Analyze, design, develop, implement, and evaluate approach to develop a pelvic floor muscle training guidebook to treat stress urinary incontinence in women

Hakim, Surahman; Santoso, Budi Iman; Rahardjo, Harrina Erlianti; Setiati, Siti; Kusumaningsih, Widjajalaksmi; , Erwinanto; Prihartono, Joedo; Ibrahim, Nurhadi; Indriatmi, Wresti

doi:.0..

Obstet Gynecol Sci > Epub ahead of print

Original Article

DOI: https://doi.org/10.5468/ogs.23212 [Epub ahead of print]
Published online March 13, 2024.

Analyze, design, develop, implement, and evaluate approach to develop a pelvic floor muscle training guidebook to treat stress urinary incontinence in women

Surahman Hakim^1,2

, Budi Iman Santoso¹, Harrina Erlianti Rahardjo³, Siti Setiati⁴, Widjajalaksmi Kusumaningsih⁵, Erwinanto ⁶, Joedo Prihartono⁷, Nurhadi Ibrahim⁸, Wresti Indriatmi⁹

¹Urogynecology Division, Department of Obstetrics and Gynecology, Dr. Cipto Mangunkusumo Hospital, Jakarta, Indonesia
²Faculty of Medicine, University of Indonesia, Jakarta, Indonesia
³Department of Urology, Dr. Cipto Mangunkusumo Hospital, Jakarta, Indonesia
⁴Geriatrics Division, Department of Internal Medicine, Dr. Cipto Mangunkusumo Hospital, Jakarta, Indonesia
⁵Department of Physical Medicine and Rehabilitation, Dr. Cipto Mangunkusumo Hospital, Jakarta, Indonesia
⁶Urogynecology Division, Department of Obstetrics and Gynecology, Dr. Kariadi Hospital, Semarang, Indonesia
⁷Department of Community Medicine, Dr. Cipto Mangunkusumo Hospital, Jakarta, Indonesia
⁸Department of Physiology and Biophysics, Faculty of Medicine University of Indonesia, Jakarta, Indonesia
⁹Dermatology and Venereology, Dr. Cipto Mangunkusumo Hospital, Jakarta, Indonesia

Correspondence: Surahman Hakim,
Email: riset.dr.oman@gmail.com

Received: 21 August 2023 • Revised: 9 December 2023 • Accepted: 27 February 2024

Abstract

Objective
Stress urinary incontinence (SUI) is a common problem that affects the quality of life of women worldwide. Pelvic floor muscle training (PFMT) is an effective conservative first-line treatment for SUI. However, low compliance with PFMT is one of the main reasons for therapeutic failure. Indirect supervision using a guidebook may improve PFMT outcomes. To develop a PFMT guidebook using the analyze, design, development, implementation, and evaluation (ADDIE) method.
Methods
A guidebook was developed from July 2020 to April 2021 using the ADDIE method. This prospective study used mixed methods, namely qualitative analysis, focus group discussions, and in-depth interviews, and involved various experts from urogynecology, urology, medical rehabilitation, and physiotherapy departments. A pilot study was conducted on patients with SUI to evaluate the effectiveness of the guidebook.
Results
The ADDIE method was successfully implemented to develop the PFMT guidebook. The formative evaluation of the ADDIE steps mainly focused on the PFMT technique, content clarity, illustration, design, and color choice of the book. After the pilot study, the guidebook significantly improved Incontinence Impact Questionnaire, Short Form, 1-hour pad test, and perineometer scores. However, the pilot study showed no significant improvement in Urogenital Distress Inventory, Short Form scores.
Conclusion
The PFMT guidebook developed using the ADDIE method improved outcomes in patients with SUI.

Key Words: Urinary incontinence, Stress incontinence, Pelvic floor, Guidebook, Physical exercises