A thematic synthesis of qualitative studies and surveys of the psychological experience of painful endometriosis

Abstract Background Endometriosis is a widespread problem in women of reproductive age, causing cyclical and non-cyclical pain in the pelvis and elsewhere, and associated with fatigue, fertility problems, and other symptoms. As a chronic pain problem, psychological variables are important in adjustm...

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Main Authors: Amanda C. de C Williams, Honor McGrigor
Format: Article
Language:English
Published: BMC 2024-01-01
Series:BMC Women's Health
Subjects:
Online Access:https://doi.org/10.1186/s12905-023-02874-3
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author Amanda C. de C Williams
Honor McGrigor
author_facet Amanda C. de C Williams
Honor McGrigor
author_sort Amanda C. de C Williams
collection DOAJ
description Abstract Background Endometriosis is a widespread problem in women of reproductive age, causing cyclical and non-cyclical pain in the pelvis and elsewhere, and associated with fatigue, fertility problems, and other symptoms. As a chronic pain problem, psychological variables are important in adjustment and quality of life, but have not been systematically studied. Methods A systematic search of multiple databases was conducted to obtain surveys and qualitative studies of women’s experience of pain from endometriosis. Surveys were combined narratively; qualitative studies were combined by thematic synthesis, and the latter rated for methodological quality. Results Over 2000 records were screened on title and abstract, and provided 22 surveys and 33 qualitative studies from which accounts could be extracted of the psychological components of pain in endometriosis. Surveys mostly addressed quality of life in endometriosis, with poorer quality of life associated with higher levels of pain and of distress, but few referred to coherent psychological models. Qualitative studies focused rather on women’s experience of living with endometriosis, including trajectories of diagnosis and treatment, with a few addressing meaning and identity. Thematic synthesis provided 10 themes, under the groupings of internal experience of endometriosis (impact on body, emotions, and life); interface with the external world (through self-regulation and social regulation); effects on interpersonal and social life, and encounters with medical care. Conclusions The psychological components of pain from endometriosis only partly corresponded with standard psychological models of pain, derived from musculoskeletal pain studies, with fewer fears about physical integrity and more about difficulties of managing pain and other symptoms in social settings, including work. Better understanding of the particular psychological threats of endometriosis, and integration of this understanding into medical care with opportunities for psychologically-based pain management, would substantially improve the experience and quality of life of women with painful endometriosis.
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spelling doaj.art-d84686602567412e8b2863f3e05bbc6b2024-01-21T12:33:33ZengBMCBMC Women's Health1472-68742024-01-0124111610.1186/s12905-023-02874-3A thematic synthesis of qualitative studies and surveys of the psychological experience of painful endometriosisAmanda C. de C Williams0Honor McGrigor1Research Dept of Clinical, Educational & Health Psychology, University College LondonResearch Dept of Clinical, Educational & Health Psychology, University College LondonAbstract Background Endometriosis is a widespread problem in women of reproductive age, causing cyclical and non-cyclical pain in the pelvis and elsewhere, and associated with fatigue, fertility problems, and other symptoms. As a chronic pain problem, psychological variables are important in adjustment and quality of life, but have not been systematically studied. Methods A systematic search of multiple databases was conducted to obtain surveys and qualitative studies of women’s experience of pain from endometriosis. Surveys were combined narratively; qualitative studies were combined by thematic synthesis, and the latter rated for methodological quality. Results Over 2000 records were screened on title and abstract, and provided 22 surveys and 33 qualitative studies from which accounts could be extracted of the psychological components of pain in endometriosis. Surveys mostly addressed quality of life in endometriosis, with poorer quality of life associated with higher levels of pain and of distress, but few referred to coherent psychological models. Qualitative studies focused rather on women’s experience of living with endometriosis, including trajectories of diagnosis and treatment, with a few addressing meaning and identity. Thematic synthesis provided 10 themes, under the groupings of internal experience of endometriosis (impact on body, emotions, and life); interface with the external world (through self-regulation and social regulation); effects on interpersonal and social life, and encounters with medical care. Conclusions The psychological components of pain from endometriosis only partly corresponded with standard psychological models of pain, derived from musculoskeletal pain studies, with fewer fears about physical integrity and more about difficulties of managing pain and other symptoms in social settings, including work. Better understanding of the particular psychological threats of endometriosis, and integration of this understanding into medical care with opportunities for psychologically-based pain management, would substantially improve the experience and quality of life of women with painful endometriosis.https://doi.org/10.1186/s12905-023-02874-3Pelvic painInfertilitySocial impactQuality of lifeDelayed diagnosisTreatment failure
spellingShingle Amanda C. de C Williams
Honor McGrigor
A thematic synthesis of qualitative studies and surveys of the psychological experience of painful endometriosis
BMC Women's Health
Pelvic pain
Infertility
Social impact
Quality of life
Delayed diagnosis
Treatment failure
title A thematic synthesis of qualitative studies and surveys of the psychological experience of painful endometriosis
title_full A thematic synthesis of qualitative studies and surveys of the psychological experience of painful endometriosis
title_fullStr A thematic synthesis of qualitative studies and surveys of the psychological experience of painful endometriosis
title_full_unstemmed A thematic synthesis of qualitative studies and surveys of the psychological experience of painful endometriosis
title_short A thematic synthesis of qualitative studies and surveys of the psychological experience of painful endometriosis
title_sort thematic synthesis of qualitative studies and surveys of the psychological experience of painful endometriosis
topic Pelvic pain
Infertility
Social impact
Quality of life
Delayed diagnosis
Treatment failure
url https://doi.org/10.1186/s12905-023-02874-3
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