Curtin enAble Institute and Curtin School of Allied Health, Curtin University, Perth, WA, Australia.
The University of New South Wales, Sydney, NSW, Australia; and Department of Obstetrics and Gynaecology, St George Hospital, Kogarah, NSW, Australia.
Aust J Prim Health. 2024 Sep;30. doi: 10.1071/PY24046.
Background Chronic pelvic pain (CPP) is a common and debilitating condition, and sufferers present to healthcare professionals with variable complex symptoms and co-morbidities. This study aimed to investigate the current beliefs and practice behaviours of healthcare professionals towards the management of CPP in Australian females. Methods We distributed an online survey to Australian healthcare professionals. Participants were questioned regarding their beliefs, the importance of various contributing factors and assessment variables, and their management preferences for two CPP vignettes. Demographic information and responses were analysed with descriptive statistics. Results Complete data were obtained and analysed from 446 respondents including gynaecologists (n =75), general practitioners (GPs) (n =184) and physiotherapists (n =187). Most of the respondents were female (88.1%), with male (11.7%) and other (0.2%) making up a smaller representation. Physiotherapists rated themselves higher in understanding mechanisms of CPP (64.7% very good to excellent) compared to gynaecologists (41.3%) and GPs (22.8%). Physiotherapists also reported higher levels of confidence in managing patients with CPP (57.8% quite or extremely confident) compared to 41.3% of gynaecologists and 22.3% of GPs who reported being quite or extremely confident. All three professions rated patient's beliefs (89.8%), nervous system sensitisation (85.7%), stress/anxiety/depression (91.9%), fear avoidance (83.3%), history of sexual/emotional/physical abuse (94.1%) and pelvic floor muscle function (85.0%) as very/extremely important factors in the development of chronic pelvic pain. Most gynaecologists (71.0%) and GPs (70.2%) always referred for pelvic ultrasound during assessment. Physiotherapists assessed goal setting (88.8%) and screened for patients' beliefs (80.9%) more often than gynaecologists (30.4% and 39.1% respectively) and GPs (46.5% and 29.0% respectively). Conclusions All three groups of healthcare professionals demonstrated a good understanding of pain mechanisms and incorporated a biopsychosocial and multidisciplinary approach to management of females with chronic pelvic pain. However, both gynaecologists and GPs were less confident in their understanding of and management of CPP, and less likely to consider patient beliefs and goals. The findings of this online survey may assist in the provision of more targeted education to further improve management of this condition.
慢性盆腔痛（CPP）是一种常见且使人虚弱的病症，患者向医疗保健专业人员呈现出各种复杂的症状和并存病症。本研究旨在调查澳大利亚女性中医疗保健专业人员对 CPP 管理的当前信念和实践行为。
我们向澳大利亚医疗保健专业人员分发了在线调查。参与者被问及他们对各种致病因素和评估变量的信念、重要性以及对两个 CPP 病例的管理偏好。对人口统计学信息和回答进行了描述性统计分析。
共获得并分析了来自 446 名受访者（妇科医生 n = 75，全科医生 n = 184，物理治疗师 n = 187）的完整数据。大多数受访者为女性（88.1%），男性（11.7%）和其他（0.2%）占比较小。与妇科医生（41.3%）和全科医生（22.8%）相比，物理治疗师对 CPP 发病机制的理解自评更高（64.7%非常好到极好）。物理治疗师在管理 CPP 患者方面也报告了更高水平的信心（57.8%相当或非常有信心），而妇科医生为 41.3%，全科医生为 22.3%，他们报告说相当或非常有信心。所有三种专业人员都将患者的信念（89.8%）、神经系统敏化（85.7%）、压力/焦虑/抑郁（91.9%）、恐惧回避（83.3%）、性/情感/身体虐待史（94.1%）和骨盆底肌肉功能（85.0%）评为慢性盆腔痛发展的非常/极其重要因素。大多数妇科医生（71.0%）和全科医生（70.2%）在评估时总是建议进行盆腔超声检查。物理治疗师比妇科医生（分别为 30.4%和 39.1%）和全科医生（分别为 46.5%和 29.0%）更频繁地评估目标设定和筛查患者的信念。
所有三组医疗保健专业人员对疼痛机制都有很好的了解，并采用生物心理社会和多学科方法来管理慢性盆腔痛的女性。然而，妇科医生和全科医生对 CPP 的理解和管理都不太自信，也不太可能考虑患者的信念和目标。这项在线调查的结果可能有助于提供更有针对性的教育，以进一步改善这种情况的管理。
