School of Nursing, Midwifery and Social Work, University of Manchester, UK.
BMC Fam Pract. 2010 Jan 27;11:7. doi: 10.1186/1471-2296-11-7.
Chronic pelvic pain (CPP) has a prevalence similar to asthma and chronic back pain, but little is known about how general practitioners (GPs) and practice nurses manage women with this problem. A clearer understanding of current management is necessary to develop appropriate strategies, in keeping with current health care policy, for the supported self-management of patients with long term conditions. The aim of this study was to explore GPs' and practice nurses' understanding and perspectives on the management of chronic pelvic pain.
Data were collected using semi-structured interviews with a purposive sample of 21 GPs and 20 practice nurses, in three primary care trusts in the North West of England. Data were analysed using the principles of Framework analysis.
Analysis suggests that women who present with CPP pose a challenge to GPs and practice nurses. CPP is not necessarily recognized as a diagnostic label and making the diagnosis was achieved only by exclusion. This contrasts with the relative acceptability of labels such as irritable bowel syndrome (IBS). GPs expressed elements of therapeutic nihilism about the condition. Despite practice nurses taking on increasing responsibilities for the management of patients with long term conditions, respondents did not feel that CPP was an area that they were comfortable in managing.
The study demonstrates an educational/training need for both GPs and practice nurses. GPs described a number of skills and clinical competencies which could be harnessed to develop a more targeted management strategy. There is potential to develop facilitated self- management for use in this patient group, given that this approach has been successful in patients with similar conditions such as IBS.
慢性盆腔疼痛（CPP）的患病率与哮喘和慢性背痛相似，但人们对全科医生（GP）和执业护士如何管理此类女性患者知之甚少。为了制定符合当前医疗保健政策的长期慢性病患者支持性自我管理策略，有必要更清楚地了解当前的管理方法。本研究旨在探讨全科医生和执业护士对慢性盆腔疼痛管理的理解和看法。
采用目的抽样法，在英格兰西北部的三个初级保健信托中，对 21 名全科医生和 20 名执业护士进行了半结构化访谈，收集数据。采用框架分析的原则对数据进行分析。
分析表明，患有 CPP 的女性给全科医生和执业护士带来了挑战。CPP 不一定被视为诊断标签，只有通过排除法才能做出诊断。这与肠易激综合征（IBS）等相对可接受的标签形成对比。全科医生对这种疾病表现出一定程度的治疗虚无主义。尽管执业护士承担了越来越多的管理慢性病患者的责任，但受访者并不认为 CPP 是他们擅长管理的领域。
该研究表明全科医生和执业护士都需要接受教育/培训。全科医生描述了一些可以利用的技能和临床能力，以制定更有针对性的管理策略。鉴于这种方法在类似 IBS 的患者中取得了成功，因此有可能为该患者群体开发促进自我管理的方法。
