| Many women with chronic pelvic pain (CPP) find themselves on a seemingly never-ending "medical merry-go-round" of diagnosis, referral, and treatments that seldom bring them relief. The primary aims of this dissertation research were to develop a theory of coping among women with CPP and to develop the groundwork of an integrated model of CPP in women. The main research question for this dissertation was, How do women with CPP cope with pain and pain-related stress? The researcher employed the grounded theory method to address this central research question within a mixed-methods study design. Sources of data included two sets of interviews with 14 women with CPP and daily tracking forms completed over the course of one menstrual period (or 30 days). The interviews and tracking forms included quantitative measures that yielded data on sense of meaning in life, pain levels, coping efforts, and stressors. Descriptive statistics and descriptions of the data provided an overview of the challenges and coping efforts that the research participants employed and informed the development of the grounded theory. The researcher identified physical, social, cultural, mental, existential, and spiritual dimensions of a core coping process---building self-determination. All of the research participants built self-determination in at least one of these dimensions. This core coping process changed over the course of five phases of living with CPP: (a) ignoring the pain, (b) seeking clarity and lasting relief, (c) recuperating, (d) empowering oneself, and (e) accommodating the pain (with or without substantial relief). Role confusion, existential distress, and demoralization were major sources of distress among the participants. Coping resources such as self-efficacy and self-awareness were important sources of support for the research participants in their processes of building self-determination. The specific kinds of beliefs, appraisals, and meanings of the pain during each phase of living with CPP were identified and mapped onto a model of transitory coping with CPP. The discussion includes a comparison between the process of building self-determination and the construct of self-determination in the literature. The researcher made recommendations for therapeutic interventions that empower women with CPP. |
