Hypothesis / aims of study
The prevalence of Pelvic floor Dysfunction (PFD) is high, but its prevention is underdeveloped. Several studies have highlighted a lack of knowledge and a need for information expressed by women. PFD is insufficiently treated, despite the existence of effective therapies. Lack of knowledge and numerous preconceived ideas are the main obstacles to seeking care. Many of the risk factors for PFD are lifestyle-related, offering opportunities for intervention through health education to reduce their incidence and impact. Several studies have demonstrated the effectiveness of such education in reducing symptoms and improving the quality of life of people already affected by these disorders. No standardised pelvic floor health education programme currently exists. The aim of this study was to reach a consensus among experts on the content and format of such a program, using the Delphi method.
Study design, materials and methods
A two-round Delphi study was conducted, involving French-speaking multidisciplinary experts in pelvic floor health (gynaecologists, midwives, physiotherapists, general practitioners, urologists, gastroenterologists, digestive surgeons and nurses). The first-round questionnaire contained 31 items on program content and 13 items on program format. The items were worded affirmatively to elicit comments and arguments from the experts. Participants rated their level of agreement with each item on a Likert scale from 1 to 9. Consensus was defined by a level of agreement ≥ 80% and a median ≥ 7. Non-consensual items were reworked and resubmitted to the experts in the second round.
Results
Of the 110 experts contacted, 52 responded in the first round and none were lost for the second round. The 52 experts were spread across France, Canada (Quebec), Belgium and Switzerland.
61% of the proposed items reached consensus in the first round. The other items were reworked in response to comments before being resubmitted to the experts. In the second round, 60% of the items were agreed to. The final program comprised 31 items, including 8 on anatomy, 4 on biomechanics, 8 on bowel and bladder physiology, 8 on risk factors and 3 on teaching aids. The format chosen by the experts consisted of 4 to 5 health education sessions of 75 minutes each, with a paper summary handed out at the end of the program.
Interpretation of results
Like the panel of experts, this health education program is intended to be multidisciplinary. It aims to unify the discourse of all the various healthcare professionals involved in the management of pelvic floor disorders to make it easier for women to understand and accept prevention messages. It aims to instill pelvic floor health education in primary and secondary prevention. In short, this program is a useful and practical resource for all healthcare professionals working in the field of pelvic floor health. Professionals will still need to work on adapting and popularising the content in order to adapt the program to the target audience.