目的:综合从盆腔或阴道网片或其去除疼痛的妇女的经验,确定疼痛相关的问题,并制定疼痛的心理方面。
方法:对盆腔或阴道网眼疼痛的定性研究进行系统评价和主题分析,或网格移除,在18岁以上的女性中,使用个人访谈,焦点小组,自由文本,或对正式查询的书面或口头贡献。
方法:Medline,Embase和PsycINFO,从成立到2023年4月26日。
方法:对盆腔或阴道网片或其去除引起的疼痛和其他症状进行定性研究;成人;无语言限制。
方法:逐行编码参与者引文和一位作者的研究作者陈述,以提供另一位作者应用于一半研究的代码,并通过讨论解决差异。两位作者将代码分为子主题和主题,然后由一个网眼受伤妇女焦点小组仔细检查和讨论是否有遗漏,强调和连贯性。使用CASP和COREQ工具的合并对研究进行了评估。
结果:2292个搜索结果产生了9项符合条件的研究,有7-752名参与者,共2000年左右。四名招募的病人,四个全部或部分来自网状倡导团体,两个是国家调查(英国和澳大利亚)。四大主题如下:破碎的身体,破碎的心灵;对医生和医疗行业的不信任;破碎的生活和继续前进——改变的未来。心理内容主要涉及对医疗失去信任,让女性在面对不确定的未来时得不到支持。网眼受伤的妇女强烈赞同这一发现。
结论:对受影响的女性来说,与骨盆网眼相关的疼痛和其他问题是深刻而深远的。更糟糕的是,他们感到受到持续的煤气灯照射,包括否认他们与网格相关的问题,以及解除他们对继续插入网格的担忧。
■CRD42022330527。
OBJECTIVE: Synthesis of the experience of women with pain from pelvic or vaginal mesh or its removal, to identify pain-related problems and to formulate psychological aspects of pain.
METHODS: Systematic
review and thematic analysis of qualitative studies of pain from pelvic or vaginal mesh, or mesh removal, in women over 18 years, using individual interviews, focus groups, free text, or written or oral contributions to formal enquiries.
METHODS: Medline, Embase and PsycINFO, from inception to 26 April 2023.
METHODS: Qualitative studies of pain and other symptoms from pelvic or vaginal mesh or its removal; adults; no language restriction.
METHODS: Line-by-line coding of participant quotations and study author statements by one author to provide codes that were applied to half the studies by another author and differences resolved by discussion. Codes were grouped into subthemes and themes by both authors, then scrutinised and discussed by a focus group of mesh-injured women for omissions, emphasis and coherence. Studies were appraised using an amalgamation of the CASP and COREQ tools.
RESULTS: 2292 search results produced 9 eligible studies, with 7-752 participants, a total of around 2000. Four recruited patients, four totally or partially from mesh advocacy groups, and two were national enquiries (UK and Australia). Four major themes were as follows: broken body, broken mind; distrust of doctors and the medical industry; broken life and keeping going-a changed future. Psychological content mainly concerned the loss of trust in medical care, leaving women unsupported in facing an uncertain future. Mesh-injured women strongly endorsed the findings.
CONCLUSIONS: Pain and other problems associated with pelvic mesh are profound and far-reaching for women affected. Worse, they feel subject to continued gaslighting, including denial of their mesh-related problems and dismissal of their concerns about continued mesh insertion.
UNASSIGNED: CRD42022330527.