Persistent pelvic pain affects up to 25% of women (1) and 8% of men (2) and is a significant global health problem. Persistent pelvic pain is a complex condition often influenced by psychological factors that can alter treatment outcomes. These factors are potentially modifiable; however, currently there is no instrument to screen for them in these individuals. The purpose of this study was to firstly determine which psychological factors should be screened in individuals with persistent pelvic pain and secondly, the most appropriate statements to represent these psychological factors.

The study was conducted in two parts. Part one involved a comprehensive literature review followed by a focus group consisting of 8 experts across the fields of Physiotherapy, Medicine and Psychology, with the aim of determining the relevant psychological factors that should be screened for. The results from the focus group informed round 1 of the e-Delphi process.

Part two of the study was an e-Delphi panel. The panel was comprised of 14 pain/pelvic pain experts across the areas of Physiotherapy, Medicine and Psychology. The e-Delphi process consisted of 3 rounds of online surveys and 2 teleconference discussions to establish consensus on the most appropriate statement to screen for each of the psychological factors. These statements were taken directly from screening tools and questionnaires that have already been validated and are widely used in clinical practice.

At the end of e-Delphi process 13 relevant psychological factors were identified as most important in persistent pelvic pain conditions. During the e-Delphi process, relevant screening statements were assessed using a 100-point allocation system. Experts could also reword and suggest new statements. Statements were assessed for consensus and stability and were eliminated as the rounds progressed if they met the exclusion criteria. At the termination of round 3, there were 15 statements remaining across the 13 psychological factors including; Catastrophisation (Helplessness, Rumination, Magnification), Fear, Avoidance, Self-Efficacy, Depression, Anxiety, Hypervigilance, Health Anxiety, Sexual Assertiveness, Stress and Trauma.

The final list of 15 statements will assist clinicians in screening for psychological factors and is an important step for clinicians in providing psychologically informed care to people with persistent pelvic pain. Future research should determine the psychometric properties of the statements to determine their clinical utility as a questionnaire.

This study has refined a list of statements to help screen for psychological factors in individuals with persistent pelvic pain. Developed robustly using an e-Delphi method, this list is an important first step forward for clinicians to provide psychologically informed care to these individuals.

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