Date of Award

7-1-2015

Document Type

Thesis

Degree Name

Doctor of Nursing (ND)

First Advisor

Dr. Brenda Hage

Abstract

Interstitial cystitis/painful bladder syndrome is a major source of chronic pelvic pain and disability affecting women of all ages, predominantly age 18 years and over. Estimates of prevalence among US women range from 2.7% to 6.5% translating to 3.4 and 7.9 million women who have symptoms consistent with this debilitating condition (Kerr, 2009). The bladder epithelium has been the focus for diagnosing and treating symptoms of IC, however taking focus away from the bladder has opened the door for clinicians to explore pelvic floor dysfunction indicating that pelvic floor therapies should be a first line treatment for those women with IC/PBS (Peters & Carrico, 2006).

In this evidence based practice change project, the problem of IC/PBS has been identified in a Urology/Gynecology practice in Northeastern Pennsylvania. Based on the clinical problem, a thorough literature review emphasized the solution of pelvic floor therapy as part of usual care to improve symptoms associated with IC/PBS. The evidence based change project was based on the Rosswurm and Larrabee Model. Several meetings were held with the office staff along with a local pelvic floor therapist to discuss details of the EBP change project including the effects this may have on the practice and patient centered care. The project was submitted to Misericordia University’s Internal Review Board and IRB approval was obtained for this project to move forward.

Women who were 18 years or older who presented with symptoms of IC/PBS receive a complete history and physical examination, voiding diary, post void residual, full gynecological examination, urinalysis with culture, urine cytology if the patient had a smoking history, and a pain evaluation was performed. These women were invited to participate in the EBP change project. The O’Leary-Sant questionnaire which measures urinary and pain symptoms as well as how problematic these symptoms were to quality of life was performed for a baseline measure. The patient was then educated on usual care in conjunction with pelvic floor therapy. The EBP change project was explained and informed consent was reviewed. If the patient chose to be a part of the project, 8 to 12 sessions of pelvic floor therapy was provided by a trained physical therapist at a local rehabilitation center. The patient then returned to the practice setting at 4 weeks and 8 weeks for follow-up evaluation at which time the O’Leary-Sant questionnaire was readministered.

The pre-test and post-test data was compiled to determine if women showed improvement of symptom and problem indices related to IC/PBS. All of the women in the project reported symptom and quality of life improvement.

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