Robstad Nastasja, Paulsen Anita, Vistad Ingvild, Hott Alexandra Christine, Hansen Berg Kari, Øgård-Repål Anita, Rabben Jannicke, Wallevik Kristoffersen Eirunn, Rohde Gudrun
Department of Health and Nursing Science, University of Agder, Kristiansand, Norway.
Department of Gynecology and Obstetrics, Sorlandet Hospital, Kristiansand, Norway.
Acta Obstet Gynecol Scand. 2025 Jan;104(1):39-54. doi: 10.1111/aogs.14995. Epub 2024 Oct 23.
Endometriosis is the leading cause of chronic pelvic pain among women. The pain associated with endometriosis significantly impacts various aspects of patients' quality of life. A notable void in the literature is the absence of a systematic review exploring pain communication between patients with endometriosis and healthcare professionals. Hence, the aim of this qualitative systematic review was to synthesize findings on how patients with endometriosis experience communicating with healthcare professionals about pain and how healthcare professionals experience these interactions.
A systematic literature search was conducted related to patients with endometriosis and pain communication in CINAHL PLUS with full text and MEDLINE (via EBSCO host) on May 12, 2023, and updated January 26, 2024. Searches were supplemented by backward searching reference lists and forward searching citations of included reports in Scopus and Google Scholar. The review was guided by the four-step meta-synthesis methodology by Sandelowski and Barosso. Critical appraisal of included studies was conducted using Critical Appraisal Skill Program (CASP). Findings were analyzed thematically, using the approach described by Thomas and Harden. The meta-synthesis was based on a registered protocol in PROSPERO (CRD 42023425430), and the study is reported adhering to the PRISMA 2020 checklist.
Overall, 37 reports published from 2003 until 2023 contributed to the review, including 4842 participants. Through thematic analysis, we developed the following themes: "Navigating the double burden," "Lack of mutual understanding," and "The complexities of conveying pain."
The communication of pain between patients with endometriosis and healthcare professionals is complex, encompassing patterns of disbelief, normalization, and psychological attribution. Engaging in discussions about pain presents diverse challenges stemming from insufficient communication skills and assessment tools. Further research is warranted to comprehensively explore the perspectives of both patients and healthcare professionals, aiming to devise strategies that enhance communication and patient care.
子宫内膜异位症是女性慢性盆腔疼痛的主要原因。与子宫内膜异位症相关的疼痛严重影响患者生活质量的各个方面。文献中一个明显的空白是缺乏对子宫内膜异位症患者与医护人员之间疼痛沟通的系统评价。因此,本定性系统评价的目的是综合关于子宫内膜异位症患者如何体验与医护人员就疼痛进行沟通以及医护人员如何体验这些互动的研究结果。
于2023年5月12日在CINAHL PLUS全文数据库和MEDLINE(通过EBSCO主机)中对与子宫内膜异位症患者和疼痛沟通相关的文献进行系统检索,并于2024年1月26日更新。通过回溯检索参考文献列表以及在Scopus和谷歌学术中对纳入报告的引用进行前向检索来补充搜索。该评价以Sandelowski和Barosso的四步元综合方法为指导。使用批判性评价技能计划(CASP)对纳入研究进行批判性评价。采用Thomas和Harden描述的方法对研究结果进行主题分析。元综合基于PROSPERO中注册的方案(CRD 42023425430),本研究按照PRISMA 2020清单进行报告。
总体而言,2003年至2023年发表的37篇报告为该评价提供了资料,包括4842名参与者。通过主题分析,我们得出了以下主题:“应对双重负担”、“缺乏相互理解”以及“传达疼痛的复杂性”。
子宫内膜异位症患者与医护人员之间的疼痛沟通很复杂,包括怀疑、正常化和心理归因等模式。就疼痛进行讨论面临着因沟通技巧和评估工具不足而产生的各种挑战。有必要进行进一步研究,全面探索患者和医护人员双方的观点,旨在制定增强沟通和患者护理的策略。