Journal article
Believing women: a qualitative exploration of provider disbelief and pain dismissal among women with interstitial cystitis/bladder pain syndrome from the MAPP research network
International urogynecology journal, Vol.35(1), pp.139-148
01/2024
DOI: 10.1007/s00192-023-05677-0
PMCID: PMC11019919
PMID: 37991567
Abstract
INTRODUCTION AND HYPOTHESIS Although allusions to the importance of a good physician-patient relationship are present throughout the interstitial cystitis/bladder pain syndrome (IC/BPS) literature, qualitative analysis of patients' perspectives on the clinical encounter is lacking, particularly among women who are most commonly affected by IC/BPS. Therefore, we adopted a patient-centered experiential approach to understanding female patients' perception of clinical encounters .METHODS We re-analyzed previously collected data from a qualitative study on patient flare experiences including eight focus groups of female IC/BPS patients (n = 57, mean = 7/group). Qualitative analysis applied grounded theory to index all physician-patient interactions, then thematically coded these interactions to elucidate common experiences of clinical encounters.RESULTS Women with IC/BPS shared common experiences of provider disbelief and pain dismissal. Discussions with participants demonstrated the extent to which these negative encounters shape patients' health care-seeking behavior, outlook, and psychosocial well-being. Appearing in more than one guise, provider disbelief and dismissal occurred as tacit insinuations, explicit statements, silence, oversimplification, and an unwillingness to listen and discuss alternative treatment. As a result, women adopted several strategies including: rotating specialists; "testing" physicians; self-advocacy; self-management; avoiding the stigma of chronic pain; crying; and opting for alternative medicine over biomedicine.CONCLUSIONS The prevalence of provider disbelief and pain dismissal among women with IC/BPS indicates a need to improve physician-patient communication, informed by the struggles, anxieties, and gendered inequities that female patients with chronic pain experience in their diagnostic journey. Results suggest that further investigation into the power dynamics of clinical encounters might be required.
Details
- Title: Subtitle
- Believing women: a qualitative exploration of provider disbelief and pain dismissal among women with interstitial cystitis/bladder pain syndrome from the MAPP research network
- Creators
- Victoria L Brown - Washington University in St. LouisAimee James - Washington University in St. LouisJean Hunleth - Washington University in St. LouisCatherine S Bradley - University of IowaJohn T Farrar - University of PennsylvaniaPriyanka Gupta - University of MichiganH Henry Lai - Washington University in St. LouisJerry L Lowder - Washington University in St. LouisRobert Moldwin - Arthur Smith Institute for UrologyLarissa V Rodriguez - Cornell UniversityClaire C Yang - University of WashingtonSiobhan Sutcliffe - Washington University in St. Louis
- Resource Type
- Journal article
- Publication Details
- International urogynecology journal, Vol.35(1), pp.139-148
- DOI
- 10.1007/s00192-023-05677-0
- PMID
- 37991567
- PMCID
- PMC11019919
- NLM abbreviation
- Int Urogynecol J
- eISSN
- 1433-3023
- Grant note
- DOI: 10.13039/100000062, name: National Institute of Diabetes and Digestive and Kidney Diseases, award: DK082370, DK082344, DK082345, DK082315, DK082316, T32DK120497
- Language
- English
- Electronic publication date
- 11/22/2023
- Date published
- 01/2024
- Academic Unit
- Epidemiology; Obstetrics and Gynecology; Urology
- Record Identifier
- 9984513362402771
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