Application of Caring Life‐Course Theory to explore care needs in women with pregnancy‐related pelvic girdle pain

Abstract

Aims To describe the care needs of women with pregnancy‐related pelvic girdle pain based on the Caring Life‐Course Theory. Design A descriptive qualitative research design. Methods Data were collected between November 2019 and February 2021 from 20 purposively selected pregnant women with pelvic girdle pain aged between 22 and 39 years in antenatal care at a tertiary hospital in Australia. Individual semi‐structured interviews were recorded via a digital audio recorder and transcribed verbatim. Qualitative content analysis method was used to analyse the data. Findings Five broad themes were identified: pain is an added burden to pregnancy; knowledge is power to own what happens to me; engaging in self‐help; care from others is useful; and pain deserves more attention from healthcare professionals. Conclusion Caring Life‐Course Theory presented a useful and applicable scaffold for describing care needs of pregnant women with pelvic girdle pain. The study revealed experiencing pelvic girdle pain led to additional care needs during pregnancy, highlighting the importance of self‐management strategies and an appreciation of care from others to assist women in limiting the effects of the pain. Participants identified the need for more information and attention from healthcare professionals to be able to better manage their condition. Impact This study presents a comprehensive picture of the change in care needs triggered by experiencing pelvic girdle pain during pregnancy. The findings have the potential to facilitate better care provision by considering novel methods of delivery, such as information and communication technology, whilst acknowledging the value placed on credible and trusted sources. Knowledge acquired through this study may be used by nurses and midwives, along with other healthcare professionals, to enhance the provision of comprehensive care that is acceptable to women with pelvic girdle pain during pregnancy.

The Experience of Pregnancy-Related Lumbopelvic Pain: A Qualitative Evidence Synthesis

“…Uncertainties about pregnancy-related lumbopelvic pain. Participants’ knowledge of pregnancy-related lumbopelvic pain before pregnancy was sparse (Ceprnja, Lawless, et al, 2022; Clarkson & Adams, 2018; Close et al, 2016; Persson et al, 2013; Shepherd, 2005), leading to them being unprepared when symptoms appeared (Persson et al, 2013). “The information about SPD [Symphysis Pubis Dysfunction] isn’t widely available, there is not enough information on it, there ought to be leaflets in doctors surgeries or things like that the doctors can give you.” (Iris) (Shepherd, 2005)…”

“…Varied experiences of the effectiveness of services/interventions provided by doctors, physiotherapists, midwives, osteopaths, and chiropractors were reported. For some, the treatment resulted in functional and pain improvement (Ceprnja, Chipchase, et al, 2022; Ceprnja, Lawless, et al, 2022; Mainjot, 2020; Monaghan & Haywood, 2017; Sheraton et al, 2018), while for others, the treatment had no effect or worsened symptoms (Close et al, 2016; Monaghan & Haywood, 2017; Wellock & Crichton, 2007a).…”

“…Profound activity consequences of pregnancy-related lumbopelvic pain . Participants in the studies reported difficulty across activities of daily living including difficulty standing and walking, especially long distances, going up and down stairs, getting in and out of bed, getting dressed, sleeping, working, pushing shopping carts, picking something off the floor, sitting on the floor and performing personal hygiene and activities associated with taking care of the home, family members and children (Bartlam et al, 2018; Ceprnja, Chipchase, et al, 2022; Ceprnja, Lawless, et al, 2022; Crichton & Wellock, 2008; Elkins-Bushnell & Boyle, 2019; Monaghan & Haywood, 2017; Persson et al, 2013; Sadr et al, 2012; Shepherd, 2005; Wuytack et al, 2015). “In the morning when I get up, I kind of crawl out of bed…”(Bartlam et al, 2018)…”

“…Uncertainties about pregnancy-related lumbopelvic pain. Participants' knowledge of pregnancy-related lumbopelvic pain before pregnancy was sparse (Ceprnja, Lawless, et al, 2022;Clarkson & Adams, 2018;Close et al, 2016;Persson et al, 2013;Shepherd, 2005), leading to them being unprepared when symptoms appeared (Persson et al, 2013).…”

“…"This (the brief C) one is difficult to wear and the belly gets in the way…it's difficult even when I put on underwear…before I am pregnant, I can just stand and wear it easily, now I have to sit on a chair first and then put it on slowly…(P3, housewife aged 30)" (Ho et al, 2009) To manage pain and/or improve function, participants used hot water bottles, hot baths, pillows, adjustable beds, acupressure mats, transcutaneous electrical neurostimulation and pregnancy clothing and belts (Aggeryd et al, 2021;Ceprnja, Lawless, et al, 2022;Close et al, 2016;Elkins-Bushnell & Boyle, 2019;Ho et al, 2009;Sadr et al, 2012;Wellock & Crichton, 2007a, 2007b, adaptations in movement or environment or footwear and specialist devices (Aggeryd et al, 2021;Close et al, 2016;Elkins-Bushnell & Boyle, 2019;Fredriksen et al, 2008;Gutke et al, 2018;Ho et al, 2009;Sadr et al, 2012). Some participants needed crutches (Close et al, 2016), others needed adaptations at home, such as using long cables to remove clothes from the washing machine or a table with wheels to stand with support (Aggeryd et al, 2021;Elkins-Bushnell & Boyle, 2019).…”