The pelvic floor plays a critical role in maintaining various bodily functions, including bladder and bowel control, sexual function, and supporting organs within the pelvis [1]. Despite its significance, pelvic floor health (PFH) often receives insufficient attention, leading to misconceptions and inadequate understanding among the general population. Addressing this gap in knowledge is crucial for promoting better health outcomes [2]. Understanding the level of knowledge regarding PFH and its association with sociodemographic, obstetric, and gynaecologic factors is essential for developing targeted interventions and promoting better health care practices.
It is hypothesized that sociodemographic, obstetric, and gynaecologic factors would be related with PFH knowledge among participants. The aim of this study was to investigate these associations and assess the level of awareness and knowledge of PFH in a diverse sample population of women.

A prospective, cross-sectional study was carried out at a private obstetrics and gynaecology clinic from December 2021 to March 2022. Data were gathered from female patients or their companions by a physiotherapist. Approval for the study protocol was obtained from the ethics committee, and in accordance with the principles outlined in the Declaration of Helsinki. All participants signed the informed consent form prior to participation. 
Women aged ≥18 years were recruited to examine the association of their knowledge of PFH with their sociodemographic (age, marital status, education level, occupation, working status and socioeconomic status), obstetric (gravida, parity, and type of delivery) and gynaecological characteristics (menstrual status, presence of urinary incontinence (UI), fecal incontinence (FI), pelvic organ prolapse (POP), and sexual dysfunction). 
Presence of UI and FI and POP was determined based on the responses given to the related questions of the Pelvic Floor Distress Inventory-20 (PFDI-20). The presence of sexual dysfunction was determined according to the Female Sexual Function Index (FSFI) scores of participants (≤22.7 points) [3]. To assess participants’ PFH knowledge, a 29-itemed Pelvic Floor Health Knowledge Questionnaire (PFHKQ) which was shown to be a reliable and valid tool was used. 
SPSS version 22 for Windows was used for statistical analysis. Independent samples t-test, one-way ANOVA and Pearson’s correlation coefficients were used to compare the PFH knowledge between subgroups, and to explore associations between sociodemographic, obstetric, and gynaecologic variables. Statistical significance for these tests was defined at p<0.05.

A total of 150 women was included in the study. The sociodemographic characteristics of the participants revealed a diverse sample, with a mean age of 35.90±10.75 years, ranging from 18 to 66 years. Many participants were married (62%), had a university degree (71.3%), had an occupation (79.7%), were working part/full time (66%), and had an income equal or higher than their expenses (68%).
The 42% of the participants were nulligravid, and the average number of pregnancies of the remaining was 2.42±1.22, with 25.3% reporting ≥3 pregnancies. The 46% of participants were nullipara, and the mean number of giving birth (parity) was 1.77±0.78 for the remaining, with 7.3% reporting ≥3 deliveries. Additionally, 34% of all participants had a history of caesarean section (C/S), while 18.7% reported vaginal deliveries.
Regarding gynaecological history, 69.3% of women had a regular menstrual cycle, and 14.7% were in menopause. 72.7% of participants reported at least one symptom of pelvic floor dysfunction (PFD) involving UI (39.3%), FI (5.3%), POP (32.7%), and sexual dysfunction (56.7%). 
The analysis of the PFHKQ data showed a variety of knowledge levels regarding PFH among participants, from 0 point to 28 points with a mean score of 17.19±6.08. There was a weak negative correlation between PFH knowledge and age (r=-0.164, p=0.045), indicating that as age increased, knowledge tended to decrease. There was a statistically significant relationship between educational level and PFH knowledge (r=0.217, p=0.008). A significant difference in PFH knowledge was observed between occupation and working status, with healthcare professionals exhibiting significantly higher levels of PFH knowledge compared to other occupational groups (p<0.05). Additionally, the knowledge levels of full-time employees were found to be higher (p<0.05). However, the PFHKQ scores of participants with different numbers of pregnancies and birth, type of birth and menstrual status were found to be similar, just like the ones with and without PFDs (p>0.05) (Table 1).

The findings of this study highlight the impact of sociodemographic characteristics on PFH knowledge. Age, education level, occupation and working status were found to be related with PFH knowledge. These findings underscore the importance of sociodemographic factors in shaping individuals' knowledge and awareness of PFH. Moreover, they highlight the necessity of considering a comprehensive range of sociodemographic variables when designing interventions or educational programs aimed at improving PFH knowledge and promoting overall pelvic health.

This study contributes valuable insights into the sociodemographic determinants of PFH knowledge. By identifying factors such as age, education, occupation and working status that influence knowledge levels, healthcare providers and policymakers can develop more effective educational interventions aimed at improving awareness and knowledge of PFH across diverse populations. Moving forward, it is essential to prioritise inclusive and accessible approaches to PFH education, addressing the specific needs of different demographic groups. Taking proactive steps towards maintaining optimal pelvic floor function and overall well-being may be possible by fostering greater awareness and knowledge of PFH. Further research is required to develop targeted interventions for improving knowledge and awareness towards pelvic floor health.

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Continence 12S (2024) 101413
DOI: 10.1016/j.cont.2024.101413