The silent, private exercise: experiences of pelvic floor muscle training in a sample of women with stress urinary incontinence

ObjectivesThe study sought women's experiences of pelvic floor muscle training (PFMT) to provide insights for interpreting the findings of a randomised controlled trial of PFMT and to explore women's understandings of the exercises.MethodsTwenty women who had participated in a trial comparing two approaches to PFMT were purposively selected and interviewed by a physiotherapist/researcher about their experience of PFMT. A descriptive content analysis identified categories of meaning from the interview transcripts; the categories were grouped into themes.ResultsThe interviews suggested there had been blurring of the boundaries between the two PFMT programmes investigated in the trial, but it was difficult to determine how much variation had occurred, and if this might have confounded the trial result. A striking feature of the interviews was the contrast between the relatively disempowered position women were in when they first presented for PFMT, and the considerable degree of self-efficacy that PFMT required. This contrast was encapsulated by the two main themes identified in the interviews: Knowledge, power and control: the women's journey and PFMT demands personal agency. Although two PFMT self-efficacy scales have been developed it is not clear how transferable these are between different sociocultural environments. It is suggested that brief motivational interviewing, a treatment approach consistent with self-efficacy theory, might be a useful way of evaluating and increasing readiness to change and self-efficacy in clinical practice.ConclusionResearch to investigate the usefulness of brief motivational interviewing in assessing and developing PFMT self-efficacy is warranted.