Department of Obstetrics and Gynaecology, Epsom & St Helier University Hospitals NHS Trust, Dorking Road, London, KT18 7EG, UK.
St George's University of London, Crammer Terrace, London, SW17 0RE, UK.
Int Urogynecol J. 2021 May;32(5):1187-1194. doi: 10.1007/s00192-021-04713-1. Epub 2021 Apr 6.
Qualitative research has an increasing role in the development of core outcome sets (COS) adding patient perspectives to the considerations of core outcomes. We aimed to identify priorities of women with experience of chronic pelvic pain (CPP).
The search strategy was a systematic review of qualitative studies identified from Cochrane Central Register of Controlled Trials (CENTRAL), CINAHL, EMBASE, MEDLINE and PsycInfo databases. Selection criteria were qualitative studies exploring the experience of women with CPP. Two independent researchers extracted data and summarized findings using thematic analysis. A CERQual assessment was performed to assess the confidence of review findings.
We identified pertinent issues affecting women with CPP including the lack of holistic care, influence of psychosocial factors and the impact of pain on quality of life. Five meta-themes central to delivering a patient-centred approach were highlighted: acceptance of pain, quality of life, management of CPP, communication and support. Management of CPP was the most commonly reported meta-theme across seven studies and half of studies reported quality of life, management, communication and support. Quality appraisal of included studies identified only a single study that met all CASP (Critical Appraisal Skills Programme) criteria. There was high confidence in the evidence for acceptance of pain, quality of life and communication meta-themes.
Meta-themes revealed by this review should be considered as a priority and reflected in outcomes reported by future studies evaluating interventions for CPP. In addition, these themes should be considered by clinicians managing women with CPP.
定性研究在核心结局集（COS）的发展中扮演着越来越重要的角色，为核心结局的考虑增添了患者视角。我们旨在确定有慢性盆腔疼痛（CPP）经历的女性的优先事项。
检索策略是对 Cochrane 对照试验中心注册数据库（CENTRAL）、CINAHL、EMBASE、MEDLINE 和 PsycInfo 数据库中定性研究的系统评价。选择标准是探索 CPP 女性体验的定性研究。两名独立研究人员使用主题分析提取数据并总结发现。进行 CERQual 评估以评估审查结果的置信度。
我们确定了影响 CPP 女性的相关问题，包括缺乏整体护理、心理社会因素的影响以及疼痛对生活质量的影响。突出了五个对提供以患者为中心方法至关重要的元主题：接受疼痛、生活质量、CPP 管理、沟通和支持。在七项研究中有五项报告了 CPP 管理是最常见的元主题，半数研究报告了生活质量、管理、沟通和支持。纳入研究的质量评估仅确定了一项符合所有 CASP（批判性评估技能计划）标准的研究。对于接受疼痛、生活质量和沟通元主题的证据有高度信心。
本综述揭示的元主题应被视为优先事项，并反映在未来评估 CPP 干预措施的研究中报告的结果中。此外，这些主题应被管理 CPP 女性的临床医生考虑。
