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‘Making Sense’ of Urinary Incontinence: A Qualitative Study Investigating Women’s Pelvic Floor Muscle Training Adherence

Hay-Smith, E. Jean C.; Pearson, Mark; Dean, Sarah G.


E. Jean C. Hay-Smith

Sarah G. Dean


Urinary incontinence is common and disabling. Pelvic floor muscle training is recommended as first-line therapy for uncomplicated urinary incontinence. The effects of such behavioural therapies depend in part on adherence. We explored women’s experiences of incontinence treatment and training adherence in a longitudinal qualitative design. Six women (40–80 years) with stress, urgency or mixed urinary incontinence symptoms were interviewed twice; once at the start of treatment and again after discharge about 3 months later. Interviews were transcribed and analysed using principles of Interpretative Phenomenological Analysis. Experiences were represented by four themes: Past experiences and meanings of leakage; the supervised treatment period; going on and looking ahead; and the relationship with and experience of others. Variable adherence was explained by how women ‘made sense of it all’. Women with the least difficulty in making sense of their incontinence and in overcoming training inertia had the best self-reported outcomes. Conversely, variable adherence, poorer self-reported outcomes, and ambivalence about engaging in treatment were characteristic of women who struggled to make sense of their apparently intermittent or unpredictable condition. Helping women make sense of incontinence and overcome inertia and ambivalence could improve adherence, but this may be a prolonged process.


Hay-Smith, E. J. C., Pearson, M., & Dean, S. G. (2023). ‘Making Sense’ of Urinary Incontinence: A Qualitative Study Investigating Women’s Pelvic Floor Muscle Training Adherence. New Zealand Journal of Physiotherapy, 51(1), 6-13.

Journal Article Type Article
Acceptance Date Feb 1, 2023
Online Publication Date Mar 30, 2023
Publication Date Mar 28, 2023
Deposit Date Mar 31, 2023
Publicly Available Date Apr 3, 2023
Journal New Zealand Journal of Physiotherapy
Print ISSN 0303-7193
Electronic ISSN 2230-4886
Publisher Physiotherapy New Zealand
Peer Reviewed Peer Reviewed
Volume 51
Issue 1
Pages 6-13
Keywords Adherence; Interpretative phenomenological analysis; Pelvic floor muscle training; Qualitative research; Urinary incontinence
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Copyright Statement
Copyright © 2023 New Zealand Journal of Physiotherapy. All rights reserved. Permission is given to copy, store and redistribute the material in this publication for non-commercial purposes, in any medium or format as long as appropriate credit is given to the source of the material. No derivatives from the original articles are permissible.

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