The British journal of general practice : the journal of the Royal College of General Practitioners最新文献

{"title":"Exploring GPs' prioritisation dilemmas - 'quick wins' versus 'eating the frog': a qualitative study in primary care.","authors":"Andrew McClarey, Agata Dunsmore, Duncan McNab, Samantha Eve Smith","doi":"10.3399/BJGP.2025.0628","DOIUrl":"10.3399/BJGP.2025.0628","url":null,"abstract":"<p><strong>Background: </strong>Prioritisation is an increasing part of a GP's workload, although learning this skill is usually left to on-the-job training. Little is known about how experienced GPs prioritise their workload.</p><p><strong>Aim: </strong>To explore the factors that experienced GPs consider when prioritising their acute workload.</p><p><strong>Design and setting: </strong>This qualitative research study used focus groups of GP educators based in central Scotland to explore the factors that they consider when prioritising their acute workload.</p><p><strong>Method: </strong>Participants were recruited through convenience sampling. The key inclusion criterion was being involved in the supervision of GP registrars. Five focus groups were carried out, and transcripts were analysed using reflexive thematic analysis to identify the dilemmas that GPs face when prioritising their workload.</p><p><strong>Results: </strong>Thirty-nine participants took part. The following five themes emerged from the data: 1) system awareness and adapting to demand, whereby GPs maintain an awareness of their work system and adapt their consultation style to demand; 2) time management, which is where they make decisions in an order that manages their time efficiently; 3) familiarity with patients, which enables them to make quick decisions about patient care, although this can lead to bias in decision making; 4) relationships, whereby they rely on their therapeutic relationships with patients and working relationships with colleagues when making decisions; 5) personal preferences, which are important such as managing the simplest or the most complex presentations first.</p><p><strong>Conclusion: </strong>Prioritisation is an increasingly important skill in modern general practice. It is crucial that those involved in prioritisation are given the time and tools necessary to adequately develop this skill.</p>","PeriodicalId":520790,"journal":{"name":"The British journal of general practice : the journal of the Royal College of General Practitioners","volume":" ","pages":"e763-e770"},"PeriodicalIF":5.2,"publicationDate":"2026-08-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147611613","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Eczema, acne, and psoriasis in people with skin of colour: a qualitative UK-based study.","authors":"Eliza J Hutchison, Roxanne M Parslow, Hannah E Wainman, Matthew J Ridd","doi":"10.3399/BJGP.2025.0720","DOIUrl":"10.3399/BJGP.2025.0720","url":null,"abstract":"<p><strong>Background: </strong>Inflammatory dermatoses have a varied prevalence and appearance in diverse skin tones. The underrepresentation of people with skin of colour in medical education and clinical trials is widely acknowledged. However, there has been limited research on experiences from a patient perspective.</p><p><strong>Aim: </strong>To explore the experiences of eczema, acne, and psoriasis in adults with skin of colour in the UK.</p><p><strong>Design and setting: </strong>This was a qualitative study of 20 people in the UK with eczema, acne, and psoriasis and skin of colour, recruited using online methods.</p><p><strong>Method: </strong>Participants took part in online, one-to-one, semi-structured interviews. NVivo qualitative data analysis software was used to code and organise the data. Reflexive thematic analysis was used to generate themes using an iterative approach.</p><p><strong>Results: </strong>Participants were mostly female (65%, 13/20), Asian/Asian British ethnicity (45%, 9/20), and had eczema (55%, 11/20). We identified eight themes: delayed or missed diagnosis; preferences regarding healthcare professionals; lack of online information and social media use; misunderstanding in cultural communities; concerns about treatment and lack of research in skin of colour; complementary medicine use; experiences and impact of dyspigmentation; and challenges with structural racism.</p><p><strong>Conclusion: </strong>The themes generated highlight the unique experiences and challenges faced by UK adults with eczema, acne, and psoriasis. The findings can help guide diagnostic approaches, culturally sensitive communication, and treatment discussions for patients with skin of colour. Further research is needed in this underrepresented group.</p>","PeriodicalId":520790,"journal":{"name":"The British journal of general practice : the journal of the Royal College of General Practitioners","volume":" ","pages":"e693-e703"},"PeriodicalIF":5.2,"publicationDate":"2026-08-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147439180","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Association of the NHS Health Check with all-cause mortality: a longitudinal cohort study in primary care.","authors":"Jasjot Saund, Hiten Dodhia, Jacopo Vanoli, Pierre Masselot, Stephen O'Neill","doi":"10.3399/BJGP.2025.0451","DOIUrl":"10.3399/BJGP.2025.0451","url":null,"abstract":"<p><strong>Background: </strong>Cardiovascular disease (CVD) prevention is a policy priority because of widening inequalities and increasing preventable deaths. The NHS Health Check (NHS-HC) programme aims to promote early detection and prevention of CVD but has a wider-reaching impact owing to targeting multiple risk factors. Although programme evaluations demonstrate improvements in detection and surrogate markers, research on mortality outcomes remain limited, particularly using representative, real-world data.</p><p><strong>Aim: </strong>To evaluate the effectiveness of NHS-HCs in reducing all-cause mortality.</p><p><strong>Design and setting: </strong>Longitudinal cohort study in an inner-city London borough.</p><p><strong>Method: </strong>Data from electronic primary care records were analysed for 158 645 eligible participants (2009-2023). Survival was modelled using a Cox proportional hazards model with time-varying exposure. All-cause mortality risk was compared between those attending ≥1 NHS-HC (<i>n</i> = 42 589) and those who did not (<i>n</i> = 116 056). Sociodemographic, geographic, and behavioural factors were adjusted using propensity score weighting.</p><p><strong>Results: </strong>Of the 158 645 participants, 63 347 (39.9%) were of Black, Asian, mixed, or other ethnicity, and 100 825 (63.6%) lived in the two most deprived quintiles in England. Attendance at ≥1 NHS-HC was associated with lower mortality (adjusted hazard ratio 0.68, 95% confidence interval = 0.63 to 0.74), indicating a 32% reduction in risk. Ten-year absolute mortality risk reduction increased with age, with the largest difference among those aged 70-74 years (18.1% versus 12.9%). Sensitivity analyses supported these findings.</p><p><strong>Conclusion: </strong>This study suggests significant long-term survival benefit associated with the NHS-HC, supporting continued investment in and optimisation of the programme to provide population health benefits. Findings were robust to missing data assumptions and COVID-19, although residual confounding cannot be ruled out.</p>","PeriodicalId":520790,"journal":{"name":"The British journal of general practice : the journal of the Royal College of General Practitioners","volume":" ","pages":"e724-e733"},"PeriodicalIF":5.2,"publicationDate":"2026-08-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147611627","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Investigating the conditions in which women GPs thrive in general practice: a realist review.","authors":"Ruth Abrams, Vickie Williams, Sophie Park, Su Golder, Aaliya Goyal, Lilith Whiley, Laura Jefferson","doi":"10.3399/BJGP.2025.0785","DOIUrl":"10.3399/BJGP.2025.0785","url":null,"abstract":"<p><strong>Background: </strong>Women GPs experience higher rates of burnout, anxiety, depression, and slower career progression than men GPs. Women GPs are sought out by patients for specific conditions, which may increase consultation length. This can be a source of job satisfaction for some. However, it can also contribute to additional exhaustion and affects career progression, meaning women GPs are at higher risk of leaving the profession. There is an urgent need to identify solutions to retain and support them.</p><p><strong>Aim: </strong>This review brings together a wide range of evidence to identify the conditions in which women GPs can thrive, to better support them at work.</p><p><strong>Design and setting: </strong>An international realist review of academic and grey literature was conducted across eight databases and Google Scholar.</p><p><strong>Method: </strong>Following a realist approach, supported by stakeholder and patient involvement, a range of published documents were analysed using a realist logic to identify how, why, for whom, and in what circumstances women GPs thrive at work.</p><p><strong>Results: </strong>A total of 72 documents are included in this review. Sixteen configurations describe the conditions in which women GPs can thrive. Results cover the following three concepts: patient-facing work; navigating competing roles; and sustainable careers, leadership, and success. However, literature also places heavy reliance on encouraging women GPs to 'fix' their own circumstances.</p><p><strong>Conclusion: </strong>This review provides evidence-based recommendations that may be of interest to those responsible for organisational culture within general practices, including (but not limited to) GP partners, and women GPs, who can utilise the recommendations to influence change.</p>","PeriodicalId":520790,"journal":{"name":"The British journal of general practice : the journal of the Royal College of General Practitioners","volume":" ","pages":"e751-e762"},"PeriodicalIF":5.2,"publicationDate":"2026-08-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147848228","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Disparities in the uptake of learning disability annual health checks: a secondary analysis of primary care data.","authors":"Daniel Sutherland, Benjamin Costello, Umesh Chauhan, Samantha Flynn, Kylie M Gray, Joanne Parsons, Rachel Spencer, Hayley Crawford","doi":"10.3399/BJGP.2026.0116","DOIUrl":"10.3399/BJGP.2026.0116","url":null,"abstract":"<p><strong>Background: </strong>People with intellectual disabilities (referred to as learning disabilities in the UK) face considerable health inequalities. One attempt to address these in England has been through incentivising general practices to complete annual health checks with people with a learning disability aged ≥14 years.</p><p><strong>Aim: </strong>To examine recent trends in learning disability registers and the uptake of learning disability annual health checks in England.</p><p><strong>Design and setting: </strong>Secondary analysis of publicly available general practice data.</p><p><strong>Method: </strong>NHS England data relating to the learning disabilities annual health check scheme from January 2022 to November 2025 were compiled and analysed.</p><p><strong>Results: </strong>The number of 14-17-year-olds and adults on learning disability registers increased during this period by 30.49% and 14.53%, respectively. The most recent estimates indicate that around 0.588% (<i>n</i> = 374 763/63 766 671) of patients are on learning disability registers, with approximately 0.526% (<i>n</i> = 355 102/63 654 156) aged ≥14 years and eligible for annual health checks. The uptake of annual health checks increased slightly from 68.08% (<i>n</i> = 15 940/23 414) to 71.58% (<i>n</i> = 19 217/26 846) among 14-17-year-olds, and from 79.07% (<i>n</i> = 226 701/286 714) to 80.71% (<i>n</i> = 248 449/307 827) among adults. Uptake was lowest in the South West and East of England, and highest in London, but was similar across deciles of patient deprivation and practice size.</p><p><strong>Conclusion: </strong>Ascertainment of people with a learning disability by primary care services appears to be improving but remains between one-third and one-quarter of prevalence estimates. The uptake of annual health checks among 14-17-year-olds continues to lag behind that of adults.</p>","PeriodicalId":520790,"journal":{"name":"The British journal of general practice : the journal of the Royal College of General Practitioners","volume":" ","pages":"e734-e741"},"PeriodicalIF":5.2,"publicationDate":"2026-08-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148379600","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"General practice closures or mergers: a survival analysis of contributing practice factors.","authors":"Joseph Hutchinson, Michael Anderson, Rita Santos, Evangelos Kontopantelis, Matt Sutton","doi":"10.3399/BJGP.2026.0126","DOIUrl":"10.3399/BJGP.2026.0126","url":null,"abstract":"<p><p>Background 20% of general practices in the England have closed or merged since 2013. Little is known about factors that are associated with these closures, despite evidence on their negative impacts. Understanding these risks is important for recovering general practice. Aim Describe how differences in the patient mix, practice location, workforce, funding and quality are associated with the future risk of closure Design and Setting Multilevel survival analysis of all general practices in England. Method All practices open on 1st April 2019 were followed until 1st April 2025 or closure. We gathered data on practice population characteristics, workforce, funding and quality. Cox proportional hazards models were used to analyse how these measures were associated with time to closure. Results Practice contract type and geographic location (region and rurality) were key factors associated with closures or mergers. For example, rates ranged from 3.7% to 19.7% by geographic region. Greater risk was associated with smaller practices, with a practice at the 10th percentile (3,032 patients) having 253% (95% CrI: 200%, 312%) higher risk of closure or merger than the median (7,256 patients). Greater risk of closure or merger was associated with losing or failing to gain patients (hazard ratio v medium increase 1.68 (95%CrI: 1.44, 1.96), lower baseline funding, poorer clinical quality, higher socioeconomic deprivation and certain contract types, but not the supply of general practitioners or nurses. Conclusion The practice contract, relevant region, practice list size, funding and quality are key hazards for the subsequent closure or merger of general practices.</p>","PeriodicalId":520790,"journal":{"name":"The British journal of general practice : the journal of the Royal College of General Practitioners","volume":" ","pages":""},"PeriodicalIF":5.2,"publicationDate":"2026-08-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148690759","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Patients' perceptions of hand osteoarthritis care in Dutch general practice.","authors":"Onur Kaya, Emma van Baalen, Rob Strijkers, Margreet Kloppenburg, Ruud Selles, Sita Bierma-Zeinstra, Dieuwke Schiphof","doi":"10.3399/BJGP.2025.0768","DOIUrl":"https://doi.org/10.3399/BJGP.2025.0768","url":null,"abstract":"<p><p>Background Hand osteoarthritis (OA) is the second most prevalent form of OA, often associated with pain, reduced function, and diminished quality of life. Despite its prevalence, patients frequently report unmet needs in primary care, where the condition is typically managed.AimTo explore patient perspectives on the management of hand OA in primary care, and identify key barriers and facilitators to care.Design and Setting A qualitative study based on semi-structured interviews with hand OA patients in the Netherlands.Method Semi-structured interviews were conducted with 16 patients using a framework-based interview guide. Patients were recruited through purposive sampling. Thematic analysis identified key themes. Respondent validation was performed via a follow-up questionnaire completed by 51 patients.ResultsSeven barriers and three facilitators were found. The quality of guidance provided by the GP, the availability of information and explanation about hand OA, and the perceived effectiveness of treatment were described as barriers when insufficient and facilitators when adequate. Other barriers included a demotivating attitude toward hand OA, poor collaboration between healthcare providers, perceived limited treatment options, and patient reluctance to pursue certain treatments.ConclusionHand OA patients face several barriers in primary care, many related to GP communication, support, and coordination. Patients desire an engaged GP who offers practical tools and guidance for managing their condition in daily life. To support GPs in this role, improved training, clearer clinical guidelines, and accessible patient education resources are needed. These measures can enable proactive, patient-centred care and improve outcomes for people with hand OA.</p>","PeriodicalId":520790,"journal":{"name":"The British journal of general practice : the journal of the Royal College of General Practitioners","volume":" ","pages":""},"PeriodicalIF":5.2,"publicationDate":"2026-08-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148820692","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Understanding risk stratification of chronic kidney disease: a qualitative study in primary care.","authors":"Kristin Veighey, Emma Teasdale, Michelle Myall, Kate Henaghan-Sykes, Thomas Blakeman, Kinda Ibrahim, Bhargav Raut, Hazel Everitt, Simon Ds Fraser","doi":"10.3399/BJGP.2025.0802","DOIUrl":"10.3399/BJGP.2025.0802","url":null,"abstract":"<p><strong>Background: </strong>Chronic kidney disease (CKD) affects approximately 10% of adults in England. Of these adults, approximately 1% progress to kidney failure with a significant impact on health-related quality of life and high healthcare costs. CKD is associated with increased cardiovascular disease risk. New therapies to improve outcomes highlight the need for effective risk stratification.</p><p><strong>Aim: </strong>To explore primary care teams' views and experiences of CKD risk stratification.</p><p><strong>Design and setting: </strong>Qualitative interview and focus group study with GP practices in South England, South London, and Yorkshire.</p><p><strong>Method: </strong>Twenty-six semi-structured interviews with GPs, pharmacists, and practice nurses, and four focus groups (31 participants) with practice teams including clinical, administration, and management staff were undertaken between January 2024 and January 2025 across 20 practices, informed by normalisation process theory, using thematic analysis.</p><p><strong>Results: </strong>We identified four key themes: 1) awareness of diagnostic criteria and risk- stratification tools, 2) value of coding CKD and discussion of risk, 3) barriers to CKD risk stratification, 4) improving CKD risk stratification. Despite universal awareness of diagnostic criteria, there was low awareness of risk-stratification tools. Coding was perceived as valuable for health professionals but not for patients. Concerns included increasing patient anxiety and overmedicalisation. Time pressures and lack of incentivisation were perceived as key barriers. Improved healthcare professional education, guidelines, pathways, and technology/automation were highlighted as areas of potential improvement.</p><p><strong>Conclusion: </strong>Primary care awareness of CKD is high, but workload, time pressures, and concerns regarding patient anxiety/overmedicalisation may contribute to incomplete risk stratification. Refining processes and effective patient communication could improve care.</p>","PeriodicalId":520790,"journal":{"name":"The British journal of general practice : the journal of the Royal College of General Practitioners","volume":" ","pages":""},"PeriodicalIF":5.2,"publicationDate":"2026-08-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147701808","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Online triage and cancer diagnostic activity in general practice: a cross-sectional study.","authors":"Armina Paule, Helen Atherton, Joanne Parsons, Louise Hiller, Gary Abel","doi":"10.3399/BJGP.2025.0735","DOIUrl":"10.3399/BJGP.2025.0735","url":null,"abstract":"<p><strong>Background: </strong>Patient-facing online triage tools potentially offer GPs a way to recognise cancer-related symptoms and features to facilitate appropriate suspected cancer referrals. Little is known about their impact on cancer diagnostic process and outcomes.</p><p><strong>Aim: </strong>To describe patterns of cancer outcome and process indicators associated with the use of online triage tools in primary care.</p><p><strong>Design and setting: </strong>This cross-sectional study examined the association between publicly reported practice-level data on 3053 English general practices. An online triage tool was used that linked to practice-level data and 31 233 594 triage forms completed using an online triage tool in 2022-2023.</p><p><strong>Method: </strong>A cross-sectional analysis (mixed-effects regression) was conducted to evaluate the association between the annual rate of eConsult forms received (weighted to practice registrations) and various cancer diagnosis process and outcome measures.</p><p><strong>Results: </strong>Increased use of online triage forms was associated with higher rates of urgent suspected cancer (USC) referrals and investigations; for example, there was a 7.75% difference in colonoscopy rate (95% confidence interval [CI] = 3.83% to 8.98%) across the 90% mid-range of practices. Despite this, there was no evidence of an association with USC referrals resulting in diagnosis or emergency presentations.</p><p><strong>Conclusion: </strong>Greater use of online triage forms is associated with more investigations and referrals for suspected cancer, but not associated with better diagnostic outcomes. This may indicate that any additional referrals are of lower quality and overall there is an increase in inappropriate use of USC referrals. Research is needed to understand how this impacts investigations and referrals for individual patients.</p>","PeriodicalId":520790,"journal":{"name":"The British journal of general practice : the journal of the Royal College of General Practitioners","volume":" ","pages":""},"PeriodicalIF":5.2,"publicationDate":"2026-08-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148146089","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Understanding chronic pelvic pain in women survivors of sexual violence: a qualitative study.","authors":"Catherine Mccarter, Amanda C de C Williams","doi":"10.3399/BJGP.2026.0057","DOIUrl":"https://doi.org/10.3399/BJGP.2026.0057","url":null,"abstract":"<p><strong>Background: </strong>Chronic pelvic pain (CPP) affects an estimated 14.8% of UK women. Survivors of sexual violence are more likely to experience CPP, but the relationship is complex and underexplored. Shame and stigma from both experiences may interact and influence help-seeking.</p><p><strong>Aims: </strong>To broaden understanding of how women survivors of sexual violence make personal meaning of CPP, and to consider clinical implications of findings.</p><p><strong>Design & setting: </strong>A qualitative study of UK community-recruited women who have survived sexual violence and who experience chronic pelvic pain (CPP).</p><p><strong>Method: </strong>Ten participants were recruited via social media and engaged in individual, semi-structured online interviews about their experiences and understandings of sexual violence and CPP. Interviews were transcribed verbatim and analysed using reflexive Thematic Analysis.</p><p><strong>Results: </strong>Three main themes were developed: (1) Healthcare professionals' attempts to silence women, who felt ignored, disbelieved or dismissed; (2) Treating the whole woman, describing the need for integrated, biopsychosocial approaches; and (3) A woman's place is in the resistance, highlighting women's active efforts to reclaim their narratives and pursue care. Shame was compounded across experiences, and women expressed frustration with fragmented care and assumptions about the psychological origins of pain.</p><p><strong>Conclusions: </strong>These results give insights into the complex meanings women survivors of sexual violence hold about their CPP, and how healthcare systems could better support them to explore and respond to those meanings. The aim should be compassionate care that recognises the complex biopsychosocial impact of sexual violence and CPP, while keeping women in control of their own care.</p>","PeriodicalId":520790,"journal":{"name":"The British journal of general practice : the journal of the Royal College of General Practitioners","volume":" ","pages":""},"PeriodicalIF":5.2,"publicationDate":"2026-08-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148714978","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}