Qualitative Analysis of Treatment Needs in Interstitial Cystitis/Bladder Pain Syndrome: Implications for Intervention

Lindsey C McKernan, Kemberlee R Bonnet, Michael T M Finn, David A Williams, Stephen Bruehl, W Stuart Reynolds, Daniel Clauw, Roger R Dmochowski, David G Schlundt, Leslie J Crofford, Lindsey C McKernan, Kemberlee R Bonnet, Michael T M Finn, David A Williams, Stephen Bruehl, W Stuart Reynolds, Daniel Clauw, Roger R Dmochowski, David G Schlundt, Leslie J Crofford

Abstract

Background: Interstitial cystitis/bladder pain syndrome (IC/BPS) is a debilitating condition carrying substantial psychosocial burden. Psychological treatment for IC/BPS is little studied, and there are barriers to its use in clinical management. Whether psychological treatments benefit patients with IC/BPS is unclear and we do not know if such treatments would meet patient needs.

Aims: Incorporating patient-reported needs and acknowledging diversity in pain experiences can inform patient-centered interventions for IC/BPS. This project characterized the experience of living with IC/BPS and patient perceptions of needs in its treatment, with the goal of informing patient-centered treatment for IC/BPS.

Methods: Using both quantitative and qualitative methods, 27 females with IC/BPS participated in a focus group and completed validated self-report assessments evaluating urinary symptoms, pain, and emotional functioning. Focus groups were audio recorded and transcribed, then coded and analyzed using an iterative inductive/deductive approach. Linear regression models evaluated the relationship between psychological functioning and symptom severity.

Results: We conducted six focus groups between 8/2017-12/2017. Five major themes emerged from qualitative analysis: managing physical symptoms, emotional symptoms, impact on daily life and socio-contextual factors, responding to illness, and addressing needs in treatment. The physiological and emotional consequences of IC/BPS were reported, highlighting their impact on interpersonal relationships and challenges obtaining appropriate treatment for IC/BPS. Quantitative analysis showed depression levels were significantly associated with worsened IC/BPS symptomology, after controlling for known confounding factors.

Conclusion: Individuals with IC/BPS could benefit from tailored psychological interventions focusing on pain management, emotion regulation, communications skills, along with sexual dysfunction and intimacy fears.

Keywords: Chronic; Cystitis; Depression; Evaluation; Focus Groups; Interstitial; Interstitial Cystitis; Pain; Painful Bladder Syndrome; Physiological; Qualitative; Sexual Behavior; Sexual Dysfunction.

Conflict of interest statement

Declaration of interest: Lindsey McKernan does not have any conflicts of interest, Michael Finn does not have any conflicts of interest, David Williams does not have any conflicts of interest, Kemberlee Bonnet does not have any conflicts of interest, Steven Breuhl does not have any conflicts of interest, W. Stuart Reynolds does not have any conflicts of interest, Daniel Clauw does not have any conflicts of interest, Roger Dmochowski does not have any conflicts of interest, David Schlundt does not have any conflicts of interest, and Leslie Crofford does not have any conflicts of interest.

Figures

Figure 1.
Figure 1.
Study flow figure
Figure 2.
Figure 2.
Biopsychosocial model of IC/BPS

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