Leonardi Mathew, Horne Andrew W, Vincent Katy, Sinclair Justin, Sherman Kerry A, Ciccia Donna, Condous George, Johnson Neil P, Armour Mike
Acute Gynaecology, Early Pregnancy, and Advanced Endoscopy Surgery Unit, Nepean Hospital, Kingswood, Australia.
Sydney Medical School Nepean, University of Sydney, Sydney, Australia.
Hum Reprod Open. 2020 Jun 1;2020(2):hoaa028. doi: 10.1093/hropen/hoaa028. eCollection 2020.
The care of patients with endometriosis has been complicated by the coronavirus disease 2019 (COVID-19) pandemic. Medical and allied healthcare appointments and surgeries are being temporarily postponed. Mandatory self-isolation has created new obstacles for individuals with endometriosis seeking pain relief and improvement in their quality of life. Anxieties may be heightened by concerns over whether endometriosis may be an underlying condition that could predispose to severe COVID-19 infection and what constitutes an appropriate indication for presentation for urgent treatment in the epidemic. Furthermore, the restrictions imposed due to COVID-19 can impose negative psychological effects, which patients with endometriosis may be more prone to already. In combination with medical therapies, or as an alternative, we encourage patients to consider self-management strategies to combat endometriosis symptoms during the COVID-19 pandemic. These self-management strategies are divided into problem-focused and emotion-focused strategies, with the former aiming to change the environment to alleviate pain, and the latter address the psychology of living with endometriosis. We put forward this guidance, which is based on evidence and expert opinion, for healthcare providers to utilize during their consultations with patients via telephone or video. Patients may also independently use this article as an educational resource. The strategies discussed are not exclusively restricted to consideration during the COVID-19 pandemic. Most have been researched before this period of time and all will continue to be a part of the biopsychological approach to endometriosis long after COVID-19 restrictions are lifted.
2019年冠状病毒病(COVID-19)大流行使子宫内膜异位症患者的护理变得复杂。医疗及相关保健预约和手术被暂时推迟。强制自我隔离给寻求缓解疼痛和改善生活质量的子宫内膜异位症患者带来了新的障碍。对于子宫内膜异位症是否可能是一种易导致严重COVID-19感染的潜在疾病,以及在疫情中何种情况构成紧急治疗的适当指征的担忧,可能会加剧焦虑。此外,COVID-19导致的限制可能会产生负面心理影响,而子宫内膜异位症患者可能本来就更容易受到这种影响。作为药物治疗的补充或替代方法,我们鼓励患者在COVID-19大流行期间考虑采用自我管理策略来对抗子宫内膜异位症症状。这些自我管理策略分为以问题为中心的策略和以情绪为中心的策略,前者旨在改变环境以减轻疼痛,后者则关注与子宫内膜异位症共存的心理问题。我们基于证据和专家意见提出本指南,供医疗保健提供者在通过电话或视频与患者会诊时使用。患者也可独立将本文用作教育资源。所讨论的策略并非仅在COVID-19大流行期间才需考虑。在此之前大多数策略都已得到研究,并且在COVID-19限制解除后的很长时间里,所有这些策略仍将是子宫内膜异位症生物心理治疗方法的一部分。