Obstet Gynecol Sci.  2024 May;67(3):323-334. 10.5468/ogs.23212.

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

Affiliations
  • 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

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.

Keyword

Urinary incontinence; Stress incontinence; Pelvic floor; Guidebook; Physical exercises

Figure

  • Fig. 1 ADDIE steps in developing the pelvic floor muscle training (PFMT) guidebook. ADDIE, analyze, design, development, implementation, and evaluation.


Reference

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