Attitudes of women with chronic pelvic pain to the gynaecological consultation: a qualitative study

Authors


Dr J Price, Department of Psychiatry, University of Oxford, The Warneford Hospital, Oxford OX3 7JX, UK. Email jonathan.price@psych.ox.ac.uk

Abstract

Objective  To describe the attitudes that women with chronic pelvic pain (CPP) attending gynaecology clinics have to their consultations and to determine the ways in which their health care can be improved.

Design  Qualitative study using semistructured individual interviews.

Setting  UK gynaecology outpatient clinics in district general and teaching hospitals.

Sample  Twenty-six women with CPP.

Methods  Semistructured individual interviews were conducted. Data gathering and analysis followed a grounded theory approach.

Main outcome measures  Women's wishes regarding their care and their actual experiences of care.

Results  Four main themes emerged. The women wanted (a) personal care, which they often did not receive; (b) to feel understood and to be taken seriously, although they often felt dismissed, which applied both to women with and without an explanation for their pain; (c) explanation as much as cure, but an adequate explanation was often not provided; and (d) to be reassured, which often they were not. Effective reassurance was complex as it included general reassurance and specific reassurance about cause and treatment.

Conclusions  Improvements are needed in the outpatient care of women presenting with CPP. Changes should focus on providing more personal care, so that presenting problems are seen to be taken seriously, findings and management are appropriately explained, and women are more effectively reassured. Interventions need to be developed that meet these needs and tested to determine if they are feasible, acceptable, and improve outcomes.

Ancillary