title: A meta-ethnography of patients' experiences of chronic pelvic pain: struggling to construct chronic pelvic pain as 'real'.
abstract: OBJECTIVE
  To review systematically and integrate the findings of qualitative research to increase our understanding of patients' experiences of chronic pelvic pain.
  
  
  BACKGROUND
  Chronic pelvic pain is a prevalent pain condition with a high disease burden for men and women. Its multifactorial nature makes it challenging for clinicians and patients.
  
  
  METHODS
  Synthesis of qualitative research using meta-ethnography.
  
  
  METHODS
  Five electronic bibliographic databases from inception until March 2014 supplemented by citation tracking. Of 488 papers retrieved, 32 met the review aim.
  
  
  METHODS
  Central to meta-ethnography is identifying 'concepts' and developing a conceptual model through constant comparison. Concepts are the primary data of meta-ethnography. Two team members read each paper to identify and collaboratively describe the concepts. We next compared concepts across studies and organized them into categories with shared meaning. Finally, we developed a conceptual model, or line of argument, to explain the conceptual categories.
  
  
  RESULTS
  Our findings incorporate the following categories into a conceptual model: relentless and overwhelming pain; threat to self; unpredictability, struggle to construct pain as normal or pathological; a culture of secrecy; validation by diagnosis; ambiguous experience of health care; elevation of experiential knowledge and embodiment of knowledge through a community.
  
  
  CONCLUSIONS
  The innovation of our model is to demonstrate, for the first time, the central struggle to construct 'pathological' vs. 'normal' chronic pelvic pain, a struggle that is exacerbated by a culture of secrecy. More research is needed to explore men's experience and to compare this with women's experience.
authors.affiliation: Nuffield Orthopaedic Centre, Oxford University Hospitals NHS Trust, UK.
authors.forename: Francine
authors.initials: F
authors.lastname: Toye
authors.forename: Kate
authors.initials: K
authors.lastname: Seers
authors.forename: Karen
authors.initials: K
authors.lastname: Barker
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000884:Anthropology, Cultural; D001294:Attitude to Health; D015984:Causality; D059350:Chronic Pain / Q000208:ethnology* / Q000451:nursing / Q000523:psychology*; D015897:Comorbidity; D004715:Endometriosis / Q000453:epidemiology / Q000523:psychology; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D016294:Models, Nursing; D017699:Pelvic Pain / Q000208:ethnology / Q000451:nursing / Q000523:psychology*; D011472:Prostatitis / Q000453:epidemiology / Q000523:psychology; D036301:Qualitative Research; D055815:Young Adult
keywords: chronic prostatitis with chronic pelvic pain syndrome; endometriosis; meta-ethnography; nursing; pelvic pain; qualitative research; review; systematic