Exploring Factors Influencing Motivation and Success in Teaching Patients Pessary Self-Management: A Qualitative Study.

Abstract

Introduction and hypothesis: Pessary self-management (PSM) may increase patient autonomy and minimize the number of doctor consultations. However, little is known about the implementation and patient perception of PSM. This study aims to explore patients' experiences, opinions, and needs regarding PSM and how this was taught. Furthermore, to develop a standardized instruction manual.

Methods: A qualitative study with semi-structured interviews was conducted among patients with pessary therapy for pelvic organ prolapse (POP). A preliminary framework was conducted for thematic content analysis. Three main themes were described: initial opinion, motivation and suggestions for healthcare workers and other patients regarding PSM.

Results: Seventeen patients were interviewed of which 11 performed PSM, five women refused PSM, and one woman was not able to perform PSM. The initial opinion of patients varied. Half of patients were confident in succeeding to perform PSM, and in the other half, nervousness and lack of confidence in being able to perform PSM predominated. Autonomy, hygiene and fewer doctor consultations were named as the main motivating factors to perform PSM. Reasons for not performing PSM were anxiety and existing comorbidities. Patients were generally satisfied with the way PSM was explained and named videos and information leaflets as tips.

Conclusions: This explorative qualitative study revealed the motivators and barriers to learning PSM. Our findings highlight the importance of addressing patients' concerns and providing adequate information. In doing so, it is important to create a supportive environment to increase patient engagement and confidence in managing their condition through PSM. These results can help to successfully implement PSM in future healthcare.