Lasting impressions: influence of the initial hospital consultation for chronic pelvic pain on dimensions of patient satisfaction at follow-up.

OBJECTIVE: Chronic pelvic pain (CPP) is a common condition in women, and care experiences are distressing and unsatisfactory for many. Research suggests that elements of the initial hospital consultation influence clinical outcome. This study aimed to identify the dimensions through which initial consultations were subsequently recalled at follow-up. METHOD: A questionnaire study of 100 women, 6 months following a hospital gynaecology consultation for CPP, was conducted. Measures of pain and ratings of the medical consultation were completed at initial consultation and at follow-up. RESULTS: Follow-up questionnaire items loaded to constructs of "affect", "expectation", and "cognition", forming three subscales. Patients' initial ratings of the consultation and scores on all three subscales measured at follow-up were correlated, remaining significant for both affect and expectation after controlling for current pain status. CONCLUSION: Doctor's affect and the appropriateness of information to meet expectations are important influences on experiences of care and contribute to the long-term therapeutic element of the consultation.

Chronic gynaecological pain: an exploration of medical attitudes.

Women with chronic pelvic pain experience serious distress and lifestyle disruption. Confronted with a difficult condition to diagnose and treat effectively, doctors express a negative perception of this group of 'heartsink' patients. This study aimed to characterise medical attitudes towards the treatment of women with chronic pelvic pain. Tape recorded focus group discussions with gynaecologists, general practitioners and patients were transcribed and analysed using ethnographic software to identify themes. A postal questionnaire was sent to 300 British gynaecologists of which 145 were returned (48%). Principal components analysis identified five factors accounting for 32.4% of the variance, labelled 'efficiency', 'complexity', 'socio-cultural liberalism', 'pathology' and 'communication'. Scores for 'socio-cultural liberalism' were higher among gynaecologists in the younger age groups, women, and those giving their ethnic origin as Caucasian. Scores for 'pathology' were lower among younger gynaecologists. A sex difference just failed to reach statistical significance. Multiple linear regression confirmed significant independent relationships with scores for 'socio-cultural liberalism' and respondent sex, ethnicity and age group under 38 years.