O Enfermeiro nos Distúrbios do Assoalho Pélvico em Mulheres : uma Revisão Integrativa

Abstract

The present study aims to analyze the available evidence in the literature regarding nursing assistance for pelvic floor disorders in women. To achieve this objective, an integrative review was developed. Initially, a research question was formulated based on the PICO acronym. Subsequently, primary studies were searched in the information sources MEDLINE/PubMed, Web of Science, Scopus, LILACS, BDENF/BVS, CINAHL, and Embase, as well as in grey literature using ProQuest and Google Scholar, and a manual search was conducted in the reference lists of the included studies to identify additional relevant research. A unique search strategy was adapted for each information source. Descriptors, alternative terms, and keywords were combined using the boolean operators AND and OR. The defined eligibility criteria included primary studies addressing nursing and/or midwifery assistance for pelvic floor disorders in women, published in Portuguese, English, and Spanish, with a time frame of the last 20 years (2004-2024). After executing the searches, the studies were exported to the Endnote online reference manager for organization and removal of duplicates. Following this process, the studies were transferred to the ASReview LAB software for reading titles and abstracts, as well as full texts of the selected studies. After selection, data were extracted using a template developed by the authors of this study, again with the assistance of ASReview LAB. Subsequently, the level of evidence for each included primary study was assessed, along with the methodological quality of these research articles. The results were analyzed descriptively in summary tables and presented in three categories: Urinary Incontinence, Pelvic Organ Prolapse, and Anal Incontinence. The evidence gathered indicates that pelvic floor disorders negatively impact women's quality of life and affect their families and social circles. These conditions may impose restrictions on lifestyle and social interactions. There are frequent misconceptions among women regarding pelvic disorders, such as the erroneous belief that these disorders are inevitable consequences of childbirth and aging. Urinary incontinence is one of the main disorders, and the literature highlights a concern regarding its clinical significance and impact on quality of life. The most common treatment, provided by trained nurses, is pelvic floor muscle strengthening through muscle training and biofeedback. Following urinary incontinence, pelvic organ prolapse is the most frequently addressed dysfunctional condition. Treatment for pelvic organ prolapse includes muscle training and the insertion of vaginal pessaries. Additionally, anal incontinence requires attention from nurses. Interventions should include guidance for reeducating bowel habits, exercises to strengthen pelvic floor muscles, and implementing biofeedback programs, as well as the use of anal plugs. Therefore, it is essential to train nurses to provide support and education to women on this topic, in order to combat misinformation and improve care, ensuring quality support.