Gynecologic care of women with chronic pelvic pain: Patient perspectives and care preferences.

OBJECTIVE
To explore the experiences and care preferences of women with chronic pelvic pain, with or without a history of sexual trauma, seeking gynaecologic care.


DESIGN
Qualitative study.


SETTING
Ambulatory endometriosis centre POPULATION OR SAMPLE: Women ages 18 to 55 with chronic pelvic pain.


METHODS
Baseline demographics and sexual trauma history were obtained, and participants were assigned to focus groups according to a positive (n=4 groups, 13 participants) or negative screen (n=2 groups, 9 participants) for a history of sexual trauma. The focus groups were led by a clinical psychologist and a gynaecologic surgeon and consisted of semi-structured interviews. The interviews were audio-recorded, transcribed, and the transcripts coded in NVivo 12.


MAIN OUTCOME MEASURES
Content analysis was used to derive themes according to the participants' own words.


RESULTS
Participants with chronic pelvic pain, with or without a history of sexual trauma, experienced delay in diagnosis and repetitive dismissals by clinicians. Participants' experiences of dismissals included: clinicians not listening, insufficient allocation of time to appointments, and perceived redundant medical testing (i.e., sexually transmitted infection testing, urine cultures, ultrasounds). Participants identified clinician interactions as pivotal in coping with both pelvic pain and sexual abuse. Participants also provided feedback regarding trauma-informed practices and care delivery specific to patients with chronic pelvic pain.


CONCLUSION
Patients with chronic pelvic pain, with or without a history of sexual trauma, report negative experiences when interacting with the healthcare system. They have clear needs and preferences regarding gynaecologic care and provide feasible suggestions for improving care delivery.