Explaining facilitators and barriers to treatment-seeking in women with pelvic organ prolapse: A qualitative study

Document Type : Original Article

Authors

1 Ph.D student of Reproductive Health, Nursing and Midwifery Care Research Center, Mashhad University of Medical Sciences, Mashhad, Iran.

2 Assistant Professor, Department of Midwifery Education, Nursing and Midwifery Care Research Center, Mashhad University of Medical Sciences, Mashhad, Iran.

3 Professor, Social Determinants of Health Research Center, School of Health, Mashhad University of Medical Sciences, Mashhad, Iran.

4 Professor, Department of Obstetrics and Genecology, Women's Health Research Center, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran.

Abstract

Introduction:Treatment seeking in pelvic organ prolapse is influenced by socio-cultural components. Studies show that in the field of urinary-genital diseases, women are less likely to seek treatment and self-care behaviors. This study was performed with aim to explain the facilitators and barriers to treatment seeking in women with pelvic organ prolapse (POP).
Methods:This qualitative study was conducted on 15 women with POP referring to gynecologic clinics of Ghaem and Imam Reza Hospital in Mashhad in 2018. Data collection with semi-structured deep interviews continued until data saturation was achieved. All interviews were audio-taped and accurately typed, and then data were analyzed using conventional content analysis of Greinham approach with MAXqda software.
Results:After categorizing and coding the data among total obtained themes, two main themes were extracted. Facilitators to treatment seeking has eight subcategories: understanding the support of the spouse and family, the recommendations of the health team to the treatment, understanding the exacerbation of symptoms, positive experiences of treatment in the community, believing the need for treatment at an early age, fear of future complications, hardship of religious duties and disturbing sexual intercourse.Barriers of seeking treatment have nine sub-categories including: lack of knowledge about POP, personal reluctant to referring for treatment, accessibility and affordability of treatment, negative experiences of treatment in people around them, economic-financial status, shame on speak about genital problems, factors related to children and family, lack of support and companion and occasional relative improvement of symptoms of the disease.
Conclusion: The facilitators and barriers of treatment-seeking among women with pelvic organ prolapse which are identified in this study help them to understand health needs and can be considered as an important issue for designing the effective interventional and consulting programs by planners and providers of reproductive health services.

Keywords

References

  1. Laganà AS, La Rosa VL, Rapisarda AMC, Vitale SG. Pelvic organ prolapse: the impact on quality of life and psychological well-being. J Psychosom Obstet Gynecol 2018; 39(2):164-6.
  2. Low LK, Tumbarello JA. Falling out: authoritative knowledge and women's experiences with pelvic organ prolapse. J Midwifery Womens Health 2012; 57(5):489-94.
  3. Chauvin C, Chéreau E, Ballester M, Daraï E. Potential relevance of pre-operative quality of life questionnaires to identify candidates for surgical treatment of genital prolapse: a pilot study. BMC Urol 2012; 12(1):9.
  4. Dietz HP, Simpson JM. Levator trauma is associated with pelvic organ prolapse. BJOG 2008; 115(8):979-84.
  5. Adhikari D. A qualitative study on uterine prolapse and quality of life. Presented for the Bachelor’s degree in Public Health Nepal Maharajgunj Medical Campus. Nepal: Institute of Medicine Tribhuvan University; 2011.
  6. Akhlaghi F. The prevalence of pelvic floor disorders in women that referred to the clinic of gynecology in Zeinab hospital, Mashhad, Iran, 2003. Iran J Obstet Gynecol Infert 2004; 7(1):25-31. (Persian).
  7. Ahmed AS, Zaky NH. Health care-seeking behaviors among women suffering from urinary incontinence. J Nurs Care 2016; 5(319):2167-8.
  8. Milart P, Woźniakowska E, Czuczwar P, Woźniak S. Pelvic organ prolapse in women: how is it diagnosed and treated currently? Prz Menopauzalny 2015; 14(3):155-60.
  9. Hale S, Grogan S, Willott S. “Getting on with it”: women's experiences of coping with urinary tract problems. Qualit Res Psychol 2009; 6(3):203-18.
  10. Ghazanfarpour M, Kaviani M, Abdolahian S, Bonakchi H, Najmabadi Khadijeh M, Naghavi M, et al. The relationship between women’s attitude towards menopause and menopausal symptoms among postmenopausal women. Gynecol Endocrinol 2015; 31(11):860-5.
  11. Dunivan GC, Cichowski SB, Komesu YM, Fairchild PS, Anger JT, Rogers RG. Ethnicity and variations of pelvic organ prolapse bother. Int Urogynecol J 2014; 25(1):53-9.
  12. Adedokun BO, Morhason-Bello IO, Ojengbede OA, Okonkwo NS, Kolade C. Help-seeking behavior among women currently leaking urine in Nigeria: is it any different from the rest of the world? Patient Prefer Adherence 2012; 6:815-9.
  13. Poortaghi S, Raiesifar A, Bozorgzad P, Golzari SE, Parvizy S, Rafii F. Evolutionary concept analysis of health seeking behavior in nursing: a systematic review. BMC Health Serv Res 2015; 15:523.
  14. Porrett T. Coping and help seeking behaviour in women with Pelvic Floor Dysfunction: the emic perspective. London: City University; 2010.
  15. Begashaw B, Tessema F, Gesesew HA. Health care seeking behavior in southwest Ethiopia. PloS One 2016; 11(9):e0161014.
  16. Ahmed A, Zaky N. Health care-seeking behaviors among women suffering from urinary incontinence. J Nurs Care 2016; 5(319):2167-8.
  17. Bonetti TR, Erpelding A, Pathak LR. Listening to “felt needs”: investigating genital prolapse in western Nepal. Reprod Health Matters 2004; 12(23):166-75.
  18. Graneheim UH, Lundman B. Qualitative content analysis in nursing research: concepts, procedures and measures to achieve trustworthiness. Nurse Educ Today 2004; 24(2):105-12.
  19. Cho JY, Lee EH. Reducing confusion about grounded theory and qualitative content analysis: similarities and differences. Qualitat Rep 2014; 19(32):1-20.
  20. Elo S, Kyngäs H. The qualitative content analysis process. J Adv Nurs 2008; 62(1):107-15.
  21. Zhang Y, Wildemuth BM. Qualitative analysis of content. Applications of social research questions in information and library. Portland: Book News; 2009.
  22. Chalise M, Steenkamp M, Chalise B. Factors enabling women with pelvic organ prolapse to seek surgery at mobile surgical camps in two remote districts in Nepal: a qualitative study. WHO South East Asia J Public Health 2016; 5(2):141.
  23. Pakbaz M, Persson M, Lofgren M, Mogren I. A hidden disorder until the pieces fall into place--a qualitative study of vaginal prolapse. BMC Womens Health 2010; 10:18.
  24. Hamid TA, Pakgohar M, Ibrahim R, Dastjerdi MV. "Stain in life": the meaning of urinary incontinence in the context of Muslim postmenopausal women through hermeneutic phenomenology. Arch Gerontol Geriatr 2015; 60(3):514-21.
  25. Sange C, Thomas L, Lyons C, Hill S. Urinary incontinence in Muslim women. Nurs Times 2008; 104(25):49-52.
  26. Pakbaz M. Vaginal prolapse–clinical outcomes and patients’ perspectives: a study using quantitative and qualitative methods. Sweden: Umeå University; 2011.
  27. Adedokun BO, Morhason-Bello IO, Ojengbede OA, Okonkwo NS, Kolade C. Help-seeking behavior among women currently leaking urine in Nigeria: is it any different from the rest of the world? Patient Prefer Adherence 2012; 6:815-9.
  28. Ravindran TS, Savitri R, Bhavani A. Women’s experiences of utero-vaginal prolapse: a qualitative study from Tamil Nadu, India. Safe Motherhood Initiat Crit Issues 1999; 11:166-72.
  29. Good MM, Korbly N, Kassis NC, Richardson ML, Book NM, Yip S, et al. Prolapse-related knowledge and attitudes toward the uterus in women with pelvic organ prolapse symptoms. Am J Obstet Gynecol 2013; 209(5):481.e1-6.
  30. Shrestha B. Challenges in prevention and timely care of uterine prolapse in Nepal. Sweden: University of Gothenburg; 2015.
  31. Hayder D, Schnepp W. Experiencing and managing urinary incontinence: a qualitative study. Western J Nurs Res 2010; 32(4):480-96.
  32. Buurman MB, Lagro‐Janssen AL. Women’s perception of postpartum pelvic floor dysfunction and their help‐seeking behaviour: a qualitative interview study. Scand J Caring Sci 2013; 27(2):406-13.
  33. Hatchett L, Hebert-Beirne J, Tenfelde S, Lavender MD, Brubaker L. Knowledge and perceptions of pelvic floor disorders among african american and latina women. Female Pelvic Med Reconstr Surg 2011; 17(4):190-4.
The Iranian Journal of Obstetrics, Gynecology and Infertility
Volume 22, Issue 3
May 2019
Pages 16-31

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