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.