Wang Lijuan, Li Yaqin, Qi Ziyi, Wang Wei
Department of Nursing, The First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China.
Front Public Health. 2023 Sep 12;11:1191508. doi: 10.3389/fpubh.2023.1191508. eCollection 2023.
Patients with prostate cancer (PCa) benefit significantly from pelvic floor exercises, but recent results indicate that these exercises have not been fully promoted in clinical settings. This scoping review aimed to identify the facilitators of and barriers to pelvic floor muscle training (PFMT) in PCa survivors.
A scoping review was conducted in November 2022. Relevant studies were identified from CINAHL, Embase, PubMed, PsycINFO, and Web of Science databases from their inception to 20 November 2022. Data were analyzed and extracted by two formally trained researchers.
A total of 53 studies were included, most of which were randomized controlled trials. The Tailored Implementation for Chronic Diseases (TICD) model framework was used to identify the contents of seven barriers and promotion areas, as well as a series of sub-domains. The most common barriers to implementing pelvic floor muscle training (PFMT) included the following: the lack of a common scheme in guidelines and the measurement of common standardized outcomes, inadequate self-monitoring or feedback from healthcare professionals to improve PFMT compliance, poor patient compliance, and a lack of implementation equipment and financial support. Good treatment effects and easy operation were the facilitators of PFMT.
The implementation of PFMT faces several challenges and opportunities that should be understood thoroughly before implementation. In terms of guidelines and clinical practice, more work is needed, and the possibility of PFMT implementation in various hospitals and community health centers or clinics should be considered.
前列腺癌(PCa)患者从盆底肌锻炼中获益显著,但近期结果表明这些锻炼在临床环境中尚未得到充分推广。本范围综述旨在确定前列腺癌幸存者盆底肌训练(PFMT)的促进因素和障碍。
于2022年11月进行了一项范围综述。从CINAHL、Embase、PubMed、PsycINFO和Web of Science数据库自创建至2022年11月20日期间识别相关研究。由两名经过正式培训的研究人员进行数据分析和提取。
共纳入53项研究,其中大部分为随机对照试验。采用慢性病定制实施(TICD)模型框架来确定七个障碍和推广领域的内容以及一系列子领域。实施盆底肌训练(PFMT)最常见的障碍包括:指南中缺乏通用方案以及通用标准化结局的测量、医疗保健专业人员对改善PFMT依从性的自我监测或反馈不足、患者依从性差以及缺乏实施设备和资金支持。良好的治疗效果和操作简便性是PFMT的促进因素。
PFMT的实施面临若干挑战和机遇,在实施前应充分了解。在指南和临床实践方面,还需要开展更多工作,并且应考虑PFMT在各医院以及社区卫生中心或诊所实施的可能性。