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Endometriosis and Negative Perception of the Medical Profession

Published:December 18, 2019DOI:https://doi.org/10.1016/j.jogc.2019.08.034

      Abstract

      Objective

      This study sought to identify factors independently associated with a negative impression of the medical profession in patients with endometriosis who were presenting to a tertiary referral centre.

      Methods

      A cross-sectional analysis was conducted on a prospective data registry between December 2013 and June 2017 at a tertiary referral centre for pelvic pain and endometriosis. The main outcome variable, negative impression about the medical profession, was measured with the four-item subscale of the Endometriosis Health Profile-30 and divided into three groups: no (0), some (1–8), and many (9–16) negative impressions. Patients with a surgical and histological diagnosis of endometriosis were included. Postmenopausal women were excluded. Bivariate analyses determined significant associations (P < 0.05) between variables from the registry and the main outcome. Variables with a significant association were put into ordinal logistic regression with sequential backwards elimination.

      Results

      Negative impression of the medical profession was independently associated with previous surgery that did not help symptoms (adjusted odds ratio [aOR] 1.77; 95% confidence interval [CI] 1.09–2.87; P = 0.021), presentation to an emergency room in the past 3 months (aOR 1.90; 95% CI 1.17–3.07; P = 0.009), and previous visits to a complementary health care provider (aOR 2.16; 95% CI 1.42–3.29; P < 0.0005), while controlling for an endometriosis pain-related morbidity composite variable.

      Conclusion

      Negative perception of the medical profession in women with endometriosis was associated with surgical treatment failure, emergency room use, and accessing complementary health care. Each identified factor offers an opportunity for intervention to improve the perception of the medical profession among women with endometriosis.

      Résumé

      Objectif

      L’étude visait à établir les facteurs indépendamment liés à une impression défavorable de la profession médicale chez des patientes atteintes d'endométriose qui ont été traitées dans un centre régional tertiaire.

      Méthodologie

      Une analyse transversale a été réalisée à partir d'un registre prospectif de données recueilles sur la douleur pelvienne et l'endométriose entre décembre 2013 et juin 2017 au sein d'un centre régional tertiaire. Le principal critère de jugement, à savoir l'impression défavorable de la profession médicale, a été évalué au moyen de la sous-échelle à quatre questions de l'EHP-30 (Endometriosis Health Profile). Les résultats ont ensuite été divisés en trois groupes : aucune impression défavorable (0), une certaine impression défavorable (1–8) et une forte impression défavorable (9–16). L’étude portait sur les patientes ayant reçu un diagnostic chirurgical et histologique d'endométriose; les femmes ménopausées ont toutefois été exclues. Des analyses bivariées ont établi des associations significatives (P < 0,05) entre les variables du registre et le critère de jugement principal. Les variables liées à une association significative ont été classées en fonction d'un modèle de régression logistique ordinale au terme d'une élimination régressive séquentielle.

      Résultats

      L'impression défavorable de la profession médicale était indépendamment liée à une intervention chirurgicale antérieure n'ayant pas aidé à atténuer les symptômes (rapport de cotes ajusté [RCa] : 1,77; intervalle de confiance [IC] de 95 % : 1,09–2,87; P = 0,021), à une visite à l'urgence dans les 3 derniers mois (RCa : 1,90; IC de 95 % : 1,17–3,07; P = 0,009) et à des consultations antérieures auprès d'un fournisseur de soins de santé complémentaires (RCa : 2,16; IC de 95 % : 1,42–3,29; P < 0,0005), tout en prenant en compte la variable composite de morbidité liée à la douleur causée par l'endométriose.

      Conclusion

      La perception défavorable de la profession médicale chez les femmes atteintes d'endométriose était liée à l'inefficacité du traitement chirurgical, aux visites à l'urgence et à l'accès à des soins de santé complémentaires. Chaque facteur relevé offre l'occasion d'agir pour améliorer la perception de la profession médicale chez les femmes atteintes d'endométriose.

      Key Words

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      Linked Article

      • Erratum
        Journal of Obstetrics and Gynaecology Canada Vol. 42Issue 8