Department of Women's and Children's Health, Uppsala University, Uppsala, Sweden.
Department of Obstetrics and Gynaecology in Norrköping, Department of Biomedical and Clinical Sciences, Linköping University, Linköping, Sweden.
BMC Womens Health. 2023 Oct 24;23(1):551. doi: 10.1186/s12905-023-02694-5.
Endometriosis often leads to a decrease in Quality of Life (QoL), due to its impact on various aspects of women's lives, such as social life, mental health, sex life, and working capacity. Although previous studies have assessed QoL in women with endometriosis, few studies have explored the impact of different clinical variables on QoL. The aim of this study was to investigate how women with endometriosis perceive their QoL, and to analyze which clinical factors are associated with QoL.
The Endometriosis Health Profile-30 and the ENDOCARE Questionnaire were distributed to 1000 women diagnosed with endometriosis from 10 different clinics across Sweden. The responses from 476 women were included in univariate and multivariable regression analyses, where the clinical factors were correlated with overall QoL and QoL dimensions.
The women participating in this study reported a low QoL. The clinical factors that showed a significant correlation with overall QoL were age at first onset of endometriosis symptoms (β= -0.64, p < 0.001), having more than 10 visits to general practitioners before referral to a gynecologist (β = 5.58, p = 0.036), current or previous mental health issues (β = 7.98, p < 0.001) patient-centeredness (β= -2.59, p < 0.001) and use of opioids (β = 7.14, p = 0.002).
This study shows that opioid use and mental health issues were associated with a worse QoL, whereas a higher degree of patient-centeredness was associated with a better QoL. The association between opioid use and a worse QoL might not entirely be caused by the opioid use itself but also by symptom severity and mental health issues. An improved patient-centeredness and more focus on taking care of mental health issues would reasonably result in a better QoL for women with endometriosis.
子宫内膜异位症常导致生活质量（QoL）下降，因为它会影响女性生活的各个方面，如社交生活、心理健康、性生活和工作能力。尽管之前的研究已经评估了子宫内膜异位症患者的 QoL，但很少有研究探讨不同临床变量对 QoL 的影响。本研究旨在探讨子宫内膜异位症患者如何感知自己的 QoL，并分析哪些临床因素与 QoL 相关。
向瑞典 10 家不同诊所的 1000 名被诊断为子宫内膜异位症的女性发放子宫内膜异位症健康状况-30 量表和 ENDOCARE 问卷。对 476 名女性的回答进行了单变量和多变量回归分析，其中将临床因素与整体 QoL 和 QoL 维度相关联。
参与本研究的女性报告生活质量较低。与整体 QoL 显著相关的临床因素包括：子宫内膜异位症症状首次发作时的年龄（β= -0.64，p<0.001）、在转诊给妇科医生之前去全科医生就诊的次数超过 10 次（β=5.58，p=0.036）、当前或之前存在心理健康问题（β=7.98，p<0.001）、以患者为中心（β= -2.59，p<0.001）和使用阿片类药物（β=7.14，p=0.002）。
本研究表明，阿片类药物使用和心理健康问题与较差的 QoL 相关，而较高的以患者为中心程度与较好的 QoL 相关。阿片类药物使用与较差的 QoL 之间的关联可能不完全是由阿片类药物本身引起的，还可能与症状严重程度和心理健康问题有关。改善以患者为中心程度并更加关注照顾心理健康问题，将合理地提高子宫内膜异位症患者的生活质量。
