Department of Obstetrics and Gynecology (Dr. Meriwether, Ms. Griego, and Dr. Komesu).
Department of Obstetrics and Gynecology (Dr. Meriwether, Ms. Griego, and Dr. Komesu).
J Minim Invasive Gynecol. 2023 Mar;30(3):216-229. doi: 10.1016/j.jmig.2022.12.002. Epub 2022 Dec 9.
Female patients with chronic pelvic pain (CPP) face complicated healthcare journeys, but narrative perspectives on CPP treatment are lacking.
We collected data in English and Spanish from discussion groups and individual interviews with stakeholders around female CPP.
A tertiary care center for gynecologic care.
Patients with CPP who self-identified as women/female, community healthcare workers, and providers who care for women with CPP.
We conducted discussion groups with all 3 types of stakeholders and individual interviews with female patients who have CPP.
Patient participants completed condition specific validated questionnaires. De-identified transcripts were coded with NVivo software. We contrasted patient characteristics and codes between patients with CPP who did and did not report opioid use in the last 90 days. The mean pain score of patient participants was 6/10 ± 2/10, and 14 of 47 (28%) reported recent opioid use, without significant differences between patients with and without recent opioid use. Thematic saturation was achieved. Five main themes emerged: the debilitating nature of CPP, emotional impacts of CPP, challenges in CPP healthcare interactions, treatment for CPP, and the value of not feeling alone. Common threads voiced by stakeholders included difficulty discussing chronic pain with others, a sense of inertia in treatment, interest in alternative and less invasive treatments before more involved treatments, and the need for individualized, stepwise, integrated treatment plans. Participants agreed that opioids should be used when other treatments fail, but women recently using opioids voiced fewer concerns about addiction and positive experiences with opioid efficacy.
These findings among female patients with CPP and also among community healthcare workers and providers advocate for a move toward patient-centered care, particularly the acknowledgment that every woman experiences pain in a singular way. Furthermore, stakeholders voice a deep need for development of individualized treatment plans.
患有慢性盆腔疼痛（CPP）的女性患者面临着复杂的医疗保健之旅，但缺乏对 CPP 治疗的叙述视角。
我们从讨论小组和与女性 CPP 相关的利益相关者的个人访谈中收集了英语和西班牙语数据。
妇科护理的三级保健中心。
自我认同为女性/女性的 CPP 患者、社区医疗保健工作者以及为 CPP 女性患者提供护理的提供者。
我们与所有 3 种类型的利益相关者进行了讨论小组，并对过去 90 天内有 CPP 的女性患者进行了个人访谈。
患者参与者完成了特定于病情的验证问卷。使用 NVivo 软件对匿名转录本进行编码。我们比较了在过去 90 天内报告使用阿片类药物和未报告使用阿片类药物的 CPP 患者的患者特征和代码。患者参与者的平均疼痛评分为 6/10±2/10，14 名患者中有 14 名（28%）报告最近使用阿片类药物，使用阿片类药物和未使用阿片类药物的患者之间没有显著差异。实现了主题饱和度。出现了五个主要主题：CPP 的衰弱性质、CPP 的情绪影响、CPP 医疗保健互动的挑战、CPP 的治疗方法以及不感到孤独的价值。利益相关者表达的共同线索包括与他人讨论慢性疼痛的困难、治疗中存在的惰性感、在更介入的治疗之前对替代和侵入性较小的治疗的兴趣，以及对个体化、逐步、综合治疗计划的需求。参与者一致认为，在其他治疗方法失败时应使用阿片类药物，但最近使用阿片类药物的女性对成瘾的担忧较少，对阿片类药物疗效的积极体验更多。
这些在 CPP 女性患者以及社区医疗保健工作者和提供者中发现的结果主张转向以患者为中心的护理，特别是承认每个女性都以独特的方式体验疼痛。此外，利益相关者强烈需要制定个体化的治疗计划。
