The accessibility of pelvic health physiotherapy for adolescents with persistent pelvic pain: a qualitative framework analysis

ABSTRACT

Background

Physiotherapy, with a specific focus on pelvic health, is one service used in the multidisciplinary management of adolescent persistent pelvic pain (PPP). However, there has been little investigations into the accessibility of physiotherapy for adolescents with PPP.

Objective

This qualitative study aimed to detail the experiences of adolescents with PPP accessing a tertiary hospital physiotherapy service.

Methods

Two focus groups included six adolescent females diagnosed with PPP that had either a) been referred and attended the physiotherapy clinic (n = 5), or b) been referred to physiotherapy but yet to attend their appointment (n = 1 plus one support person). Focus group transcripts were deductively thematically analyzed according to four domains from the patient-centered healthcare accessibility framework.

Results

The domain of ‘Approachability and ability to perceive’ was impacted by limited information and poor patient health literacy. ‘Acceptability and ability to seek’ was hindered by adolescent mental health struggles and failures of previous PPP management. ‘Availability and accommodation, and ability to reach’ was influenced by lengthy referral processes, and reliance on familial support for transport. ‘Acceptability and ability to engage’ was facilitated by engaging clinicians and group environments, however, adolescents became dependent on physiotherapy for pain management.

Conclusion

Physical, social, and environmental factors influence the accessibility of physiotherapy for adolescents with PPP. Healthcare services should consider the specific needs of adolescents with PPP for optimizing accessibility.

KEYWORDS:

• Persistent pelvic pain
• adolescents
• pelvic health physiotherapy
• accessibility
• qualitative

Acknowledgments

AKM was supported by the Research Training Programme domestic (RTPd) Stipend as a postgraduate student at the University of South Australia. KJC was supported by a research grant from The Hospital Research Foundation [Grant Number PG105576] and a Leadership Investigator grant from the National Health & Medical Research Council of Australia (ID 1178444).

Disclosure statement

AKM has been reimbured for costs associated with giving presentations on pelvic pain. KJC has received funding for research on pelvic health from The Hospital Research Foundation and the Australian Health Research Alliance and received payment for presentations given on pelvic health.

All other authors report no conflicts of interest.

Additional information

Funding

This work was supported by the The Allied and Scientific Health Office.