Chronic pelvic pain portraits: perceptions and beliefs of 80 women

João Elias De Godoi,José Miguel De Deus,Dário Rafael Macêdo Dos Reis,Jakeline Resende Carvalho

doi:10.5935/2595-0118.20190003

Abstract

ABSTRACT BACKGROUND AND OBJECTIVES: Because of its expressive prevalence and difficult clinical management, chronic pelvic pain is an important cause of morbidity, disability, and reduction of quality of life in women. Psychological factors influence the perception of pain and can interfere in the medical approach, justifying the application of projective tools, such as the pain portrait, previously not applied in women with chronic pelvic pain. The objective of this study was to obtain a greater clarification about the psychological component in the assessment of the chronic pelvic pain by applying the pain portrait in women with chronic pelvic pain. METHODS: This is an exploratory cross-sectional study conducted with 80 women with chronic pelvic pain. It was applied a pre-structured interview to collect sociodemographic, behavioral and clinical data. The pain portrait was applied to investigate the perceptions and beliefs about pain. The drawings were classified by content analysis and consensus among the authors. RESULTS: The average age of the participants was 39.40±9.21 years, average pain intensity of 7.03±2.58 and average pain duration of 8.84±7.65 years. The main portraits referred to negative feelings (37.50%), harmful instruments (33.75%) and geometric forms (25%), with a predominance of cold colors (63.70%). More than 60% of the participants put hope only in medical procedures, while 25% believed that there was no solution to their pain. CONCLUSION: Women represented their chronic pelvic pain in an affective way, with the use of few and cold colors. They considered themselves having a passive role in their treatment and related their pain to family losses.

Highlights

Chronic pelvic pain (CPP) is understood as a continuous or intermittent non-menstrual pain, lasting for six months or more, located in the lower or pelvic abdominal region, interfering in daily activities and requiring clinical or surgical intervention[1,2]. It is an important cause of morbidity, functional disability and reduction of women’s quality of life (QoL)[3,4,5,6], involving 5.7 to 26.6% of women worldwide[7]
The objective of this study was to clarify the influence of the psychological component in the evaluation of the CPP by analyzing its graphic expression in women with CPP and investigating their perceptions and beliefs about pain
The mean pain intensity was 7.03±2.58 by visual analog scale (VAS); mean duration of 8.84±7.65 years, and in 72.50% of cases, it worsened with menstruation

Summary

Introduction

Chronic pelvic pain (CPP) is understood as a continuous or intermittent non-menstrual pain, lasting for six months or more, located in the lower or pelvic abdominal region, interfering in daily activities and requiring clinical or surgical intervention[1,2] It is an important cause of morbidity, functional disability and reduction of women’s quality of life (QoL)[3,4,5,6], involving 5.7 to 26.6% of women worldwide[7]. A great example of this is the artist Magdalena Carmen Frieda Kahlo y Calderón, who portrayed in her paintings a personal and unique vision of chronic pain, composing a visual narrative with diagnostic and therapeutic potential[16] In this context, Loduca and Samuelian[15] reported the development of the Portrait of Pain (PoP) in 1998, a projective resource in which the patient uses creativity to translate his/her pain in the form of a drawing.

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