This study aimed to explore the experiences of postmenopausal women with urinary incontinence regarding their engagement with a telehealth-delivered PFMT program.
This qualitative exploration was nested in a randomized controlled trial on the effects of a telehealth-delivered PFMT program in postmenopausal women with urinary incontinence as compared with that of a traditional face-to-face PFMT. The intervention consisted of eight individualized PFMT sessions delivered by a physical therapist via telehealth, supplemented by weekly telephone coaching over a 12-week period. Participant satisfaction was evaluated using a five-point Likert scale, with 1 indicating "very satisfied" and 5 indicating "very unsatisfied." The acceptability of the intervention was assessed through semi-structured interviews based on the TFA’s constructs, including perceived effectiveness, burden, self-efficacy, ethicality, intervention coherence, affective attitude, and opportunity costs. Qualitative data were analyzed using content analysis with deductive coding.
Eight participants completed the interviews, with an average duration of 16 minutes per interview. Satisfaction with the telehealth sessions was high, with 50% of participants reporting they were "satisfied" and the other 50% reporting they were "very satisfied." Several participants noted that the PFMT did not significantly impact their daily activities, though some observed improvements in muscle strength and symptom management. Half of the participants found the program easy to follow, and most reported a positive experience working with the program facilitator. Additionally, the majority of participants indicated increased confidence in performing PFMT after the intervention compared to the program's onset. No ethical concerns were raised regarding the pelvic floor muscle assessments and interventions, and participants expressed appreciation for being included in the program. Most participants demonstrated a clear understanding of the program's purpose. While some participants reported positive feelings toward the program, others expressed neutral feelings, often due to uncertainty about their ability to correctly perform the pelvic floor muscle contractions and the overall effectiveness of the program. Most participants reported no concerns regarding the time commitment or associated costs of participating in the program.
The findings suggest a high level of satisfaction and acceptability for the telehealth-delivered PFMT program among postmenopausal women with urinary incontinence. However, the presence of neutral feelings among some participants highlights the need for program designs that ensure accurate pelvic floor muscle contraction and enhance participant confidence in the intervention's effectiveness within a home setting. Future research could focus on developing and evaluating innovative tools or techniques to ensure accurate exercise performance and assess their impact on long-term outcomes in telehealth-delivered PFMT programs.
Telehealth effectively supports self-management of urinary incontinence but requires improved tools to verify correct muscle contraction. Clinicians should integrate interactive feedback to enhance patient confidence and develop tailored, patient-centered interventions for postmenopausal women with urinary incontinence.
Pelvic floor muscle training
Telehealth
