Patients’ recommendations to improve help-seeking for vaginismus: a qualitative study

Abstract Background Research to improve healthcare experiences for women with vaginismus tends to be produced from the perspective of healthcare professionals or health-based researchers. There is lacking research on women’s experiences and recommendations to improve help-seeking for vaginismus from their perspective. To address this research gap, this qualitative study aimed to identify the issues that women face when help-seeking for vaginismus and their recommendations to address it. This sought to support the wellbeing of patients to advocate for their healthcare needs which is often overlooked. Methods Using a feminist theoretical approach, semi-structured interviews were conducted with 21 participants who sought help for their vaginismus. Thematic analysis was employed to analyse participants’ recommendations. Results Four main themes emerged: Increase awareness of vaginismus, Dismantle myths about sex, Destigmatise vaginismus, and Empower people with vaginismus during medical consultations. Subthemes were identified as actionable strategies that participants recommended to improve help-seeking and healthcare for vaginismus. Conclusions The findings from this study can inform healthcare practice and policy to foster better synchronicity between health professionals and their patients’ perceptions and expectations of treating vaginismus. This can promote more acceptance of patients’ advocacy of their needs and goals to improve the therapeutic alliance and treatment outcomes for vaginismus in healthcare practice. The strategies recommended to increase awareness of vaginismus and challenge its stigma should be considered in policy to incite a culture of change in healthcare practice and broader society.

摘要
背景 目前针对阴道痉挛（vaginismus）女性就医体验改善的相关研究，多从医疗从业者或健康研究人员的视角展开，而从女性自身视角出发，探讨其就医经历及优化就医途径的相关研究仍较为匮乏。为填补这一研究空白，本质性研究旨在明确女性在寻求阴道痉挛诊疗时面临的各类问题，以及她们针对该问题提出的改善建议，以期助力患者更好地维护自身健康权益，而这类权益往往易被忽视。
方法 本研究采用女性主义理论框架，对21名曾因阴道痉挛寻求医疗帮助的女性参与者开展半结构化访谈，并运用主题分析法对参与者提出的建议进行分析。
结果 研究共提炼出四大核心主题：提升阴道痉挛认知度、破除性相关认知误区、消除阴道痉挛污名化，以及在就医过程中赋能阴道痉挛患者。同时还识别出若干子主题，作为参与者提出的可落地策略，用于优化阴道痉挛患者的就医体验与医疗服务。
结论 本研究结果可为医疗实践与政策制定提供参考，助力缩小医疗从业者与患者对阴道痉挛诊疗的认知与预期差异，推动医疗场景中对患者权益主张的接纳度，进而优化医患治疗联盟，提升阴道痉挛的临床治疗效果。此外，研究提出的提升阴道痉挛认知、破除其污名化的相关策略，应纳入政策考量范畴，以推动医疗行业乃至全社会形成积极的变革文化。