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"I Will Try to Fix You": A Qualitative Investigation on Italian Women Struggling With Chronic Pelvic Pain
Fabio Bernardi1, Nadia Laterza1, Michele Marelli1
1Department of Medicine and Health Science "Vincenzo Tiberio", University of Molise, c/o Cardarelli Hospital, Campobasso, Italy.
Objectives:
To explore how Italian women with chronic pelvic pain (CPP) describe and interpret clinicians' language, assessment and treatment recommendations, and how these perceived encounters may relate to meaning-making, activity behaviors, and expectations of rehabilitation.
Design:
Qualitative observational study using semi-structured one-to-one online interviews. Interviews were audio-video recorded, transcribed verbatim, pseudonymized, and analyzed using inductive, semantic, and reflexive thematic analysis.
Setting:
Online interviews conducted in Italy. Participants described experiences across routine healthcare encounters; no single clinical center was involved.
Participants:
Adult Italian women reporting a specialist diagnosis of CPP consistent with ICD-11 were eligible. Twenty-one women were recruited and completed the study.
Interventions:
No experimental intervention was delivered. The study examined participants' experiences of usual care, including prior clinical assessment, treatment, and rehabilitation recommendations.
Main Outcome Measures:
The primary outcome was the identification of themes representing how participants interpreted and responded to clinicians' explanations and management approaches. Supporting descriptive measures included the Numeric Pain Rating Scale (NPRS), Örebro short form, and Pain and Psychological Inflexibility in Pain Questionnaire (PPIQ).
Results:
Twenty-one women (mean age 30.47 years) reported high symptom burden and psychosocial risk (mean NPRS 6.8; mean Örebro 62.23; mean PPIQ 19.85). Four interrelated themes were generated: (1) Trigger points as the root cause of pain; (2) Need to avoid everything; (3) Diagnosis: reassurance or stigma; and (4) Manual Therapy: will it fix me? Divergent accounts indicated that clear explanations and shared decisions were described by some participants as supporting re-engagement in meaningful activities despite persistent symptoms.
Conclusions:
Women with CPP in this sample often described muscle-centered explanations and restrictive advice as influential in their understanding of pain, activity choices, and expectations of care.
