International urogynecology journal, 30(11), 1903-1909.
- Eickmeyer, S. M. (2017). Anatomy and physiology of the pelvic floor. Physical medicine and rehabilitation clinics of north america, 28(3), 455-60.
- Eliasson, K., Elfving, B., Nordgren, B., & Mattsson, E. (2008). Urinary incontinence in women with low back pain. Manual therapy, 13(3), 206-212.
- Fuentes-Márquez, P., Cabrera-Martos, I., & Valenza, M. C. (2019). Physiotherapy interventions for patients with chronic pelvic pain: a systematic review of the literature. Physiotherapy theory and practice, 35(12), 1131-1138.
- Geoffrion, R., Robert, M., Ross, S., van Heerden, D., Neustaedter, G., Tang, S., & Milne, J. (2009). Evaluating patient learning after an educational program for women with incontinence and pelvic organ prolapse. International Urogynecology Journal, 20(10), 1243-1252.
- Haylen, B. T., De Ridder, D., Freeman, R. M., Swift, S. E., Berghmans, B., Lee, J., ... & Schaer, G. N. (2010). An International Urogynecological Association (IUGA)/International Continence Society (ICS) joint report on the terminology for female pelvic floor dysfunction. Neurourology and Urodynamics: Official Journal of the International Continence Society, 29(1), 4-20.
- Hill, A. M., McPhail, S. M., Wilson, J. M., & Berlach, R. G. (2017). Pregnant women’s awareness, knowledge and beliefs about pelvic floor muscles: a cross-sectional survey. International urogynecology journal, 28(10), 1557-1565.
- Hodges, P. W., & Gandevia, S. C. (2000). Changes in intra-abdominal pressure during postural and respiratory activation of the human diaphragm. Journal of applied Physiology, 89(3), 967-976.
- Hodges, P. W., Sapsford, R., & Pengel, L. H. M. (2007). Postural and respiratory functions of the pelvic floor muscles. Neurourology and urodynamics, 26(3), 362-371.
- Kavalcı, K. B., Oskay, K., & Toprak Celenay, S. (2021). Comparison of lumbopelvic stability, low back pain and well-being of women who have overactive bladder syndrome to asymptomatic controls: cut-off points. Somatosensory and motor research, doi: 10.1080/08990220.2021.1961722.
- Laycock, J., & Haslam, J. (2002) Pelvic floor muscle exercise in the treatment of urinary incontinence. Therapeutic management of incontinence and pelvic pain pelvic organ disorders. London: springer-verlag, pp.63-72.
- Li, C., Gong, Y., & Wang, B. (2016). The efficacy of pelvic floor muscle training for pelvic organ prolapse: a systematic review and meta-analysis. International urogynecology journal, 27(7), 981-992.
- Liu, B., Wang, L., Huang, S. S., Wu, Q., & Wu, D. L. (2014). Prevalence and risk factors of urinary incontinence among Chinese women in Shanghai. International journal of clinical and experimental medicine, 7(3), 686-96.
- Mamuk, R., Dişsiz, M., & Dinç, H. (2018). Sağlık Profesyonellerinin Pelvik Taban Kas Egzersizlerini Uygulama ve Öğretme Konusundaki Bilgi Tutum ve Davranışlarının Değerlendirilmesi. JAREN/Hemşirelik Akademik Araştırma Dergisi, 4(1), 15-20.
- Mandimika, C. L., Murk, W., McPencow, A. M., Lake, A., Wedderburn, T., Collier, C. H., ... & Guess, M. K. (2014). Knowledge of pelvic floor disorders in a population of community-dwelling women. American journal of obstetrics and gynecology, 210(2), 165-e1.
- Martinho, N. M., Silva, V. R., Marques, J., Carvalho, L. C., Iunes, D. H., & Botelho, S. (2016). The effects of training by virtual reality or gym ball on pelvic floor muscle strength in postmenopausal women: a randomized controlled trial. Brazilian journal of physical therapy, 20(3), 248-257.
- Mateus-Vasconcelos, E. C. L., Ribeiro, A. M., Antônio, F. I., Brito, L. G. D. O., & Ferreira, C. H. J. (2018). Physiotherapy methods to facilitate pelvic floor muscle contraction: a systematic review. Physiotherapy theory and practice, 34(6), 420-432.
- Messelink, B., Benson, T., Berghmans, B., Bo, K., Corcos, J., Fowler, C., ... & Nijeholt, G. A. (2005). Standardization of terminology of pelvic floor muscle function and dysfunction: report from the pelvic floor clinical assessment group of the International Continence Society. Neurourology and urodynamics, 24(4), 374-80.
- Neels, H., Tjalma, W. A., Wyndaele, J. J., De Wachter, S., Wyndaele, M., & Vermandel, A. (2016). Knowledge of the pelvic floor in menopausal women and in peripartum women. Journal of physical therapy science, 28(11), 3020-3029.
- Panjabi, M. M. (1992). The stabilizing system of the spine. Part I. Function, dysfunction, adaptation, and enhancement. Journal of spinal disorders, 5(4), 383-389.
- Rivalta, M., Sighinolfi, M. C., Micali, S., De Stefani, S., & Bianchi, G. (2010). Sexual function and quality of life in women with urinary incontinence treated by a complete pelvic floor rehabilitation program (biofeedback, functional electrical stimulation, pelvic floor muscles exercises, and vaginal cones). The journal of sexual medicine, 7(3), 1200-1208.
- Salvesen, K. Å., & Mørkved, S. (2004). Randomised controlled trial of pelvic floor muscle training during pregnancy. Bmj, 329(7462), 378-380.
- Toprak Celenay, S., Coban, O., Korkut, Z., & Alkan, A. (2021). Do community-dwelling pregnant women know about pelvic floor disorder?. Women & Health, 61(6), 609-616.
- Toprak Celenay, S., Dusgun, E. S., & Degirmendereli, A. R. (2021). High-impacts Sport Athletes’ Pelvic Floor Knowledge, Awareness, and Lower Urinary Tract Symptoms: A Cross Sectional Pilot Study. Turkiye klinikleri journal of sports sciences, doi: 10.5336/sportsci.2021-82598.
- Voorham-van der Zalm, P. J., à Nijeholt, G. A. L., Elzevier, H. W., Putter, H., & Pelger, R. C. (2008). “Diagnostic investigation of the pelvic floor”: a helpful tool in the approach in patients with complaints of micturition, defecation, and/or sexual dysfunction. The journal of sexual medicine, 5(4), 864-871.