Abstract
Introduction and hypothesisStress urinary incontinence (SUI) is a common condition with a major impact on quality of life (QoL). Various factors prevent women from seeking help. However, eHealth (Internet-based therapy) with pelvic floor muscle training (PFMT) is an effective and satisfying intervention for these women. We hypothesize that women with symptoms after regular therapy will profit from eHealth. This study explores the expectations regarding an eHealth intervention among women who still suffer from SUI despite treatment.MethodsA qualitative study with semistructured interviews was conducted using a grounded theory approach. The study included women with SUI who had ever sought help for their condition.ResultsThirteen women were interviewed, most whom had experience with PFMT and still suffered from moderate-to-severe incontinence. Two themes emerged from data analysis: the need to meet, and eHealth as a tool to bridge obstacles. Women greatly emphasized that a healthcare professional, preferably one they know, should be available with eHealth. Several women indicated that the absence of personal contact caused lack of trust in success. However, several women were willing to use eHealth because its anonymity and flexibility could overcome obstacles in regular care.ConclusionseHealth based on PFMT is currently not a preferable treatment modality for women who still suffer from SUI despite treatment. eHealth cannot act as a substitute for their positive experience with personal contact. Some women are willing to use eHealth because of its advantages over regular care. Future experiences with eHealth might enable women with SUI to trust digital care.
Highlights
Introduction and hypothesisStress urinary incontinence (SUI) is a common condition with a major impact on quality of life (QoL)
Healthcare professional attended for SUIc General practitioner Physiotherapist Urogynecologist
BMaybe eHealth could provide information about more [treatment] options or possibilities, those things you forget to ask [your general practitioners (GPs)].^ (ID4, 48 years, moderate) BWomen should be informed that if they have problems after delivery, or if they have a prolapse, before it gets worse [...] Go to your doctor! Talk about it.^(ID9, 84 years, severe). Women who said they were used to checking the Internet regularly for information on health problems appreciated eHealth for SUI as a source of information
Summary
Seventeen eligible patients were approached to participate in the study; four declined because of lack of time. Women appreciated the contact they had with their GP, physiotherapist, or nurse practitioner when they sought help for the first time After they had overcome barriers to seeking help, they felt at ease and trusted their healthcare provider because he or she discussed SUI openly with them and normalized the problem. Several women mentioned that eHealth was a solution for socially determined factors that were obstacles to help seeking These factors included having transportation limits or time restrictions to attend a healthcare professional because women were caregivers. A few women appreciated that, with eHealth, you have direct access to information about therapy when you forget to ask your GP, for example Another woman who would not use eHealth herself emphasized its importance for others because if women learned more about incontinence, they would be more likely to be encouraged to seek help. BMaybe eHealth could provide information about more [treatment] options or possibilities, those things you forget to ask [your GP].^ (ID4, 48 years, moderate) BWomen should be informed that if they have problems after delivery, or if they have a prolapse, before it gets worse [...] Go to your doctor! Talk about it.^(ID9, 84 years, severe)
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