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Supporting and Inhibiting Factors When Coping with Endometriosis From the Patients' Perspective.

ABSTRACT: Aim: Endometriosis is a chronic gynaecological disorder with manifold symptoms and psychosocial effects on the lives of affected women. The prevalence of endometriosis is estimated to be up to ten percent of women of reproductive age. As a result of its unclear aetiology, only limited treatment options are available. The treatment and care of affected women is therefore a challenge for their doctors. There is a need for healthcare services to provide affected women with support to cope with the disorder better. The aim of the study was to identify supporting and inhibiting factors on disease management to develop new support ideas. Materials and Methods: The results are based on a content analysis evaluation of text responses from 135 women with confirmed endometriosis. Open questions about disease management were posed in a patient questionnaire. A classification system was developed according to Mayrings Qualitative Content Analysis, which allowed the main topics to be identified and summarised qualitatively using a quantitative intermediate step. Results: Social support, treatment, as well as professional and healthcare system performance were found to be particularly supportive by patients. However, when questioned about inhibiting factors, healthcare system professionals and their performance were most commonly criticised. Just over 50?% of women expressed their criticism of doctors. Quality of care and empathy towards the patients were especially criticised. There is also a need for improvement with regard to communication and general support from doctors. The results illustrate the importance of doctors for women affected by endometriosis, but make it clear that there is a great need for improvement with regard to the profession. Conclusion: The results provide the first indication of problem areas in the management of endometriosis from which approaches could be developed to improve care. However, it must be pointed out that the perspective of affected women was solely investigated. For a comprehensive analysis, it would be necessary to include the perspective of care providers and the influence of society as well as the healthcare system.

SUBMITTER: Kundu S

PROVIDER: S-EPMC4461676 | biostudies-literature | 2015 May

REPOSITORIES: biostudies-literature

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Supporting and Inhibiting Factors When Coping with Endometriosis From the Patients' Perspective.

Kundu S S Wildgrube J J Schippert C C Hillemanns P P Brandes I I

Geburtshilfe und Frauenheilkunde 20150501 5

<b>Aim:</b> Endometriosis is a chronic gynaecological disorder with manifold symptoms and psychosocial effects on the lives of affected women. The prevalence of endometriosis is estimated to be up to ten percent of women of reproductive age. As a result of its unclear aetiology, only limited treatment options are available. The treatment and care of affected women is therefore a challenge for their doctors. There is a need for healthcare services to provide affected women with support to cope wi ...[more]

PMID: 26097250

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Project description:A large number of studies suggest that humor is associated with mental well-being and effective as a means of coping. However, it is less well-understood which mechanisms are effective for this particular function of humor. The present study examines whether processes of change of perspective, which are often regarded as constitutive for humor, could be an effective coping-factor when facing unrequited love as a specific psychological burden. In a questionnaire study, N = 148 persons aged 18-65 years (w = 96) with actual or past experiences of unrequited love reported on their subjective burden due to this experience, their self-esteem and satisfaction with life, two scales for humor (Multidimensional Sense of Humor Scale: MSHS, and a self-constructed scale: Humorous Change of Perspective, HCOP) and a coping scale which measure change of perspective in the confrontation with goal blockages (Flexible Goal Adjustment, FGA). Results indicated that the burden of unrequited love [operationalized objectively as actuality of experience (dichotomous) or subjectively as burden experienced] and both indicators of well-being were negatively associated. Multiple regression analyses showed that humor was a significant moderator of this relationship in nearly all combinations of operationalizations of humor and indicators of well-being: Higher levels of humor are associated with better well-being even when the perceived burden was high. In addition, the study examined whether the coping effect of humor can be partly or mainly attributed to the individual's capacity to perspective change as captured by FGA. When including this scale as a covariate in the regression models, the moderation effect for MSHS did not persist; however, for HCOP the moderation effect remained unchanged: the moderator effect of humorous change of perspective proved to be independent of FGA. Taken together the results suggest that perspective-changing skills play a significant role in the coping effect of humor in dealing with psychological burdens. However, depending on which humor facet is measured, the entailed perspective change may or may not appear to go beyond what the individual's FGA can account for. This suggests that the coping effect caused by humorous change of perspective includes aspects that are also discussed for other coping resources as well as its own, humor-specific aspects. Potential avenues for future studies are discussed both with respect to the necessity for replication and extension of the present study and to the determination of other potential alleviativing effects of other facets of humor.

Project description:BackgroundEndometriosis is well known as a chronic inflammatory disease. The development of endometriosis is heavily influenced by the estrogen receptor β (ERβ), while NOD-like receptors (NLRs) family CARD domain-containing 5 (NLRC5) exhibits anti-inflammatory properties during endometriosis. However, whether NLRC5-mediated anti-inflammation is involved in the ERβ-mediated endometriosis is still uncertain. This study aimed to assess that relation.MethodsNine cases of eutopic endometrial tissue and ten cases of ectopic endometrial tissue were collected from patients with endometriosis, and endometrial samples from ten healthy fertile women were analyzed, and the expression levels of ERβ were quantified using immunohistochemistry (IHC). Subsequently, we constructed mouse model of endometriosis by intraperitoneal injection. We detected the expression of ERβ, NLRC5, tumor necrosis factor-alpha (TNF-α), interleukin (IL)-6, and IL-10 and measured the volume of ectopic lesions in mice with endometriosis. In vitro, human endometrial stromal cells (hESCs) were transfected respectively with ERβ-overexpressing and NLRC5-overexpressing plasmids. We then assessed the expression of ERβ and NLRC5 using quantitative real-time PCR (qRT-PCR) and western blot analysis. Furthermore, we measured the concentrations of TNF-α, IL-6, and IL-10 in the cell culture supernatant through enzyme-linked immunosorbent assay (ELISA). Additionally, we evaluated the migration and invasion ability of hESCs using transwell and wound healing assays.ResultsInhibition of NLRC5 expression promotes the development of ectopic lesions in mice with endometriosis, upregulates the expression of pro-inflammatory factors TNF-α and IL-6, and downregulates the expression of anti-inflammatory factor IL-10. The high expression of NLRC5 in endometriosis depended on the ERβ overexpression. And ERβ promoted the migration of hESCs partially depend on inflammatory microenvironment. Lastly, NLRC5 overexpression inhibited ERβ-mediated development and inflammatory response of endometriosis.ConclusionsOur results suggest that the innate immune molecule NLRC5-mediated anti-inflammation participates in ERβ-mediated endometriosis development, and partly clarifies the pathological mechanism of endometriosis, expanding our knowledge of the specific molecules related to the inflammatory response involved in endometriosis and potentially providing a new therapeutic target for endometriosis.

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Supporting and Inhibiting Factors When Coping with Endometriosis From the Patients' Perspective.

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Supporting and Inhibiting Factors When Coping with Endometriosis From the Patients' Perspective.

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