Patients’ life values affect their attendance at medical treatment for pelvic-floor dysfunction

Dec 15 2017

New research from psychologists and health professionals in Swansea has found that the types of life values that patients hold affect their attendance at medical treatment for pelvic-floor dysfunction, a condition affecting over 25% of all women in the UK.

This condition involves incontinence and prolapse, and is treated initially by physiotherapy.  Promoting key life values could be important in developing the medical support received by patients, increasing their attendance for treatment, and saving the NHS significant money by preventing later unnecessary operations.

The study: 'Health, work and spirituality values predict attendance at pelvic floor muscle training sessions', published in the Journal of Pelvic, Obstetric and Gynaecological Physiotherapy, was undertaken by health professionals from Abertawe Bro Morgannwg University Health Board (ABMU) and Professor Phil Reed from Swansea University.

The study found that patients valued their relationships more strongly than any other aspect of their lives.  However, holding this value did not predict the patients' attendance for treatment.  Rather, the life values related to treatment attendance were the women's health values, values related to work and achievement, and those related to spirituality, loyalty, and responsibility.

Speaking about the study, Professor Phil Reed said: "The fact that holding strong health values is an important predictor of treatment attendance is no surprise - but the data show that many ladies place this aspect of their life lower than many other areas - and we need to help empower them to value their own health.  The finding regarding spirituality was a bit of a surprise, but it might reflect some patients' tendency to accept 'external authority', and so adhere to treatment plans."

Patient life values influence outcomes in several healthcare contexts, but the impact of these values on pelvic floor muscle training (PFMT), used to treat this condition, was previously unknown.  The team's motivation in conducting the study was to gain a better understanding of the views of patients and the kinds of things that they regard as important, in order to develop appropriate support for women undergoing PFMT and to enhance treatment attendance.

Pelvic-floor dysfunction affects at least 25% of all women in the UK, and many more in Wales.  It causes substantial reductions in women's quality of life and impacts ability to work, as well as involving substantial costs to the NHS.  PFMT for pelvic-floor dysfunction is effective, safe, and cost-efficient relative to alternative treatments, like surgery.  However, many psychological factors are associated with its outcome and with patient adherence to treatment.  

One implication of these new findings is that supporting patients to develop the sorts of values that predict attendance, especially valuing their own health, might enhance their attendance at PFMT sessions for pelvic-floor dysfunction, and may help them recover their pelvic-floor function without the need of operations.

Professor Phil Reed commented: "Physiotherapy treatment for this very common problem can be so effective and safe for the patients, and it is really important that the ladies who attend have their needs fully recognized and supported.  If we do that, then we will enhance attendance and outcomes for these patients, and stop them having to go for operations, which will also have the benefit of saving the NHS much-needed money that can then be used to help other patients."

The team have previously shown that supporting the motivation of women to attend PFMT through short group-based sessions improves attendance by around 60%, and the current findings will help to tailor this support to the needs of the women even more closely.

A short animated video has been developed by Clare Lehane, Impact Support Officer in the College of Human and Health Sciences, Swansea University, which illustrates the research findings, and helps patients and health professionals to approach this important health issue. The video can be accessed here: https://www.powtoon.com/online-presentation/cviLsDZWe8n/?mode=movie