Qualitative research as the basis for a biopsychosocial approach to women with chronic pelvic pain

Abstract

Chronic pelvic pain (CPP) is a highly prevalent clinical condition and is recognized as a public health problem. Although the number of qualitative studies related to the topic is increasing, it is essential that this knowledge be presented in a synthesized manner, grounded in the context of the care provided to patients with CPP, in order to increase the clinical and research applicability of the findings. Little attention is given to CPP in undergraduate courses and in meetings for the continuing education of health professionals, the approach to CPP typically being based on the biomedical model. We believe that qualitative research can provide insights into CPP and form the basis for a biopsychosocial approach to the condition, which can in turn lead to better results, including resolution of the pain and greater patient/health professional satisfaction. Therefore, we conducted a metasynthesis of seven qualitative studies of CPP, the principal themes of which were as follows: (a) coping with CPP versus secondary gain; (b) the great importance of determining the cause of the pain; (c) expectations regarding the doctor-patient relationship; and (d) gender issues. We hope that the present study can aid in restoring the humanistic aspects of CPP treatment.

Keywords::

• gynacological pain
• pain
• psychosomatic gynaecology
• qualitative methods
• women’s health

Declaration of interest: The authors report no declarations of interest.

Current knowledge on this subject

• Only one in five women with chronic pelvic pain (CPP) improve after physiotherapy, pharmacological treatment, or surgery. This low rate of resolution, which can be attributed to the biomedical model of treatment, generates frustration and conflicts between professionals and patients.

• Qualitative approaches can improve our understanding of CPP. The qualitative studies reviewed here show the problems of CPP from the perspective of the patients and address issues such as pain-related changes in their daily lives and the types of relationships they establish with their physicians, as well as their quest for specific medical care.

What this study adds

• We sought to deepen the knowledge of CPP, moving beyond the physical aspects and providing tools for reflection on the quality and management of the care of CPP patients, as well as on the relevant physical and psychosocial issues.

• We believe it is necessary to rethink and reassess the benefits and efficacy of the biomedical model for this type of care, seeking a more humanistic and individualized approach to CPP.