Telehealth in the rehabilitation of female pelvic floor dysfunction: a systematic literature review.

INTRODUCTION AND HYPOTHESIS: The pandemic caused by coronavirus disease 2019 (COVID-19) increased the awareness and efforts to provide care from distance using information technologies. We reviewed the literature about the practice and effectiveness of the rehabilitation of the female pelvic floor dysfunction via telehealth regarding symptomatology and quality of life and function of pelvic floor muscles (PFM). METHODS: A bibliographic review was carried out in May 2020 in the databases: Embase, Medline/PubMed, LILACS and PEDro. A total of 705 articles were reviewed after the removal of duplicates. The methodological quality of the articles was evaluated by the PEDro scale. Two authors performed data extraction into a standardized spreadsheet. RESULTS: Four studies were included, two being randomized controlled trials. Among the RCTs, only one compared telehealth with face-to-face treatment; the second one compared telehealth with postal treatment. The other two studies are follow-up and cost analysis reports on telehealth versus postal evaluation. Data showed that women who received the intervention remotely presented significant improvement in their symptoms, such as reducing the number of incontinence episodes and voiding frequency, improving PFM strength and improving quality of life compared to women who had the face-to-face treatment. CONCLUSIONS: Telehealth promoted a significant improvement in urinary symptoms, PFM function and quality of life. Telehealth is still emerging, and more studies are needed to draw more conclusions. The recommendations of the governmental authorities, physical therapy councils and corresponding associations of each country also need to be considered.

Percepção dos usuários acerca das práticas de promoção da saúde, vivenciadas em grupos, em uma unidade básica de saúde da família / Users perception of group-experienced health promotion practices in a family health basic unit

Este estudo de campo, do tipo exploratório, descritivo e com abordagem qualitativa, teve como objetivo identificar a percepção dos usuários acerca das práticas de promoção da saúde vivenciadas em grupos, em uma unidade básica de saúde da família. O cenário da pesquisa foi uma unidade básica de saúde, localizada na zona Leste de São Paulo, onde há implantada a estratégia saúde da família. Foram convidadas a participar pessoas da comunidade que frequentam ou já frequentaram algum grupo da unidade. Os grupos de pintura, caminhada, idosos, canto, gestantes e hipertensão/diabetes dessa unidade têm enfoque na promoção da saúde. Foi escolhido um participante de cada grupo, por meio de sorteio, totalizando seis participantes a população do estudo. Foram respeitados todos os preceitos éticos em pesquisa. Utilizou-se a técnica da entrevista para coleta de dados, realizada no mês de junho de 2009. Os dados coletados foram trabalhados pela análise temática. Observou-se uma tendência e valorização das práticas individuais relacionadas ao atendimento clínico-individual. Todos apresentaram opiniões positivas com relação aos grupos. O grupo que ganhou destaque sobre conhecimento e participação foi o grupo da caminhada. Notou-se, de maneira geral, uma falta de interesse na participação nos grupos oferecidos pela unidade. Todos afirmaram que os grupos são bons, pois contribuem para o aprendizado e são oportunidades de lazer e entretenimento. Poucos usuários propuseram novas ideias para grupos. A escolha dos temas e as ações ocorrem ainda de maneira verticalizada, em que os profissionais repassam o conteúdo, vindo com propostas prontas, não valorizando a participação da população na construção conjunta. Todos desconheciam o termo promoção da saúde e alguns correlacionaram qualidade de vida com alimentação saudável e outros com trabalho e renda. A realização de grupos com enfoque na promoção da saúde e educação em saúde de maneira ampla não se constitui uma tarefa fácil.

This work exploratory, descriptive and qualitative work aimed to identify the users? perception of group--experienced health promotion practices in a family health basic unit. The research scenery was a basic health unit located in the São Paulo?s Eastern Zone, a region where the family health strategy has been implemented. Community dwellers who attended or had attended any group meeting organized by the unit were invited to participate. The following existing groups prioritize health promotion: painting, walking, elderly, singing, prenatal and hypertension/diabetes. One participant from each group was chosen, by means of a draw, totalizing 6 participants for the study population. All the ethical precepts were respected in the research. During the month of June 2009, the interview technique was used for data collection. The data collected were then analyzed according to the thematic analysis. There was a trend towards and valorization of individual practices related to clinical-individual assistance. All participants were positive about their groups. The walking group was singled out for excelling in knowledge and participation. A general lack of interest in participating in the groups offered by the unit was observed. The groups were unanimously acknowledged as good opportunities for learning and having leisure and entertainment. Few users suggested new ideas for the groups. The choice of topics and actions still occurs in a vertical, in which service providers pass on the content and come up with ready-made proposals, not valuing people?s participation in joint construction. While all were unaware of the term health promotion, some correlated the quality of life with healthy eating and others with work and income. The performance of the groups with a focus on health promotion and health education in a broad sense is not an easy task, considering the range of activities that health professionals in the family health strategy must develop.