Expectations regarding eHealth among women with stress urinary incontinence

Firet, Lotte; Teunissen, Doreth; Verhoeks, Carmen; Lagro-Janssen, Antoine L. M.

doi:10.1007/s00192-018-3849-2

Cited by 18 publications

(46 citation statements)

References 29 publications

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“…For these women the standalone character of the e-Health intervention was a barrier to adopt it. The wish for contact is in line with previous studies [ 15 , 19 , 20 ] although Asklund et al found a lower need in women using a mobile app, reflected by their overarching theme entitled ‘Enabling my independence’ [ 19 ].…”

Section: Discussionsupporting

confidence: 85%

“…Key topics that were addressed were: reasons for participation, previous experiences with treatment for SUI, expectations prior to the start of the intervention, effects of the intervention, performing and prioritizing PFMT in daily life, adherence and technical aspects of the intervention. We explicitly asked women about their experiences with unsupervised treatment, because literature shows that women feel the need to meet with someone during the training program [ 15 ]. After seven interviews, we adjusted the interview guide [ 28 ].…”

Section: Methodsmentioning

confidence: 99%

“…Interviews with Dutch GPs by our group showed that GPs consider the use of e-Health with PFMT as a welcome new tool for treating women with SUI [ 14 ]. When interviewed, Dutch women with SUI reported that they expected that e-Health could serve as a tool to bridge obstacles they encountered in regular care, but they underlined they felt the need to also be able to meet with a person during therapy for SUI [ 15 ].…”

Section: Introductionmentioning

confidence: 99%

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Women’s adoption of a web-based intervention for stress urinary incontinence: a qualitative study

Firet¹,

Teunissen²,

Kool³

et al. 2021

BMC Health Serv Res

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Background Stress urinary incontinence (SUI) is common among women and affects their quality of life. Pelvic floor muscle training is an effective conservative therapy, but only a minority of women seek help. E-health with pelvic floor muscle training is effective and increases access to care. To implement an e-Health intervention in a sustainable way, however, we need to understand what determines adoption. The aim is to investigate the barriers and facilitators to adopting an e-Health intervention among Dutch women with stress urinary incontinence. Methods Semi-structured telephonic interviews were carried out among participants of the Dutch e-Health intervention for women with stress urinary incontinence. Women were purposively sampled. The ‘Fit between Individuals, Task and Technology’ (FITT) framework was used for both the data collection and data analysis, to gain a more in-depth insight into the adoption of the intervention. Results Twenty women were interviewed, mean age 51 years and mostly highly educated. The adoption of e-Health for women with SUI mainly depends on the interaction between users and e-Health, and users and pelvic floor muscle training exercises. Facilitators for the adoption were the preference for an accessible self-management intervention, having a strong sense of self-discipline and having the ability to schedule the exercises routinely. Women needed to possess self-efficacy to do this intervention independently. Barriers to the adoption of e-Health were personal circumstances restricting time for scheduling pelvic floor muscle training and lacking skills to perform the exercises correctly. Despite guidance by technical features several women remained uncertain about their performance of the exercises and, therefore, wanted additional contact with a professional. Conclusions For stress urinary incontinence e-Health is an appropriate option for a target audience. Use of the FITT framework clearly demonstrates the conditions for optimal adoption. For a subgroup it was a suitable alternative for medical care in person. For others it identified the need for further support by a health care professional. This support could be provided by improvements of technical features and incorporating modes for digital communication. The additional value of integration of the e-Health intervention in primary care might be a logical next step. Trial registration The study was prospectively registered in the Netherlands Trial Registry (NTR) NTR6956.

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Section: Discussionsupporting

confidence: 85%

Section: Methodsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Women’s adoption of a web-based intervention for stress urinary incontinence: a qualitative study

Firet¹,

Teunissen²,

Kool³

et al. 2021

BMC Health Serv Res

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“…A review of the expectations and experiences of women concerning eHealth applications for UI [18] identified only one study of an online self-help program with email support of stress UI [19]. Recently, studies have been published on eHealth for women with stress UI, including their expectations of eHealth [20] and their experiences of an app focused on pelvic muscle training [21]. Notably, the two studies on experience with eHealth identified themes that overlapped considerably with those in our study [19,21].…”

Section: Discussionmentioning

confidence: 51%

User Experiences and Preferences Regarding an App for the Treatment of Urinary Incontinence in Adult Women: Qualitative Study

Wessels¹,

Hulshof²,

Loohuis³

et al. 2020

JMIR Mhealth Uhealth

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Background Although several apps are available to support the treatment of urinary incontinence (UI), little has been reported about the experiences and preferences of their users. Objective The objective of this study was to explore the experiences and preferences of women using a mobile app for the treatment of UI and to identify potential improvements to the app. We developed this app for three types of UI: stress UI, urgency UI, and mixed UI. Methods The participants in this qualitative study were women with self-reported stress UI, urgency UI, or mixed UI who used an app-based treatment to manage their condition for at least six weeks. Following the intervention, semistructured interviews were conducted to explore the participants’ experiences and preferences regarding the app. All interviews were audio-recorded, transcribed verbatim, and analyzed separately by two researchers. Results Data saturation was reached after interviewing 9 women (aged 32-68 years) with stress UI (n=1, 11%), urgency UI (n=3, 33%), or mixed UI (n=5, 56%). Accessibility, awareness, usability, and adherence emerged as the main themes. On the one hand, participants appreciated that the app increased their accessibility to care, preserved their privacy, increased their awareness of therapeutic options, was easy to use and useful, and supported treatment adherence. On the other hand, some participants reported that they wanted more contact with a care provider, and others reported that using the app increased their awareness of symptoms. Conclusions This qualitative study indicates that women appreciate app-based treatment for UI because it can lower barriers to treatment and increase both awareness and adherence to treatment. However, the app does not offer the ability of face-to-face contact and can lead to a greater focus on symptoms.

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“…The complexity of mHealth interventions with multiple interacting components calls for a thorough evaluation of the connection between patient experience, adherence, and effectiveness but is often lacking [ 5 , 6 ]. Previous qualitative studies of women suffering from urinary incontinence have identified factors that could affect app- or internet-based treatment for urinary incontinence by exploring their expectations and experiences [ 7 - 10 ]. Women expected that internet-based treatment would be more accessible, more flexible, and improve treatment adherence, but they expressed concern about the lack of contact with a caregiver [ 7 , 8 ].…”

Section: Introductionmentioning

confidence: 99%

Barriers and Facilitators Associated With App-Based Treatment for Female Urinary Incontinence: Mixed Methods Evaluation

Wessels¹,

Loohuis²,

Worp³

et al. 2021

JMIR Mhealth Uhealth

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Background App-based treatment for urinary incontinence is a proven effective and cost-effective alternative to care as usual, but successful implementation requires that we identify and address the barriers and facilitators associated with app use. Objective The goal of the research was to explore the factors influencing app-based treatment for urinary incontinence and identify which barriers or facilitators are associated with treatment success or failure. Methods We used a sequential explanatory mixed methods design to connect the results of a randomized controlled trial with data from semistructured interviews. This previous RCT had shown the noninferiority of app-based treatment compared with care as usual for urinary incontinence over 4 months. Participants who reported success or failure with app-based treatment, as measured by the change in International Consultation on Incontinence Modular Questionnaire Urinary Incontinence Short Form symptom score, were selected for telephone interview by purposive sampling (n=17). This study reports mainly on the qualitative component of our mixed methods study. Qualitative analyses were conducted in two ways. First, we analyzed the qualitative data of all interviewed participants and discussed the relationships between the main themes. Second, the experiences between the success (n=9) and failure group (n=8) were compared and contrasted to explore factors that were positively or negatively associated with the quantitative effect of app-based treatment. These factors were then interpreted as barriers to and facilitators of successful app-based treatment. Results Four interrelated themes were identified as affecting the app based treatment effect: adherence, personal factors, app factors, and awareness. Qualitative analyses of the relationships between the themes showed that adherence-related factors directly influenced treatment effect in both a positive and negative matter. In turn, adherence was also positively and negatively influenced by the other 3 themes. Additionally, awareness was positively influenced by the treatment effect. Within these themes, several factors were identified that acted as barriers (eg, unrealistic expectation of time investment and interfering personal circumstances), facilitators (eg, strict integration of exercises and prior pelvic floor muscle therapy), or both (eg, personality traits and increased awareness of symptoms). Conclusions This study shows that the effect of app-based treatment for urinary incontinence is mainly influenced by adherence, which in turn is affected by personal factors, app-based factors, and awareness. The identified factors could function as both facilitators and barriers depending on the user and interaction with other themes. Insight into these facilitators and barriers could lead to improved implementation and increased treatment effectiveness by targeting women most likely to benefit and through further development of the app. International Registered Report Identifier (IRRID) RR2-10.1002/nau.23507

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Expectations regarding eHealth among women with stress urinary incontinence

Cited by 18 publications

References 29 publications

Women’s adoption of a web-based intervention for stress urinary incontinence: a qualitative study

Women’s adoption of a web-based intervention for stress urinary incontinence: a qualitative study

User Experiences and Preferences Regarding an App for the Treatment of Urinary Incontinence in Adult Women: Qualitative Study

Barriers and Facilitators Associated With App-Based Treatment for Female Urinary Incontinence: Mixed Methods Evaluation

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