Constellations of pain : a qualitative study of the complexity of women’s endometriosis-related pain

Introduction: Prior research into endometriosis-related pain has focused on specific aspects of the pain experience such as cyclical pain, emotional aspects of pain and certain types of pain such as dysmenorrhea and dyspareunia. However, research has paid less attention to the diversity and complexity of women’s pain experiences, which can lead to failure to recognise some symptoms as part of endometriosis and poor symptom management. Methods: We conducted qualitative semi-structured face-to-face interviews with 20 women in the United Kingdom recruited from an endometriosis self-help group with a diagnosis of endometriosis via laparoscopy. A topic guide framed questions around experiences of pain. Interviews were audio-recorded and transcribed verbatim. Transcripts were analysed using inductive thematic analysis. Results: Women experienced multiple types of pain that they felt were caused by endometriosis and affected many different parts of the body including bowel, bladder, lungs, kidneys, nerves, upper body, lower limbs and head. These pains consisted of different conceptual categories: type, pattern and intensity. These categories came together to create a complex, interrelated experience for each individual that we termed ‘constellations of pain’ because each woman had a complex set of pain categories and no two individuals appeared to have the same pain experience. Conclusion: The complexity and diversity of endometriosis-related pain found in this study has implications for improving diagnosis, medical and non-medical pain management and improving the clinical encounter between women and healthcare professionals

Prevalence of diabetes mellitus and the associated behavioral risks factors among the staff of three secondary schools in Owo, Ondo State, Nigeria

Objective: The prevalence of type 2 Diabetes is associated with significant morbidity and mortality, hence the need for early identification of risk factors. This study, therefore, aimed to determine the prevalence of diabetes mellitus and the associated behavioral risks among secondary school staff in Owo, Ondo State, Nigeria.Methods: A cross-sectional survey of 118 staff at three secondary schools in Owo was conducted using a structured interviewer-administered questionnaire. Demographic and clinical data were obtained as well as fasting or random blood glucose measurements using standard methods. Data were analyzed with SPSS version 21.0.Results: The mean age of participants was 43 ± 8 years, 59.3% were females. Type 2 Diabetes Mellitus was found in 2.8% of the participants, 18.5% were hypertensive, 22.0% were Obese while 25.4% had abdominal obesity. In all, 13.6% smoke cigarette, 35.6% drank alcohol, 49.2% does not add at least a spoonful of vegetable to their meals, 27.1% does not engage in physical exercise while 78.0% do not eat fruits at least once a day. About 58.4% of the respondents had at least one risky behaviour. More male respondents (22.9%) had a self-perceived risk of Diabetes Mellitus (p=0.001), 40.0% of female respondents had abdominal obesity (p<0.001). Correlation (r=0.347) exist between Waist/Hip ratio and random blood glucose, (p=0.012)Conclusion: Despite low prevalence of diabetes mellitus, many had at least one risky behaviour. Intensifying efforts on educating the general population on the risk factors for Diabetes Mellitus and lifestyle modification is important.Keywords: Diabetes Mellitus, behavioural risk factors, lifestyle, blood pressure, obesit