Pelvic floor health in the nursing and midwifery workforce

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BACKGROUND Integral to pelvic floor (PF) health are social practices that preserve continence. When PF health is diminished, urinary symptoms may be experienced, which by their very nature remain under-reported despite negative effects on quality of life. Many people spend large portions of their lives at work; employers and organisations have a duty to support PF health in the workplace. AIMS This research sought to investigate PF health in the female nursing and midwifery workforce. The questions addressed were: 1. What is the prevalence and impact of PF dysfunction in the nursing and midwifery workforce? 2. What factors negatively influence the experience of symptoms at work, and what strategies will ameliorate these? 3. Based on these findings, what are key recommendations to nurses, midwives, managers and policy makers for PF health promotion in this workforce? METHODS Firstly, an operational definition for the concept ‘PF health’ is offered. Then, a review of the literature with respect to the prevalence and impact of PF dysfunctions in workforce groups determined gaps in knowledge. A mixed methods observational study using surveys and focus groups investigates PF dysfunctions in female nurses and midwives. The first survey is a state-wide investigation, the second involves three urban hospitals, examining the relationship of urinary symptoms to work ability and future work plans. Experiences of symptoms in the workplace, explored though focus group discussion, provide in-depth understanding, informing recommendations for PF health at work. FINDINGS PF health encompasses the physical and functional integrity of the PF unit through an individual’s life stages to permit optimal quality of life, where access to knowledge empowers the ability to prevent or manage dysfunctions. Of the nurses and midwives surveyed in this research, half experience urinary symptoms while at work. Those with severe incontinence are likely to leave their job and moderate incontinence negatively impacts concentration and time management at work. Delaying voiding and limiting fluid intakes are common work practices linked to nurses’ and midwives’ experiences of urinary symptoms, reflecting poor self-care. Workplace team relationships, workforce management and adequacy of amenities are key influences on nurses’ and midwives’ health practices. SIGNIFICANCE PF dysfunctions are common in this workforce, associated with poor self-care and reduced work ability. Policies for PF health at work will support cultural, social and organisational change. Equitable and dignified access to amenities will empower female nurses and midwives to self-care, enabling them to care for others.
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