Translating Patient–Professional Divergence into Care-Improvement Priorities in Pelvic Floor Rehabilitation: A Delphi-Dialogue Study

Background/Objectives: Pelvic floor dysfunctions (PFD) have functional and psychosocial impact. Although pelvic floor rehabilitation is recommended as first-line care, effectiveness depends on access, communication, adherence support, and self-management. This study quantified patient–professional alignment and translated gaps into care-improvement recommendations using a Delphi-Dialogue Patients–Professionals (DDPP) framework. Methods: A two-phase observational study with Real-Time Delphi-based feasibility assessment was conducted within the Spanish Society of Physical Medicine and Rehabilitation (SERMEF). In Phase 1, parallel online surveys were completed by patients with PFD (n = 225) and rehabilitation professionals (n = 164). Shared items were rated on a six-point Likert scale. Concordance was explored using descriptive statistics and an operational divergence index combining mean differences and differences in agreement proportions. In Phase 2, ten recommendations were assessed for feasibility by 35 PM&R physicians and two Spanish Incontinence Association representatives. Results: Alignment was heterogeneous and domain-specific. The greatest divergences concerned digital competence, information timing, bladder/bowel diaries, and adherence. Divergence was bidirectional: professionals rated diaries and some group-based activities as more useful, whereas patients reported higher digital competence, timelier information, and better adherence. Strong alignment was observed for hybrid care models, written and video-based instructions, app-supported follow-up, and satisfaction. Feasibility ratings supported prioritization of adherence monitoring tools, pathway visibility, and digital monitoring applications; home exercise programs and educational materials emerged as consolidation targets. Conclusions: Patient–professional divergence appears to reflect context-dependent differences in perceived value rather than generalized disagreement. The DDPP framework offers a structured exploratory approach to translate experiential gaps into feasibility-informed service-improvement priorities.