Nijland, Carlijn Marlie (2022) Healthcare needs of women with pelvic floor dysfunction six months postpartum: assessing the clinical relevance and screening properties of PROMs A Dutch prospective cohort study among 182 women. thesis, Medicine.
Full text available on request.Abstract
Introduction: Use of patient-reported outcome measures (PROMs) may improve health outcomes and patient-clinician communication. International Consortium for Health Outcomes Measurement (ICHOM) reported pelvic floor dysfunction (PFD) six months postpartum as important, whereby previous studies reported considerable percentages of PFD. Little is known about healthcare needs of these women and importance of PROMs in Dutch obstetric care. Objective: Evaluation of healthcare needs of women with PFD six months postpartum assessed by PROMs in order to improve patient-centered care. Methods: A prospective cohort study in which women, who delivered at Medical Spectrum Twente Enschede between April 2021 and June 2021, were approached 20 to 26 weeks postpartum to complete the PFD PROMs questionnaire including five domains: urine incontinence, anal incontinence, pelvic organ prolapse, dyspareunia and patient global impression. Cut-off values for normal- and alert scores (‘red flags’) for PFD domains were used. After survey completion, participants were called within three weeks to discuss results and explore healthcare needs. Results: In total, 182 women completed the PFD PROMs questionnaire whereof 117 scored at least one alert score on the PFD domains. Thirty-nine women, all with ³ 1 alert score(s), had a care demand, varying from already ongoing treatment (N=9) versus need of new treatment (N=30). Women with alert score(s) on their PROMs or women with alert scores on multiple PFD domains were significantly more likely to report a care demand. A positive predictive value (PPV), meaning women with alert score(s) had a need of care for their PFD, of 0.39 was found. Conclusion: We explored healthcare needs of women six months postpartum with PFD assessed by PROMs and identified a group of women who needed care and are currently not receiving care. The PFD PROMs questionnaire is currently not workable in clinical practice because of low PPV and evaluation six months postpartum is not standard scheduled care. Future research have to evaluate long-term effects of follow-up of women with healthcare needs and implementation of PROMs.
| Item Type: | Thesis (UNSPECIFIED) |
|---|---|
| Supervisor name: | Baalman, Drs. J.H. |
| Faculty: | Medical Sciences |
| Date Deposited: | 13 Jun 2023 12:58 |
| Last Modified: | 13 Jun 2023 12:58 |
| URI: | https://umcg.studenttheses.ub.rug.nl/id/eprint/3555 |
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