Knowledge, attitude and practice of physical therapists in the care of women undergoing treatment for cervical cancer: a survey of practice in Brazil
The increase in survival rates among women treated for cervical cancer (CC) requires greater attention to the side effects of treatment. Although a high prevalence of pelvic floor disorders (PFD) in this population is documented, there is a lack of consensus regarding physical therapy approaches. Cross-sectional observational study with 56 physiotherapists who answered a questionnaire. The data were exported to Microsoft Excel® and analyzed descriptively. Most physiotherapists interviewed have postgraduate degrees in Women's Health (74.5%). The most common PFDs treated are sexual dysfunctions (26%), mixed urinary incontinence (23.9%), urge urinary incontinence (14,3%), pelvic organ prolapse (8,9%) and anal incontinence (4,1%). The PERFECT scale is the most used (20.2%) to assess the pelvic floor muscles. Female Sexual Function Index is the most used questionnaire for evaluation of sexual dysfunctions (46.7%) and vaginal desensitization (23.3%) for treatment of this condition. To assess urinary incontinence, 45.9% of the physiotherapists use voiding diary and the most cited intervention are pelvic floor muscle training (32.9%), bladder training and behavioral therapy (31.7%). Most of the physiotherapist intervieweddo not use specific instruments (65.4%) to assess pelvic organ prolapse and use pelvic floor muscle training (77.4%) for treatment. Anal incontinence is usually evaluated by Bristol Stool Scale (42.2%) and treated by Electrostimulation of the posterior tibial nerve (38.8%). Most physiotherapists are qualified to manage PFDs. The variability in assessment methods and therapeutic approaches highlights the lack of consensus on managing PFD in women with cervical cancer, indicating the need for evidence-based guidelines.