Abstract
BackgroundStress urinary incontinence (SUI) affects 10%-39% of women. Its first-line treatment consists of lifestyle interventions and pelvic floor muscle training (PFMT), which can be performed supervised or unsupervised. Health apps are increasing in number and can be used to improve adherence to treatments. We developed the Tät app, which provides a 3-month treatment program with a focus on PFMT for women with SUI. The app treatment was evaluated in a randomized controlled trial, which demonstrated efficacy for improving incontinence symptoms and quality of life. In this qualitative interview study, we investigated participant experiences of the app-based treatment.ObjectiveThis study aimed to explore women’s experiences of using an app-based treatment program for SUI.MethodsThis qualitative study is based on telephone interviews with 15 selected women, with a mean age of 47 years, who had used the app in the previous randomized controlled trial. A semistructured interview guide with open-ended questions was used, and the interviews were transcribed verbatim. Data were analyzed according to the grounded theory.ResultsThe results were grouped into three categories: “Something new!” “Keeping motivation up!” and “Good enough?” A core category, “Enabling my independence,” was identified. The participants appreciated having a new and modern way to access a treatment program for SUI. The use of new technology seemed to make incontinence treatment feel more prioritized and less embarrassing for the subjects. The closeness to their mobile phone and app features like reminders and visual graphs helped support and motivate the women to carry through the PFMT. The participants felt confident that they could perform the treatment program on their own, even though they expressed some uncertainty about whether they were doing the pelvic floor muscle contractions correctly. They felt that the app-based treatment increased their self-confidence and enabled them to take responsibility for their treatment.ConclusionsUse of the app-based treatment program for SUI empowered the women in this study and helped them self-manage their incontinence treatment. They appreciated the app as a new tool for supporting their motivation to carry through a slightly challenging PFMT program.Trial RegistrationClinicalTrials.gov NCT01848938; https://clinicaltrials.gov/ct2/show/NCT01848938 (Archived by WebCite at https://clinicaltrials.gov/ct2/show/NCT01848938)
Highlights
Urinary incontinence (UI) is defined as complaints of any involuntary leakage of urine [1]
When deciding to try pelvic floor muscle training (PFMT) to treat their incontinence, the participants wanted some kind of support, and they searched for something new and something better than what they had previously tried, which is described in the category “Something new!” They needed some help with motivation and coaching to be able to carry through the treatment they had engaged in, which is described in the category “Keeping motivation up!” In addition, they had to deal with the fact that performing a treatment independently involves a certain amount of uncertainty, which is described in the category “Good enough?” The core category “Enabling my independence” was related to all other categories and illustrates the women’s wish to take responsibility for their health and treatment
This is the first qualitative study of an app-based treatment for Stress urinary incontinence (SUI). We considered this interview study an important complement to our randomized controlled trial (RCT), because we wanted to understand how and why an app treatment could be effective for SUI
Summary
Urinary incontinence (UI) is defined as complaints of any involuntary leakage of urine [1]. The app treatment was evaluated in a randomized controlled trial, which demonstrated efficacy for improving incontinence symptoms and quality of life In this qualitative interview study, we investigated participant experiences of the app-based treatment. The use of new technology seemed to make incontinence treatment feel more prioritized and less embarrassing for the subjects The closeness to their mobile phone and app features like reminders and visual graphs helped support and motivate the women to carry through the PFMT. Conclusions: Use of the app-based treatment program for SUI empowered the women in this study and helped them self-manage their incontinence treatment They appreciated the app as a new tool for supporting their motivation to carry through a slightly challenging PFMT program. Trial Registration: ClinicalTrials.gov NCT01848938; https://clinicaltrials.gov/ct2/show/NCT01848938 (Archived by WebCite at https://clinicaltrials.gov/ct2/show/NCT01848938)
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