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慢性盆腔痛女性的分离现象:与手术治疗、盆腔疼痛严重程度和健康相关生活质量的关系。

Dissociation Among Women with Chronic Pelvic Pain: Relation to Surgical Treatment, Pelvic Pain Severity, and Health-Related Quality of Life.

机构信息

School of Social Work, Wayne State University, Detroit, Michigan, USA.

Department of Obstetrics and Gynecology, Albany Medical Center, Albany, New York, USA.

出版信息

J Trauma Dissociation. 2023 Mar-Apr;24(2):296-311. doi: 10.1080/15299732.2023.2168828.

Abstract

Chronic pelvic pain (CPP) is associated with a history of trauma and symptoms of somatoform dissociation. We aimed to describe how somatoform dissociation impacts CPP symptoms, surgical treatment, and health-related quality of life (HRQOL). Patients ( = 133) diagnosed with CPP presenting for an appointment at a women's health clinic between November, 2019 - July, 2021 were recruited to participate in a cross-sectional study and complete a survey assessing symptoms of somatoform dissociation, post-traumatic stress disorder (PTSD), pelvic pain severity, history of CPP-related surgeries, and mental and physical HRQOL. We also conducted a post-hoc analysis assessing correlations of individual symptom items on the Somatoform Dissociation Questionnaire (SDQ-20) with HRQOL outcomes. We did not find a relationship between somatoform dissociation and pelvic pain severity or surgical history. Physical HRQOL outcomes were related to somatoform dissociation, PTSD symptoms, and pelvic pain severity, while mental HRQOL outcomes were connected to somatoform dissociation and PTSD symptoms. Our study reveals preliminary evidence suggesting that among CPP patients, HRQOL outcomes are affected by unique profiles of positive and negative symptoms of somatoform dissociation, including sensory disturbances, localized genital pain, and generalized numbness and bodily analgesia. Addressing specific symptoms of somatoform dissociation may enhance HRQOL among trauma-exposed women with CPP. Replication studies are needed to validate our findings. Integrating trauma-informed approaches, including standardized evaluations of trauma exposure and symptoms of somatoform dissociation into routine care for women with CPP is encouraged.

摘要

慢性盆腔痛(CPP)与创伤史和躯体形式解离症状有关。我们旨在描述躯体形式解离如何影响 CPP 症状、手术治疗和健康相关生活质量(HRQOL)。2019 年 11 月至 2021 年 7 月期间,在一家妇女健康诊所就诊的 CPP 患者被招募参与一项横断面研究,并完成一项调查,评估躯体形式解离、创伤后应激障碍(PTSD)、盆腔疼痛严重程度、CPP 相关手术史以及心理和生理 HRQOL 的症状。我们还进行了一项事后分析,评估躯体形式解离问卷(SDQ-20)中个体症状项目与 HRQOL 结果的相关性。我们没有发现躯体形式解离与盆腔疼痛严重程度或手术史之间存在关系。躯体形式解离、PTSD 症状和盆腔疼痛严重程度与生理 HRQOL 结果相关,而躯体形式解离和 PTSD 症状与心理 HRQOL 结果相关。我们的研究初步表明,在 CPP 患者中,HRQOL 结果受躯体形式解离的阳性和阴性症状的独特特征影响,包括感觉障碍、局部生殖器疼痛以及全身麻木和身体镇痛。针对躯体形式解离的特定症状可能会提高创伤后 CPP 女性的 HRQOL。需要进一步的研究来验证我们的发现。鼓励将以创伤为中心的方法(包括对创伤暴露和躯体形式解离症状的标准化评估)纳入对 CPP 女性的常规护理中。

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