Department of Obstetrics and Gynecology, Máxima Medical Center, P.O. Box: 7777, Veldhoven, MB 5500, The Netherlands.
Department of Obstetrics and Gynecology MUMC+, Grow-School of Oncology and Reproduction Maastricht University, Maastricht, The Netherlands.
BMC Womens Health. 2024 Aug 2;24(1):439. doi: 10.1186/s12905-024-03268-9.
Several treatment modalities for heavy menstrual bleeding are available. However, many women report being unsatisfied in their search for an appropriate and effective treatment. The aim of this study is to gain insights in the experienced impact of heavy menstrual bleeding and the motives and considerations of women during the decision-making process for treating heavy menstrual bleeding.
An interpretative qualitative study was performed, using in-depth interviews. In total, 14 semi-structured interviews were conducted with patients who consulted a physician for treatment of heavy menstrual bleeding. Participants were recruited via the Netherlands Patients Federation (N = 10) or via the outpatient clinic in the Máxima Medical Center (N = 4). The interviews were conducted by phone or online between February 2020 and March 2021. In the interviews three topics were addressed: (1) participant's experience with heavy menstrual bleeding, (2) experience with patient journey of treatment decision-making and (3) elaborating on alternative treatments for heavy menstrual bleeding. A thematic analysis was conducted.
Fourteen participants aged between 30 and 59 years old were interviewed. Three main themes emerged; "Considerations in taking the (next) step to seek help", "Various sources of information can contribute, confuse or frighten decision-making process" and "A physician's understanding and a relationship of trust are needed to guide the decision-making process".
Our results show that women's considerations and decision making strongly depend on the obtained information and experience, the relationship with the physician, the influence of the social environment, the pre-visit expectations/desires, the fear of treatment complications and uncertainty of the effect of the treatment. It is a physicians role to create a trusting and open atmosphere during consultation. Patient-centered communication is helpful to share knowledge, and gain insights into a patient's hopes, fears and worries.
有多种治疗月经过多的方法。然而，许多女性报告说，在寻找合适且有效的治疗方法时感到不满意。本研究旨在深入了解月经过多的影响，以及女性在治疗月经过多的决策过程中的动机和考虑因素。
采用解释性定性研究方法，进行深入访谈。共对 14 名因月经过多就诊的患者进行了 14 次半结构式访谈。参与者通过荷兰患者联合会（N=10）或马克西玛医疗中心的门诊（N=4）招募。访谈于 2020 年 2 月至 2021 年 3 月通过电话或在线进行。访谈中讨论了三个主题：（1）参与者的月经过多经历，（2）治疗决策患者旅程的经验，（3）详细阐述月经过多的替代治疗方法。进行了主题分析。
共访谈了 14 名年龄在 30 至 59 岁之间的参与者。出现了三个主要主题：“寻求帮助时的考虑因素”、“各种信息来源可以促进、混淆或吓倒决策过程”和“医生的理解和信任关系是指导决策过程所必需的”。
我们的研究结果表明，女性的考虑因素和决策主要取决于所获得的信息和经验、与医生的关系、社会环境的影响、就诊前的期望/愿望、对治疗并发症的恐惧以及对治疗效果的不确定性。医生的角色是在咨询期间营造信任和开放的氛围。以患者为中心的沟通有助于分享知识，并深入了解患者的希望、恐惧和担忧。
