Opportunities, challenges and concerns for the implementation and uptake of pelvic floor muscle assessment and exercises during the childbearing years: protocol for a critical interpretive synthesis
Opportunities, challenges and concerns for the implementation and uptake of pelvic floor muscle assessment and exercises during the childbearing years: protocol for a critical interpretive synthesis
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DOI：
10.1186/s13643-017-0420-z
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发表时间：
2017-01-01
影响因子：
3.7
通讯作者：
Pearson, Mark
中科院分区：
文献类型：
--
作者：
Salmon, Victoria E.;Hay-Smith, E. Jean C.;Pearson, Mark
背景：妊娠和分娩是女性尿失禁（UI）的重要危险因素。骨盆底肌肉锻炼（PFME）是预防UI的有效方法。UI管理指南建议在首次怀孕期间为女性提供骨盆底肌肉训练（PFMT）作为预防策略。本综述的目的是了解个人、专业、跨专业和组织的机会、挑战和问题之间的关系，这些机会、挑战和问题对于最大限度地发挥育龄期PFMT的影响和实现所需的行为改变至关重要。在系统搜索以确定纳入的来源之后，我们将使用批判性解释综合（CIS）方法来产生概念模型，绘制个人、专业、跨专业和组织因素与育龄期PFME教育、评估和培训的实施、可接受性和吸收之间的关系。将采用有目的的抽样方法，以确定随着审查的进展而出现的与主题或感兴趣的领域有关的潜在相关材料。广泛的经验和非经验来源将有资格纳入，以涵盖与生育年龄期间PFME相关的个人，专业，专业间和组织问题的广度。数据分析和综合将确定关键主题、概念、这些主题之间的联系和关系。将结合现有的执行框架、个人的态度和信念以及行为变化来解释调查结果。我们将整理的例子来说明在概念模型中表达的关系，并确定模型和驱动程序之间的潜在联系changes.Discussion：CIS审查结果和由此产生的概念模型将说明可能影响的实施，可接受性和摄取的PFME教育，评估和培训在生育年龄的因素之间的关系。该模式将为制定和评价一套培训方案提供信息，以支持助产士在产前实施和提供有效的PFME。该审查是英国国家健康研究所资助的“产前骨盆底运动和定位（APPEAL）”计划（资助编号：RP-PG-0514-20002）的第一阶段的一部分，旨在预防与怀孕和分娩相关的UI相关的健康状况不佳。
Background: Pregnancy and childbirth are important risk factors for urinary incontinence (UI) in women. Pelvic floor muscle exercises (PFME) are effective for prevention of UI. Guidelines for the management of UI recommend offering pelvic floor muscle training (PFMT) to women during their first pregnancy as a preventive strategy. The objective of this review is to understand the relationships between individual, professional, inter-professional and organisational opportunities, challenges and concerns that could be essential to maximise the impact of PFMT during childbearing years and to effect the required behaviour change.Methods: Following systematic searches to identify sources for inclusion, we shall use a critical interpretive synthesis (CIS) approach to produce a conceptual model, mapping the relationships between individual, professional, inter-professional and organisational factors and the implementation, acceptability and uptake of PFME education, assessment and training during the childbearing years. Purposive sampling will be used to identify potentially relevant material relating to topics or areas of interest which emerge as the review progresses. A wide range of empirical and non-empirical sources will be eligible for inclusion to encompass the breadth of relevant individual, professional, inter-professional and organisational issues relating to PFME during childbearing years. Data analysis and synthesis will identify key themes, concepts, connections and relationships between these themes. Findings will be interpreted in relation to existing frameworks of implementation, attitudes and beliefs of individuals and behaviour change. We will collate examples to illustrate relationships expressed in the conceptual model and identify potential links between the model and drivers for change.Discussion: The CIS review findings and resulting conceptual model will illustrate relationships between factors that might affect the implementation, acceptability and uptake of PFME education, assessment and training during the childbearing years. The model will inform the development and evaluation of a training package to support midwives with implementation and delivery of effective PFME during the antenatal period. The review forms part of the first phase of the United Kingdom National Institute for Health Research funded 'Antenatal Preventative Pelvic floor Exercises And Localisation (APPEAL)' programme (grant number: RP-PG-0514-20002) to prevent poor health linked to pregnancy and childbirth-related UI.