Experiences of women with advanced cervical cancer before starting the treatment: Systematic review of qualitative studies.

BACKGROUND: Advanced stage and high mortality are characteristics of cervical cancer in developing countries. Comprehension of the diagnosis itinerary is one of the main strategies to control the disease impact. OBJECTIVES: To identify reasons for the delay in diagnosing symptomatic cervical cancer according to the patient's perspectives reported in qualitative studies. We searched four databases (PubMed, Embase, CINAHL, and Web of Science). SELECTION CRITERIA: We included qualitative studies of women with advanced cervical cancer that explored their experiences before treatment. We excluded unoriginal, non-qualitative, and duplicated studies. DATA COLLECTION AND ANALYSIS: We selected 39 articles for a full-text reading and included 15 in the present review. We chose the Consolidated Criteria for Reporting Qualitative Research (COREQ) for quality assessment and The Model of Pathways to Treatment to guide the codifying process. MAIN RESULTS: Four main themes emerged from the synthesis: (1) Health-seeking motivators; (2) Obstacles to seeking medical care; (3) Diagnosis delay; and (4) Coping with the disease. These themes were derived from patients' personal knowledge and beliefs, social relationships, socioeconomic status, and healthcare system characteristics. CONCLUSIONS: Individual behavior, social factors, and healthcare organization contribute to the delay in diagnosing advanced cervical cancer.

Daily life attitudes of women with moderate or severe chronic pelvic pain. A qualitative study.

OBJECTIVE: How a woman copes with the pain might play a significant role in the management of chronic pelvic pain. This study aimed to understand the attitudes adopted by women with chronic pelvic pain (CPP) to deal with daily life problems caused by the illness. STUDY DESIGN: We conducted a qualitative study including 58 women diagnosed with chronic pelvic pain regardless of the cause. To collect the data, we used semi-structured interviews with the key question: "How do you handle the pain in your daily life?". The interviews were audio-recorded and transcribed. We conducted a qualitative thematic analysis of transcribed texts following the sequence: 1) initial reading; 2) preliminary identification of codes; 3) identification of themes; 4) review of themes; 5) nominating the themes in categories; 6) final study synthesis. The analysis was performed with the aid of the RQDA package in the R environment. RESULTS: Daily life attitudes varied from submission to the pain to positive coping. We identified five major categories: 1) shaping life by pain; 2) isolating from social contact; 3) avoiding sexual relationship; 4) seeking pain relief; 5) seeking positive strategies. Positive strategies were more frequent in older women. CONCLUSION: Women with chronic pelvic pain adopted a broad spectrum of attitudes to deal with the pain in daily life. The depth understanding of patient perspectives has the potential to improve the multidisciplinary care of this debilitating condition.

Current usage of qualitative research in female pelvic pain: a systematic review.

PURPOSE: Qualitative research has received growing attention in the multidisciplinary investigation of patients' perceptions about chronic diseases. The purpose of this systematic review was to characterize the usage of qualitative research in women with chronic pelvic pain (CPP). METHODS: We performed a structured search in Web of Science, Pubmed, and EMBASE platforms until June 2019. The search combined the keywords: "pelvic pain", "endometriosis", "dyspareunia", "dysmenorrhea", "vaginismus", "focus groups", "qualitative research", "hermeneutics", "grounded theory", and "women". Qualitative studies on female CPP were included and the main findings combined using thematic synthesis. RESULTS: We found 1211 citations, of which 52 were included in this review. The majority of included studies were based on phenomenological design. The main method for data collection was semi-structured interviews. Endometriosis was the theme of 23 studies, chronic pelvic pain of eight, dysmenorrhea of eight, dyspareunia of four, interstitial cystitis of two, vaginismus of two, vulvodynia of two, and pelvic inflammatory disease of one study. We found a wide variety of contributions. Among them, the impact of the disease on women's lives was the commonest. CONCLUSION: Qualitative research has the potential to reveal and explain several aspects of CPP in women. The medical community may better accept knowledge gained from these studies if the methods are described more transparently in published articles.