Unmet treatment needs in patients with chronic pelvic pain in a New Zealand gynaecology service

Karen Joseph, Jessica Mills
The Australian & New Zealand journal of obstetrics & gynaecology · 2019 · vol. 59(6) , pp. 856–860 · doi:10.1111/ajo.13059 · PMID:31514250 · W2972656419
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This audit of 100 women with chronic pelvic pain revealed a high prevalence of pain catastrophizing, indicating unmet psychosocial needs within the current gynaecological care model.

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Abstract

BACKGROUND: Chronic pelvic pain, which carries a high burden of disability and distress, is a common presentation to gynaecology clinics. While there is increasing acknowledgment of the complexity of chronic pelvic pain, and the benefits of providing management from a multidisciplinary team within a sociopsychobiomedical framework, the mainstay of management in gynaecology outpatient clinics remains within a single clinician biomedical-focused model. This model of care is only sufficient for women who present with minimal psychosocial complexity to their pain. AIMS: To estimate the proportion of women attending the gynaecology outpatient clinic at a public women's hospital in New Zealand referred with chronic pelvic pain who have needs unmet by the current biomedical model of care. Informed by international research, pain catastrophising was used as a psychosocial correlate of this complexity. METHODS: An audit was undertaken of 100 consecutive pre-appointment questionnaires of women, referred to a gynaecology outpatient clinic for review of pelvic pain of duration over six months, with no red flags in their referral history. RESULTS: An unexpectedly high level of catastrophic thoughts about pain was reported. Seventy-seven percent of the women scored in the high or severe range, with 55% endorsing clinically significant scores for helpless catastrophising. CONCLUSIONS: The Pain Catastrophising Scores in this cohort were found to be higher than those in similar groups in the published international literature and also than in patients referred to the local tertiary level pain management centre, further reinforcing the need for investment into appropriate services for women with chronic pelvic pain.

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Condition tags

mesh:D017699chronic_pelvic_pain

MeSH descriptors

Catastrophization Chronic Pain Gynecology Needs Assessment Outpatient Clinics, Hospital Pelvic Pain Adult Catastrophization Catastrophization Catastrophization Chronic Pain Chronic Pain Chronic Pain Cohort Studies Female Humans New Zealand Pelvic Pain Pelvic Pain Pelvic Pain

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