How Do We Assess Patient Skills in a Competence-Based Program? Assessment of Patient Competences Using the Spanish Version of the Prolapse and Incontinence Knowledge Questionnaire and Real Practical Cases in Women with Pelvic Floor Disorders
Abstract
:1. Introduction
2. Materials and Methods
2.1. Translation and Cultural Adaptation
2.2. Testing Measurement Properties
2.2.1. Participants and Procedure
2.2.2. Demographic Data and PIKQ Score Determination
2.2.3. Data Analysis
2.3. Development of the Real Practical Cases
3. Results
3.1. Translation and Cultural Adaptation
3.2. Measurement Properties of the Spanish PIKQ
3.2.1. Characteristics of Participants, Interpretability, and Feasibility of PIKQ
3.2.2. Validity
3.2.3. Reliability
3.2.4. Responsiveness
3.3. Practical Cases Proposal
4. Discussion
5. Conclusions
Supplementary Materials
Author Contributions
Funding
Informed Consent Statement
Data Availability Statement
Acknowledgments
Conflicts of Interest
References
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Competences | Dimensions |
---|---|
Identify, analyze | Identify and analyze the significant elements, summarize and integrate the different parts, organize the elements and the connection among them, deduce some ideas and/or results and provide some conclusions. |
Decision making | Apply systematic methods to make decisions, compile and analyze data to take the most suitable decision, show certainty, be consistent with the solution adopted, collaborate with other on taking decisions. |
Communicate needs | Intonation and volume, level of preparation of exposition, gestures and body language, clarity of exposure, ability to answer questions, speech clarity, structure, and sequence within the speech. |
Problem-solving | Define the problem, identify strategies, propose solutions/hypotheses, evaluate potential solutions, implement solutions, evaluate results. |
Know how to manage | Identify the different resources, access resources, use resources efficiently, assess the suitability of resources based on the results. |
Patients Group (n = 147) | Experts Group (n = 128) | |
---|---|---|
Age, years. (SD) | 38.57 (8.21) | 24.18 (7.59) |
Education level: | ||
Primary School | 16 (10.9) | 0 (0) |
High School | 49 (33.3) | 0 (0) |
College or University | 82 (55.8) | 127 (100) |
Occupational Status | ||
Unemployed | 30 (20.4) | 0 (0) |
Employed | 115 (78.2) | 28 (22) |
Student | 2 (1.4) | 100 (78) |
Incomes | ||
<EUR 12,000/year | 12 (8.2) | 28 (22) |
EUR 12,000–24,000/year | 52 (35.4) | - |
EUR 24,000–36,000/year | 35 (23.8) | 100 (78) |
EUR 36,000–48,000/year | 29 (19.7) | - |
>EUR 48,000 | 19 (12.9) | - |
Vaginal delivery: | ||
None | 7 (4.8) | 120 (93.7) |
One | 92 (62.6) | 5 (3.9) |
Two | 40 (27.2) | 2 (1.5) |
Three or more | 8 (5.4) | 1 (0.7) |
Cesarean | 11 (7.5) | 1 (0.7) |
Menopause | 18 (12.2) | 2 (1.5) |
Urogynecological symptoms | ||
SUI | 57 (38.7) | - |
UUI | 17 (11.5) | - |
POP | 12 (8.2) | - |
Effect Size (95%CI) | SRM (95%CI) | ||||
---|---|---|---|---|---|
Patients (n = 147) | PIKQ-IU | 8.99 (2.05) | 11.24 (0.66) | 1.09 (0.95–1.2) | 1.16 (1.01–1.32) |
PIKQ-POP | 7.15 (2.79) | 10.38 (0.53) | 1.16 (0.99–1.34) | 1.15 (0.99–1.33) | |
Experts (n = 128) | PIKQ-IU | 11.92 (0.27) | - | - | - |
PIKQ-POP | 11.96 (0.23) | - | - | - |
SEM | SDCind | SDCgroup | ICC (95%CI) | |||
---|---|---|---|---|---|---|
PIKQ-IU | 8.56 (2.02) | 8.52 (2.04) | 0.15 | 0.42 | 0.017 | 0.995 (0.989–0.998) |
PIKQ-POP | 7.04 (2.56) | 7.04 (2.42) | 0.37 | 1.03 | 0.04 | 0.977 (0.951–0.990) |
Session | Topic | Contents | Learning Tools | Activities | Assessment Tools |
---|---|---|---|---|---|
1 | What do you know about PFD? | - Knowledge about the PFD symptoms and treatment options. - Beliefs about causes and evolution of PFD - Possible resources and self-efficacy facing a PFD | - Exploratory motivational interview - PIKQ - Real practical cases | - To fill in the PIKQ - To detect the PFD symptoms, the risk factors, and the treatment options of each real practical case | - PIKQ & real practical cases rubric are discussed - The notes of the contents in a notebook are requested and reviewed |
2 | Why PF is important? | - PF anatomy - Where PFM are - PFM function - What PFD are - Risk factors of PFD | - Anatomical prints - Pelvic bones and muscles anatomical model - Small ball | - To identify the boundaries and parts of the PF - To spatially locate the PFM in a picture and in themselves - To relate structures to functions, risk factors, and PFD | - A drawing of the PF anatomy is requested - A task of connecting anatomical structures with different functions is requested |
3 | How to contract the PFM correctly? | - Visualization of self PFM contraction - How to contract PFM - How to perform PFM exercises - Identifying her own PFD risk factors | - Ultrasound images of the PF and PFM contraction - Ultrasound biofeedback - Physiotherapist manual and auditory feedback - PFD risk factors sheet | - To understand the correct movement of the PFM - To watch and sense the correct contraction of the PFM - To contract the PFM in supine and sitting positions - To identify unwanted contraction of muscles close to the PFM - To fill in the PFD risk factors sheet at home. | - To review recordings of PFM contractions and identify the correct ones is requested - PFM contraction is assessed through vaginal palpation and transabdominal ultrasound - A diary of the PFM contractions practice is requested - The PFD risk factors sheet is discussed |
4 | How to relax the PFM and empty your bladder adequately? What are your voiding routines? | - Coordination between PFM and breathing - How to relax PFM - Urinary, defecatory and liquid intake patient habits | - Anatomical prints - Physiotherapist manual and auditory feedback - Motor imagery - Voiding and intake diary | - To try to contract the PFM when breathing out - To try to relax the PFM when breathing in - To fill in the voiding and intake diary during three consecutive days | - On-site test on PFM contraction and relaxation - The voiding and intake diary is requested and saved for later review |
5 | How important is the position of the pelvis? | - Pelvis positions during PFM exercises - Pelvis position during daily tasks - Pelvis position during micturition and defecation | - Anatomical prints - Pelvic bones and muscles anatomical model - Swiss ball | - To identify and practice the neutral pelvic position and the anterior and posterior pelvic tilt sitting and standing - To deduce which pelvic alignment assists each excretory process | - On-site test on pelvic alignment |
6 | What is the role of the PFM in intra-abdominal pressure? | - Coordination between PFM and abdominal muscles - Knack maneuver - How to lift weight | - Anatomical prints - Ultrasound biofeedback - A mirror - A light weight | - To contract the PFM and deep abdominal muscles when breathing out - To practice the PFM contraction before and during coughing and head lifting - To practice the knack when lifting a weight | - Ultrasound checking - A diary of the knack maneuver practice is requested |
7 | What are the best habits for the pelvic floor? | - Voiding ideal frequency - Infection prevention - Use of vaginal weight devices - Role of the pelvic floor in sexual intercourse | - Anatomical prints - A balloon - Vaginal weights | - To analyze the voiding frequency - To understand how the detrusor muscle and the PFM work - To list tips to avoid urine infections and improve sexual practice - To understand the use and guidelines for the use of vaginal devices | - To answer a short test about bladder function - To prepare your own “do’s and dont’s” as purposes to improve |
8 | What have I learned? | - All the contents of the program (session 1 to 7) | - Exploratory motivational interview - PIKQ - Real practical cases - Anatomical prints | - To fill in the PIKQ again - To detect the PFD symptoms, the risk factors, and the treatment options of each real practical case - To propose therapeutic resources to improve a PFD | - PIKQ & rubric of real practical cases are discussed |
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Sánchez-Sánchez, B.; Arranz-Martín, B.; Navarro-Brazález, B.; Vergara-Pérez, F.; Bailón-Cerezo, J.; Torres-Lacomba, M. How Do We Assess Patient Skills in a Competence-Based Program? Assessment of Patient Competences Using the Spanish Version of the Prolapse and Incontinence Knowledge Questionnaire and Real Practical Cases in Women with Pelvic Floor Disorders. Int. J. Environ. Res. Public Health 2021, 18, 2377. https://doi.org/10.3390/ijerph18052377
Sánchez-Sánchez B, Arranz-Martín B, Navarro-Brazález B, Vergara-Pérez F, Bailón-Cerezo J, Torres-Lacomba M. How Do We Assess Patient Skills in a Competence-Based Program? Assessment of Patient Competences Using the Spanish Version of the Prolapse and Incontinence Knowledge Questionnaire and Real Practical Cases in Women with Pelvic Floor Disorders. International Journal of Environmental Research and Public Health. 2021; 18(5):2377. https://doi.org/10.3390/ijerph18052377
Chicago/Turabian StyleSánchez-Sánchez, Beatriz, Beatriz Arranz-Martín, Beatriz Navarro-Brazález, Fernando Vergara-Pérez, Javier Bailón-Cerezo, and María Torres-Lacomba. 2021. "How Do We Assess Patient Skills in a Competence-Based Program? Assessment of Patient Competences Using the Spanish Version of the Prolapse and Incontinence Knowledge Questionnaire and Real Practical Cases in Women with Pelvic Floor Disorders" International Journal of Environmental Research and Public Health 18, no. 5: 2377. https://doi.org/10.3390/ijerph18052377
APA StyleSánchez-Sánchez, B., Arranz-Martín, B., Navarro-Brazález, B., Vergara-Pérez, F., Bailón-Cerezo, J., & Torres-Lacomba, M. (2021). How Do We Assess Patient Skills in a Competence-Based Program? Assessment of Patient Competences Using the Spanish Version of the Prolapse and Incontinence Knowledge Questionnaire and Real Practical Cases in Women with Pelvic Floor Disorders. International Journal of Environmental Research and Public Health, 18(5), 2377. https://doi.org/10.3390/ijerph18052377