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Pelvic floor dysfunction: a conceptual framework for collaborative patient-centred care.

Kathryn Davis¹, Devinder Kumar

¹Department of Surgery and Gastrointestinal Motility Unit, St George's Hospital, London, UK.

Journal of Advanced Nursing

|September 3, 2003

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Pelvic floor dysfunction affects many women, impacting their quality of life. Improved healthcare professional education and interdisciplinary strategies are crucial for better assessment and treatment of these common conditions.

Area of Science:

Women's Health
Pelvic Floor Disorders
Public Health

Background:

Pelvic floor dysfunction (PFD) is a prevalent condition affecting at least one-third of adult women, significantly impacting their quality of life.
PFD encompasses a range of functional problems, often occurring concurrently, with significant psychosocial and economic implications.
Key etiological factors include pregnancy, childbirth trauma, aging, hormonal changes, hysterectomy, and lifestyle, yet PFD management is often neglected in healthcare education.

Purpose of the Study:

To critically review the literature on the mechanisms, presentation, and management of multiple symptoms associated with pelvic floor dysfunction.
To propose a conceptual framework to understand the impact of PFD on women and guide healthcare professionals in improving care.

Main Methods:

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A comprehensive literature search was conducted across multiple medical and nursing databases (BIOMED, NESLI, EMBASE, CINAHL, Cochrane).
Keywords included 'pelvic floor dysfunction,' 'incontinence,' 'genital prolapse,' 'sexual dysfunction,' 'aetiology,' 'epidemiology,' and 'treatment.'
Retrospective and prospective studies, clinical reviews, and relevant textbooks were analyzed, with a focus on papers addressing multiple PFD symptoms.

Main Results:

Pelvic floor dysfunction is a complex condition with multiple symptoms that rarely occur in isolation, affecting women across all age groups.
There is widespread misinformation regarding the incidence, causes, and treatment of PFD.
Current assessment and management of PFD are often inadequate due to insufficient healthcare professional training, leading to suboptimal outcomes.

Conclusions:

Significant gaps exist in women's healthcare services for PFD, with functional pelvic floor problems often perceived as low priority.
There is a critical need for interdisciplinary, multi-professional strategies to enhance PFD assessment and treatment across all healthcare settings.
Empowering nurses in frontline roles, improving education, and exploring specialist pelvic floor nurse roles are essential for advancing women's health care and improving PFD outcomes.