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- Berterö, Carina, et al.
(författare)
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Striving for a biopsychosocial approach : A secondary analysis of mutual components during healthcare encounters between women with endometriosis and physicians
- 2019
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Ingår i: JOURNAL OF ENDOMETRIOSIS AND PELVIC PAIN DISORDERS. - : Sage Publications. - 2284-0265 .- 2284-0273. ; 11:3, s. 146-151
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Tidskriftsartikel (refereegranskat)abstract
- Objective:The objective of this study was to identify and describe mutual components during healthcare encounters between women with endometriosis and physicians.Methods:Secondary analysis of data was obtained from two original face-to-face interview studies, one with nine women with endometriosis and one including 16 physicians. Data in this secondary analysis were analysed using thematic analysis.Results:Three themes were identified. (1) Continuity as a foundation for a biopsychosocial approach. The women and the physicians described the importance of continuity and both parties strived for a biopsychosocial approach whereby the female body was not treated as biomedical defect object, but as a part of the unity that constitutes a human being. (2) Listening sensitively. Women and physicians believed that listening sensitively involved more than just hearing the actual words – it required thoughtfulness, reflection and responsiveness. (3) Timing of diagnosis. The physicians tried to protect the women from worrying by treating the painful menstruations without mentioning endometriosis. However, the women regarded not mentioning endometriosis as a lack of competence on the part of the physicians.Conclusion:This study provides new insights into the need for further support in the provision of psychosocial care for women with endometriosis, in the striving towards a biopsychosocial approach.
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| 2. |
- Grundström, Hanna, 1982-, et al.
(författare)
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Associations between pain thresholds for heat, cold and pressure, and Pain Sensitivity Questionnaire scores in healthy women and in women with persistent pelvic pain
- 2019
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Ingår i: European Journal of Pain. - : John Wiley & Sons. - 1090-3801 .- 1532-2149. ; 23:9, s. 1631-1639
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Tidskriftsartikel (refereegranskat)abstract
- BackgroundThe Pain Sensitivity Questionnaire (PSQ) is a self‐rating instrument developed as a time‐ and cost‐saving alternative to quantitative sensory testing (QST). The aims of the study were to assess (a) the associations between PSQ scores and QST in women with persistent pelvic pain and in pain‐free controls and (b) to what extent demographic variables and psychological distress influenced PSQ scores.MethodsFifty‐five healthy women and 37 women with persistent pelvic pain participated. All filled in the PSQ and Hospital Anxiety and Depression Scale and had QST (heat, cold and pressure pain thresholds) performed on six locations on the body. Information on age, body mass index, smoking habits and pain duration were collected. Principal component analysis and orthogonal partial least square regressions were used.ResultsThe patients scored significantly higher on PSQ than the controls. Significant multivariate correlations between pain thresholds and PSQ scores were found only in the patient group. In the patient group, the heat and cold pain thresholds correlated more strongly with PSQ scores than the pressure pain threshold.ConclusionsThe PSQ score was significantly higher in pelvic pain patients, and correlations between QSTs and the PSQ were only found for patients.SignificanceThe PSQ reflects pain sensitivity in women with PPP and can be used as a non‐invasive and painless way to assess this condition in clinical practice.
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| 3. |
- Grundström, Hanna, 1982-, et al.
(författare)
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Reduced pain thresholds and signs of sensitization in women with persistent pelvic pain and suspected endometriosis
- 2019
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Ingår i: Acta Obstetricia et Gynecologica Scandinavica. - : John Wiley & Sons. - 0001-6349 .- 1600-0412. ; 98:3, s. 327-336
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Tidskriftsartikel (refereegranskat)abstract
- INTRODUCTION: Endometriosis is a gynecological disorder that may cause considerable pelvic pain in women of fertile age. Determining pain mechanisms is necessary in order to optimize the treatment of the disease. The objective of the study was to evaluate pain thresholds in women with persistent pelvic pain with and without confirmed endometriosis, and healthy, unaffected controls, and analyze how pain thresholds in these cohorts related to duration of pelvic pain, quality of life, and symptoms of anxiety and depression.MATERIAL AND METHODS: Pain thresholds for heat, cold and pressure were assessed with quantitative sensory testing on six locations on a reference group of 55 healthy women and on 37 women with persistent pelvic pain who had been admitted for diagnostic laparoscopy on the suspicion of endometriosis. Validated instruments were applied to assess quality of life and symptoms of anxiety and depression. Data were analyzed by means of uni- and multivariate analysis of variance and Spearman's rank-order correlation.RESULTS: The women with persistent pelvic pain had significantly lower pain thresholds compared with the reference women. In the women with pain, no differences were observed in pain thresholds between women with (n = 13) and women without (n = 24) biopsy-proven endometriosis. The duration of pelvic pain correlated significantly positively with reduced pain thresholds, ie, the longer the duration, the more sensitization. In the persistent pelvic pain group, pain thresholds for heat correlated significantly with the Short Form Health Survey 36 dimension of bodily pain, and thresholds for cold correlated with Short Form Health Survey 36 bodily pain and with symptoms of depression.CONCLUSIONS: Our results showed widespread alterations in pain thresholds in women with persistent pelvic pain that are indicative of central sensitization and a time-dependent correlation. Women with pelvic pain and suspicion of endometriosis should probably be treated more thoroughly to prevent or at least minimize the concomitant development of central sensitization.
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