Effects of Patient-Provider Interactions on Diagnosis and Care for Women With Chronic Pelvic Pain: A Qualitative Study

Abstract

Background: Evidence indicates that women with chronic pelvic pain (CPP) frequently experience negative patient-provider interactions (PPIs) that contribute to diagnosis delays, comorbidity with other conditions, and psychological and socioenvironmental complications. However, specific components of PPIs and their effect on diagnosis and care for women with CPP are poorly understood. Objectives: To determine the themes and patterns of PPIs affecting health care experiences for women with CPP. Study Design: Phenomenological qualitative study using semistructured, in-depth interviews. Methods: Thirteen women, aged 18 to 65 years, with CPP for a minimum of 6 months participated. Transcribed data from standardized, in-person interviews were analyzed with qualitative analysis software to manually code thematic nodes. For interpretive phenomenological analysis, an open and inductive approach with constant comparison was used. Results: Emergent themes were consequences and effects of PPIs on health care. The described consequences of these interactions for women with CPP included increased emotional toll and decreased trust. The effects of these interactions on diagnosis and care influenced health care experiences related to information and resources provided, diagnosis, medical error (eg, misdiagnosis and inappropriate treatment), and plan (eg, treatment, management, and referral). Conclusion: Results of the current analysis demonstrated certain components of PPIs adversely affected health care experiences for women with CPP by contributing to the emotional burden of living with CPP, interfering with communication and trust between patients and providers, and impeding proper diagnosis and treatment for these patients.