Radboud University Medical Centre, Department of Primary and Community Care, Unit Gender & Women's Health, Nijmegen, The Netherlands.
Academic Medical Center, University of Amsterdam, Department of Sexology and Psychosomatic Obstetrics and Gynaecology, Amsterdam, The Netherlands.
Fam Pract. 2019 Nov 18;36(6):791-796. doi: 10.1093/fampra/cmz021.
Provoked Vulvodynia (PVD) is the most common cause of vulvar pain. General practitioners (GPs) are insufficiently familiar with it, causing a delay in many women receiving correct diagnosis and treatment. Besides patients factors, this delay can partly be explained by the reluctance of GPs to explore the sexual context of PVD and by their negative emotional reactions such as helplessness and frustration when consulted by patients with medically unexplained symptoms like PVD.
To gain insight into how women with PVD perceive and evaluate condition management by their GP, in order to support GPs in the consultation of women with PVD.
We performed face-to-face in-depth interviews with women diagnosed with PVD. The interviews were recorded, transcribed verbatim and thematically analysed. The Consolidated Criteria for reporting Qualitative Research (COREQ-criteria) were applied.
Analysis of the interviews generated four interrelated themes: Doctor-patient relationship, Lack of knowledge, Referral process and Addressing sexual issues. Empathy of the GP, involvement in decision-making and referral were important factors in the appreciation of the consultation for women with PVD who were referred to a specialist. Because women were reluctant to start a discussion about sexuality, they expected a proactive attitude from their GP. The communication with and the competence of the GP ultimately proved more important in the contact than the gender of the GP.
Women with PVD prefer a patient-centred approach and want GPs to acknowledge their autonomy and to address sexuality proactively.
诱发性外阴痛（PVD）是外阴疼痛最常见的原因。全科医生（GP）对此了解不足，导致许多女性迟迟得不到正确的诊断和治疗。除了患者的因素外，这种延迟在一定程度上可以解释为 GP 不愿探讨 PVD 的性背景，以及当患者出现像 PVD 这样无法用医学解释的症状时，GP 会感到无助和沮丧，从而产生负面的情绪反应。
深入了解患有 PVD 的女性如何看待和评价她们的 GP 对病情的管理，以支持 GP 为患有 PVD 的女性提供咨询服务。
我们对被诊断患有 PVD 的女性进行了面对面的深入访谈。对访谈进行了录音、逐字记录，并进行了主题分析。应用了定性研究报告的统一标准（COREQ 标准）。
对访谈的分析产生了四个相互关联的主题：医患关系、知识缺乏、转诊过程和解决性问题。GP 的同理心、参与决策和转诊是影响接受转诊到专科医生治疗的 PVD 女性对咨询满意度的重要因素。由于女性不愿意开始讨论性问题，她们希望 GP 能主动提出这个话题。女性认为与 GP 的沟通和 GP 的能力比 GP 的性别更重要。
患有 PVD 的女性更喜欢以患者为中心的方法，希望 GP 承认她们的自主权，并主动解决性问题。
