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Girard E, Mazloum A, Navarria-Forney I, Pluchino N, Streuli I, Cedraschi C. Women's lived experience of endometriosis-related fertility issues. PLoS One 2023; 18:e0293531. [PMID: 37930971 PMCID: PMC10627452 DOI: 10.1371/journal.pone.0293531] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2023] [Accepted: 10/15/2023] [Indexed: 11/08/2023] Open
Abstract
OBJECTIVE The aim of the present study is to conduct a qualitative investigation to provide a deeper understanding of women's views about endometriosis, fertility and their perception of reproductive options. METHODS Semi-structured interviews were conducted by two female psychiatrists, specialized in gynecology and obstetrical consultation-liaison psychiatry, trained in qualitative procedures, with experience in qualitative studies and in psychological support of women attending infertility consultations. No prior relationship with respondents was established before data collection. Interviews were tape-recorded and transcribed. Interviews lasted 45-75 minutes. The transcripts were then analysed using thematic content analysis. RESULTS Twenty-nine women were contacted. Twelve agreed to an interview at the hospital's infertility clinic. Eleven women with diverse sociodemographic characteristics were included. The key findings of thematic content analysis can be grouped into four topics: (1) Diagnostic announcement and initial delay; (2) Negative perceptions of initial care: pre-diagnosis phase; (3) Struggle with endometriosis and its treatment; (4) Issues related to health problems, fertility and reproductive options. CONCLUSION Our analysis of the interviews corroborates the distressing impact of the trivialization of pain and the uncertainty of or the long quest for diagnosis. The findings also stress various associated issues, from the diagnostic delay to the low success rates of fertility treatments. This qualitative analysis contributes to better understand the accumulation of negative emotions within the illness trajectory and the poor dyadic adjustment within the couple.
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Affiliation(s)
- Elodie Girard
- Division of Liaison Psychiatry and Crisis Intervention, Department of Psychiatry, Geneva University Hospitals, Geneva, Switzerland
| | - Anna Mazloum
- Division of Liaison Psychiatry and Crisis Intervention, Department of Psychiatry, Geneva University Hospitals, Geneva, Switzerland
| | | | - Nicola Pluchino
- Division of Gynaecology, Lausanne University Hospitals and the Faculty of Medicine of Lausanne, Lausanne, Switzerland
| | - Isabelle Streuli
- Division of Gynaecology, Reproductive Medicine Unit, Geneva University Hospitals and the Faculty of Medicine of University of Geneva, Geneva, Switzerland
| | - Christine Cedraschi
- Division of General Medical Rehabilitation, Department of Geriatrics and Rehabilitation, Faculty of Medicine, Geneva University Hospitals (HUG), University of Geneva, Geneva, Switzerland
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2
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Bergström M, Larsson Ranada Å, Sverker A, Thyberg I, Björk M. A dyadic exploration of support in everyday life of persons with RA and their significant others. Scand J Occup Ther 2023; 30:616-627. [PMID: 34846249 DOI: 10.1080/11038128.2021.2007997] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2021] [Revised: 10/22/2021] [Accepted: 11/13/2021] [Indexed: 10/19/2022]
Abstract
BACKGROUND Support from significant others is important for participation in everyday life for persons with rheumatoid arthritis (RA). Meanwhile, significant others also experience limitations. AIMS To explore how support is expressed by persons with RA and significant others, and how support relates to participation in everyday life of persons with RA. MATERIAL AND METHODS Sixteen persons with RA and their significant others participated in individual semi-structured interviews. The material was analyzed using dyadic analysis. RESULTS Persons with RA and significant others reported that RA and support had become natural parts of everyday life, especially emotional support. The reciprocal dynamics of support were also expressed as imperative. Also, support from people outside of the dyads and well-functioning communication facilitated everyday life. CONCLUSIONS Significant others and the support they give are prominent factors and facilitators in everyday life of persons with RA. Concurrently, the support persons with RA provide is important, along with support from outside of the dyads. SIGNIFICANCE The results indicate that the interaction between persons with RA and the social environment is central to gain insight into how support should be provided for optimal participation in everyday life. Significant others can preferably be more involved in the rehabilitation process.
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Affiliation(s)
- Maria Bergström
- Department of Health, Medicine and Caring Sciences, Linköping University, Norrköping, Sweden
| | - Åsa Larsson Ranada
- Department of Health, Medicine and Caring Sciences, Linköping University, Norrköping, Sweden
| | - Annette Sverker
- Department of Activity and Health and Department of Health, Medicine and Caring Sciences, Linköping University, Linköping, Sweden
| | - Ingrid Thyberg
- Department of Rheumatology in Östergötland, and Department of Biomedical and Clinical Sciences, Linköping University, Linköping, Sweden
| | - Mathilda Björk
- Pain and Rehabilitation Centre and Department of Health, Medicine and Caring Sciences, Linköping University, Linköping, Sweden
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3
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Heng FW, Shorey S. Experiences of endometriosis‐associated infertility among women and their partners: A qualitative systematic review. J Clin Nurs 2022; 31:2706-2715. [DOI: 10.1111/jocn.16145] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2021] [Revised: 10/11/2021] [Accepted: 10/29/2021] [Indexed: 11/29/2022]
Affiliation(s)
| | - Shefaly Shorey
- Alice Lee Centre for Nursing Studies Yong Loo Lin School of Medicine Level 2, Clinical Research Centre National University of Singapore Singapore City Singapore
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4
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Yao H, Chan CHY, Hou Y, Chan CLW. Ambivalence experienced by infertile couples undergoing IVF: a qualitative study. HUM FERTIL 2022:1-13. [PMID: 35850620 DOI: 10.1080/14647273.2022.2099314] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
The emotional consequences of infertility are well documented. However, relatively few studies have emphasized the dyadic emotional interaction within couples, despite infertility being a shared life event. This study adopted a dyadic (between two people) approach to explore the emotional complexity that infertile couples face. A descriptive qualitative study was conducted with 24 participants, including eight infertile couples and eight wives undergoing infertility treatments. Conjoint and individual interviews were conducted through purposive sampling in a large fertility centre in Tianjin, China, between June and August 2015. Thematic analysis identified two main themes: (i) 'decisional ambivalence', with subthemes of 'ambivalent attitudes towards treatment', 'uncertainty about treatment outcomes', and 'treatment-related lifestyle changes'; and (ii) 'relational ambivalence' which included subthemes of 'intergenerational ambivalence' and 'partner ambivalence'. Complex emotions of ambivalence among infertile couples were common as infertility clearly shattered their assumptive world on family formation. With complex entanglement of mixed emotions, ambivalence was intimately associated with cultural norms, social expectations, and active or over engagement of family members in Chinese societies. Since ambivalence could threaten mental and physical health during pregnancy, healthcare professionals should be prepared to assist infertile couples with identifying, articulating, and normalizing decisional and relational ambivalence during the treatment process.
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Affiliation(s)
- Hong Yao
- School of Ethnology and Sociology, Minzu University of China, Beijing, China
| | - Celia Hoi Yan Chan
- Department of Social Work and Social Administration, The University of Hong Kong, Hong Kong, China
| | - Yajie Hou
- China Population and Development Research Center, Beijing, China
| | - Cecilia Lai Wan Chan
- Department of Social Work and Social Administration, The University of Hong Kong, Hong Kong, China
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5
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Rodrigues R, Filipovič Hrast M, Kadi S, Hurtado Monarres M, Hlebec V. Life Course Pathways Into Intergenerational Caregiving. J Gerontol B Psychol Sci Soc Sci 2022; 77:1305-1314. [PMID: 35137055 PMCID: PMC9255941 DOI: 10.1093/geronb/gbac024] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2021] [Indexed: 11/14/2022] Open
Abstract
OBJECTIVES We develop a framework for the analysis of pathways into intergenerational caregiving to older people provided by family members using life course concepts of key turning events in life, cumulative processes, and linked lives within the family realm. METHODS Using framework analysis, we analyze semistructured qualitative interviews from a sample of dyads (older cared-for adults and their main family carers comprised of children, children-in-law, and grandchildren) in Austria (N = 24) and Slovenia (N = 52). Data were collected in 2019 through purposive sampling, including dyads from a differentiated socioeconomic background and gender. RESULTS The analysis reveals 4 nonexclusive pathways into caregiving. One pathway is associated with single turning events occurring in family or work trajectories of carers that expanded the possibilities for caregiving later in life. A second pathway referred to cumulative processes that later influenced transitions into caregiving, such as personal biographies marked by weak labor market attachment. Another cumulative pathway, exclusive to caregiving, is characterized by continued and sustained exchanges of support within families that cement reciprocal ties that underpin caregiving at later stages. In the fourth pathway, life trajectories of siblings, but also family relationships and conflicts, constrained carers into their role. DISCUSSION Decisions regarding caregiving within families can be best understood as processes, linked to developments in other trajectories in carers' lives, as much as to internal family dynamics and relationships. Becoming a carer may be itself the result of intertwined accumulated vulnerabilities, as well as cumulative exchanges within families.
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Affiliation(s)
- Ricardo Rodrigues
- European Centre for Social Welfare Policy and Research, Vienna, Austria
| | | | - Selma Kadi
- European Centre for Social Welfare Policy and Research, Vienna, Austria
| | | | - Valentina Hlebec
- University of Ljubljana Faculty of Social Sciences, Ljubljana, Slovenia
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6
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Maren S, Ariane G, Bettina B, Stephanie H, Magdalena G, Sabine R, Monika E, Kilian V, Bettina T, Thomas S, Tewes W, Beate D. Partners matter: The psychosocial well-being of couples when dealing with endometriosis. Health Qual Life Outcomes 2022; 20:86. [PMID: 35643578 PMCID: PMC9148469 DOI: 10.1186/s12955-022-01991-1] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2022] [Accepted: 05/12/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Endometriosis is often associated with severe dysmenorrhea, pelvic pain and dyspareunia and has a high impact on daily life as well as sexuality. Quality of partnership positively influences the course of various diseases and ability to cope with emotional and physical distress. However, studies focusing on the male partners of endometriosis patients are rare, and even less is known about the reciprocal relationship in these couples. Therefore, this study aims to explore the interrelations in couples with endometriosis in matters of psychological distress, sexual and partnership satisfaction and social support. METHODS The cross-sectional study was conducted in two university-affiliated fertility centres in Germany and Austria with n = 104 female/male couples affected by endometriosis. Participants completed a questionnaire regarding endometriosis, partnership, sexuality, stress, anxiety, depression and social support. Both women and men were asked about the impact of women's endometriosis-related pain (IEP) on their everyday life (e.g. leisure time). Data were analysed using the Actor-Partner-Interdependence Model. RESULTS Significant partner effects were evident: High depression, anxiety and stress scores in women were associated with a higher IEP in men (all p ≤ 0.01), reciprocally high stress and depression scores in men were correlated with a higher IEP in women (all p ≤ 0.05). Less sexual satisfaction in women was associated with a higher IEP in men (p = 0.040). There was a significant reciprocal association between the perceived lack of understanding from the social environment and a higher IEP, for both women (p = 0.022) and men (p = 0.027). CONCLUSIONS The male partner should be taken into account when counselling or treating women with endometriosis. Our study shows a high interdependence and reciprocal influence from both partners-positively and negatively-concerning psychological distress and sexual satisfaction. Furthermore, there ought to be more awareness for the psychosocial impact of endometriosis, especially in regard to social support and understanding. Talking about and improving sexual satisfaction as well as enhancing stress reducing techniques may hold great benefits for dealing with endometriosis. Registration number The study is registered with the German Clinical Trials Register (DRKS), number DRKS00014362.
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Affiliation(s)
- Schick Maren
- Institute of Medical Psychology, Heidelberg University Hospital, Ruprecht-Karls University, Heidelberg, Bergheimer Str. 20, 69115 Heidelberg, Germany
| | - Germeyer Ariane
- Department of Gynecological Endocrinology and Fertility Disorders, University Women’s Hospital Heidelberg, Im Neuenheimer Feld 440, 69120 Heidelberg, Germany
| | - Böttcher Bettina
- Department of Gynecological Endocrinology and Reproductive Medicine, Medical University of Innsbruck, Anichstraße 35, 6020 Innsbruck, Austria
| | - Hecht Stephanie
- Department of Gynecological Endocrinology and Fertility Disorders, University Women’s Hospital Heidelberg, Im Neuenheimer Feld 440, 69120 Heidelberg, Germany
| | - Geiser Magdalena
- Department of Gynecological Endocrinology and Reproductive Medicine, Medical University of Innsbruck, Anichstraße 35, 6020 Innsbruck, Austria
| | - Rösner Sabine
- Department of Gynecological Endocrinology and Fertility Disorders, University Women’s Hospital Heidelberg, Im Neuenheimer Feld 440, 69120 Heidelberg, Germany
| | - Eckstein Monika
- Institute of Medical Psychology, Heidelberg University Hospital, Ruprecht-Karls University, Heidelberg, Bergheimer Str. 20, 69115 Heidelberg, Germany
| | - Vomstein Kilian
- Department of Gynecological Endocrinology and Reproductive Medicine, Medical University of Innsbruck, Anichstraße 35, 6020 Innsbruck, Austria
| | - Toth Bettina
- Department of Gynecological Endocrinology and Reproductive Medicine, Medical University of Innsbruck, Anichstraße 35, 6020 Innsbruck, Austria
| | - Strowitzki Thomas
- Department of Gynecological Endocrinology and Fertility Disorders, University Women’s Hospital Heidelberg, Im Neuenheimer Feld 440, 69120 Heidelberg, Germany
| | - Wischmann Tewes
- Institute of Medical Psychology, Heidelberg University Hospital, Ruprecht-Karls University, Heidelberg, Bergheimer Str. 20, 69115 Heidelberg, Germany
| | - Ditzen Beate
- Institute of Medical Psychology, Heidelberg University Hospital, Ruprecht-Karls University, Heidelberg, Bergheimer Str. 20, 69115 Heidelberg, Germany
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7
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Rossi V, Galizia R, Tripodi F, Simonelli C, Porpora MG, Nimbi FM. Endometriosis and Sexual Functioning: How Much Do Cognitive and Psycho-Emotional Factors Matter? INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19095319. [PMID: 35564711 PMCID: PMC9100036 DOI: 10.3390/ijerph19095319] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 04/03/2022] [Revised: 04/23/2022] [Accepted: 04/25/2022] [Indexed: 12/02/2022]
Abstract
Women with endometriosis often suffer from genito-pelvic pain. The objective of the present study was to analyze the relationship between cognitive and psycho-emotional factors and sexual functioning of women with endometriosis, comparing women with and without endometriosis. A total of 87 women with endometriosis (EG) and 100 women without endometriosis (CG) completed a socio-demographic questionnaire; the short-form of McGill Pain Questionnaire (SF-MPQ); the Female Sexual Functioning Index (FSFI); the Sexual Distress Scale (SDS); the Symptoms Checklist (SCL-90-R); the Toronto Alexithymia Scale (TAS-20); the Positive and Negative Affects Scale (PANAS); the Sexual Dysfunctional Belief Questionnaire (SDBQ); the Sexual Modes Questionnaire (SMQ); and the Questionnaire of Cognitive Schema Activation in Sexual Context (QCSASC). EG obtained worse scores than CG in SF-MPQ, Pain subscale of FSFI, and SDS. EG reached higher scores than CG on almost all scales of SCL-90-R and lower scores in the “Identifying Feelings” scale of TAS-20. Furthermore, EG reported more negative emotions toward sexuality than CG (PANAS) higher scores on the “Affection Primacy” scale of SDBQ and the “Helpless” sexual cognitive schema of QCSASC than CG. No significant differences were found in SMQ. Sexual health professionals should address psychological, emotional, and cognitive factors since they seem involved in patients’ sexual experiences.
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Affiliation(s)
- Valentina Rossi
- Institute of Clinical Sexology, 00198 Rome, Italy;
- Correspondence: ; Tel.: +39-3480324419
| | - Roberta Galizia
- Department of Dynamic, Clinical and Health Psychology, “Sapienza” University, 00185 Rome, Italy; (R.G.); (C.S.); (F.M.N.)
| | | | - Chiara Simonelli
- Department of Dynamic, Clinical and Health Psychology, “Sapienza” University, 00185 Rome, Italy; (R.G.); (C.S.); (F.M.N.)
| | - Maria Grazia Porpora
- Department of Maternal and Child Health and Urology, “Sapienza” University, 00161 Rome, Italy;
| | - Filippo Maria Nimbi
- Department of Dynamic, Clinical and Health Psychology, “Sapienza” University, 00185 Rome, Italy; (R.G.); (C.S.); (F.M.N.)
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8
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Facchin F, Buggio L, Vercellini P, Frassineti A, Beltrami S, Saita E. Quality of intimate relationships, dyadic coping, and psychological health in women with endometriosis: Results from an online survey. J Psychosom Res 2021; 146:110502. [PMID: 33932718 DOI: 10.1016/j.jpsychores.2021.110502] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/10/2020] [Revised: 04/23/2021] [Accepted: 04/23/2021] [Indexed: 10/21/2022]
Abstract
OBJECTIVE To explore the associations between intimate relationships, psychological health, and endometriosis-related variables such as pelvic pain and infertility. METHODS In this cross-sectional study, data were collected with an online survey delivered through Qualtrics and posted on the Facebook page and website of a patient association (Associazione Progetto Endometriosi-APE) in August 2020. The survey was composed of a researcher-made questionnaire and four validated questionnaires assessing relational satisfaction (adapted Quality of Marriage Index), dyadic coping (Dyadic Coping Questionnaire), and psychological health (Hospital Anxiety and Depression Scale and Rosenberg Self-Esteem Scale). RESULTS Participants were 316 women (age: 35.9 ± 6.7) with endometriosis, who reported being in an intimate relationship from at least one year. A greater perceived negative impact of the disease on past and current intimate relationships was associated with poorer psychological health, lower relational satisfaction and worse dyadic coping. Women who perceived their partner as more informed about endometriosis, more informed about and interested in their health conditions, and more likely to accompany them to the medical appointments, showed greater relational satisfaction and dyadic coping. Relational satisfaction and dyadic coping were associated with psychological health. A greater perceived negative impact of endometriosis on intimate relationships was associated with more severe pelvic pain (especially dyspareunia). CONCLUSION Endometriosis has a negative impact on intimate relationships, which is associated with poorer psychological health. For the women with the disease, partner's support is important, and our findings suggest that effort should be made to involve both members of the couple in multidisciplinary treatment.
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Affiliation(s)
- Federica Facchin
- Department of Psychology, Catholic University of the Sacred Heart, Milan, Italy.
| | - Laura Buggio
- Gynecology Unit, Fondazione Istituto di Ricovero e Cura a Carattere Scientifico Ca' Granda - Ospedale Maggiore Policlinico, Milan, Italy.
| | - Paolo Vercellini
- Gynecology Unit, Fondazione Istituto di Ricovero e Cura a Carattere Scientifico Ca' Granda - Ospedale Maggiore Policlinico, Milan, Italy.
| | - Annalisa Frassineti
- Associazione Progetto Endometriosi - Organizzazione di Volontariato (Endometriosis Project Association - Volunteer Organization), Reggio Emilia, Italy.
| | - Sara Beltrami
- Associazione Progetto Endometriosi - Organizzazione di Volontariato (Endometriosis Project Association - Volunteer Organization), Reggio Emilia, Italy.
| | - Emanuela Saita
- Department of Psychology, Catholic University of the Sacred Heart, Milan, Italy.
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9
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Delanerolle G, Ramakrishnan R, Hapangama D, Zeng Y, Shetty A, Elneil S, Chong S, Hirsch M, Oyewole M, Phiri P, Elliot K, Kothari T, Rogers B, Sandle N, Haque N, Pluchino N, Silem M, O'Hara R, Hull ML, Majumder K, Shi JQ, Raymont V. A systematic review and meta-analysis of the Endometriosis and Mental-Health Sequelae; The ELEMI Project. ACTA ACUST UNITED AC 2021; 17:17455065211019717. [PMID: 34053382 PMCID: PMC8182632 DOI: 10.1177/17455065211019717] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
Background: It is important to evaluate sequalae for complex chronic health conditions such as endometriosis and mental health disorders. Endometriosis impacts 1 in 10 women. Mental health outcomes can be a primary determinant in many physical health conditions although this is an area not well researched particularly in women’s health. This has been problematic for endometriosis patients in particular, who report mental health issues as well as other key comorbidities such as chronic pelvic pain and infertility. This could be partly due to the complexities associated with comprehensively exploring overlaps between physical and mental health disorders in the presence of multiple comorbidities and their potential mechanistic relationship. Methods: In this evidence synthesis, a systematic methodology and mixed-methods approaches were used to synthesize both qualitative and quantitative data to examine the prevalence of the overlapping sequalae between endometriosis and psychiatric symptoms and disorders. As part of this, an evidence synthesis protocol was developed which included a systematic review protocol that was published on PROSPERO (CRD42020181495). The aim was to identify and evaluate mental health reported outcomes and prevalence of symptoms and psychiatric disorders associated with endometriosis. Findings: A total of 34 papers were included in the systematic review and 15 were included in the meta-analysis. Anxiety and depression symptoms were the most commonly reported mental health outcomes while a pooled analysis also revealed high prevalence of chronic pelvic pain and dyspareunia. Interpretation: It is evident that small-scale cross-sectional studies have been conducted in a variety of settings to determine mental health outcomes among endometriosis patients. Further research is required to comprehensively evaluate the mental health sequalae with endometriosis.
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Affiliation(s)
| | - Rema Ramakrishnan
- Nuffield Department of Women's & Reproductive Health, University of Oxford, Oxford, UK
| | - Dharani Hapangama
- University of Liverpool, Liverpool, UK.,Liverpool Women's NHS Foundation, Liverpool, UK
| | - Yutian Zeng
- Southern University of Science and Technology, Shenzhen, China
| | - Ashish Shetty
- University College London Hospitals NHS Foundation Trust, London, UK.,University College London, London, UK
| | - Sohier Elneil
- University College London Hospitals NHS Foundation Trust, London, UK.,University College London, London, UK
| | - Sam Chong
- University College London Hospitals NHS Foundation Trust, London, UK.,University College London, London, UK
| | - Martin Hirsch
- University College London Hospitals NHS Foundation Trust, London, UK.,Oxford Health NHS Foundation Trust, Oxford, UK
| | - Molola Oyewole
- University College London Hospitals NHS Foundation Trust, London, UK.,University College London, London, UK
| | - Peter Phiri
- Southern Health NHS Foundation Trust, Southampton, UK.,School of Primary Care, Population Sciences and Medical Education, University of Southampton, Southampton, UK
| | | | | | - Bryony Rogers
- University of Liverpool, Liverpool, UK.,Liverpool Women's NHS Foundation, Liverpool, UK
| | - Natasha Sandle
- Oxford Brain Health Clinical Trials Unit, University of Oxford, Oxford, UK
| | - Nyla Haque
- Oxford Brain Health Clinical Trials Unit, University of Oxford, Oxford, UK
| | - Nicola Pluchino
- Divisions of Gynecology and Obstetrics, Geneva University Hospitals, Geneva, Switzerland
| | - Martin Silem
- University Medical Center Freiburg, Freiburg, Germany
| | - Rebecca O'Hara
- Robinson Research Institute, The University of Adelaide, Adelaide, SA, Australia
| | - M Louise Hull
- Robinson Research Institute, The University of Adelaide, Adelaide, SA, Australia
| | | | - Jian Qing Shi
- Southern University of Science and Technology, Shenzhen, China.,The Alan Turing Institute, London, UK
| | - Vanessa Raymont
- Oxford Brain Health Clinical Trials Unit, University of Oxford, Oxford, UK.,Department of Psychiatry, University of Oxford, Oxford, UK
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10
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Kumar S, Pedersen R, Sahajpal A. Liver Transplant Using Donation After Circulatory Death Donors: A Low-Volume Single-Center Experience. EXP CLIN TRANSPLANT 2021; 19:580-587. [PMID: 33928874 DOI: 10.6002/ect.2020.0441] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
OBJECTIVES Although donor shortages have prompted increased use of livers from donors after circulatory death, data are limited on their outcomes in low-volume centers and their applicability in this setting. MATERIALS AND METHODS We retrospectively reviewed liver transplants from donors after circulatory death performed at our low-volume center over a 7-year period and identified predictors of outcomes. RESULTS Between 2007 and 2014, of 196 liver transplants (mean 28/year), donations after circulatory death accounted for 31%. Patient/liver graft survival rates were similar in recipients of brain dead donor versus circulatory death donor allografts (P = .47 and P = .87 respectively): 88.4% versus 85.7%/87.7 versus 86.3% at 1 year, 78.5 versus 74.2%/76.5% versus 75.4% at 3 years, and 70.8% versus 62.0%/65.1% versus 63.7% at 5 years. Multivariable analysis identified recipients with hepatitis C virus from donors >50 years old as an independent predictor of graft and patient survival (P < .01). Biliary complications trended higher in recipients of circulatory death donor livers. Among solitary liver transplant recipients, although biliary complications adversely affected graft survival in both groups (circulatory death vs brain dead donor cohorts, P = .02 vs P = .03), patient survival was only affected in the circulatory death donor cohort (P = .01). However, when all transplants were included in graft loss modeling, presence of biliary complications significantly impacted graft survival only in recipients of livers from circulatory death donors (P < .01). Among biliary complications, ischemic cholangiopathy had the greatest impact on graft loss (P ≤ .01). CONCLUSIONS Donation after circulatory death allografts could be safely used to expand the donor pool even in low-volume liver transplant centers. Outcomes were comparable to grafts from donors after brain death, although biliary complications, mainly because of ischemic cholangiopathy, had a greater effect on liver transplants from circulatory death donors. Efforts to minimize ischemic cholangiopathy could enable their greater utilization, regardless of center volume, without compromising outcomes.
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Affiliation(s)
- Shiva Kumar
- From the Digestive Disease Institute, Cleveland Clinic Abu Dhabi, Abu Dhabi, United Arab Emirates.,From the Transplant Center, Aurora St. Luke's Medical Center, Milwaukee, Wisconsin, United States
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11
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Rossi V, Tripodi F, Simonelli C, Galizia R, Nimbi FM. Endometriosis-associated pain: a review of quality of life, sexual health and couple relationship. Minerva Obstet Gynecol 2021; 73:536-552. [PMID: 33904688 DOI: 10.23736/s2724-606x.21.04781-3] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
INTRODUCTION Endometriosis is a chronic gynecological disease that affects women's quality of life, sexuality, and relationship. Endometriosis-associated pain plays an essential role in well-being impairment. The present review aimed to analyze literature about endometriosis-associated pain and quality of life, sexual health, and quality of the relationship, assessing the role of the biopsychosocial factors involved and the women's pain experience. EVIDENCE ACQUISITION Bibliographic research of relevant articles published from 2015 to 2020 in PubMed, Google Scholar, Web of Science, Scopus, EBSCO, and Cochrane Library. EVIDENCE SYNTHESIS Endometriosis is associated with impairing all women's quality of life domains, and pain appears to be the most influential variable. The pain mechanism is not simple and implies several biological, psychological, and social factors. Women's sexual health is also impaired, and patients report dyspareunia, sexual dysfunctions, dissatisfaction, and distress. Partners' sexual well being is compromised as well. Endometriosis negatively influences relationship quality, and the illness burden affects both couple members. CONCLUSIONS A multidisciplinary team using a couple-centered and a biopsychosocial approach is crucial to provide appropriate treatment for endometriosis-associated pain. A better comprehension of all bio-psycho-social aspects implicated in women's well-being and pain experience needs more research.
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Affiliation(s)
| | | | - Chiara Simonelli
- Department of Dynamic, Clinical and Health Psychology, Sapienza University of Rome, Rome, Italy
| | - Roberta Galizia
- Department of Dynamic, Clinical and Health Psychology, Sapienza University of Rome, Rome, Italy
| | - Filippo M Nimbi
- Department of Dynamic, Clinical and Health Psychology, Sapienza University of Rome, Rome, Italy
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Sousa H, Ribeiro O, Figueiredo D. End-stage renal disease is not yours, is not mine, is OURS: Exploring couples lived experiences through dyadic interviews. Hemodial Int 2021; 25:361-371. [PMID: 33763973 DOI: 10.1111/hdi.12929] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2020] [Revised: 02/27/2021] [Accepted: 03/01/2021] [Indexed: 11/28/2022]
Abstract
INTRODUCTION As a psychosocial dyad, couples are greatly challenged by end-stage renal disease (ESRD). Renal replacement therapies are highly demanding and involve lifelong restrictions and readjustments that sometimes translate into profound changes in couples' routines. However, little is known about the experiences of these couples with this condition. This study examined the experiences of couples living with ESRD. METHODS A qualitative exploratory study was conducted with a purposive sample. Semistructured dyadic interviews were conducted with 12 patients (65.1 ± 12.8 years old; eight males) undergoing in-center hemodialysis for 18.6 (±13.3) months and their spouses (60.3 ± 11.2 years old; seven females). The interviews were digitally audio-recorded, transcribed verbatim, and submitted to thematic analysis by two independent researchers. FINDINGS The findings from the dyadic perspective were conceptualized into two major themes: negative impacts (emotional distress, constraints on leisure and daily activities, impacts on couples' dynamics, and difficulties in meal planning) and unmet needs (educational, relational, financial, instrumental, and supportive needs). DISCUSSION The findings suggested that ESRD has several negative impacts that are related to the reported unmet needs, which might difficult couples' psychosocial adjustment to the condition. Both partners may benefit from educational and supportive interventions that address their needs, targeting the couple as a unit. Recognizing ESRD as a family condition is crucial for the development of innovative family-based interventions that can promote couples' healthy adjustment to the disease.
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Affiliation(s)
- Helena Sousa
- Center for Health Technology and Services Research (CINTESIS.UA), School of Health Sciences, University of Aveiro (Campus Universitário de Santiago), Aveiro, Portugal
| | - Oscar Ribeiro
- Center for Health Technology and Services Research (CINTESIS.UA), Department of Education and Psychology, University of Aveiro (Campus Universitário de Santiago), Aveiro, Portugal
| | - Daniela Figueiredo
- Center for Health Technology and Services Research (CINTESIS.UA), School of Health Sciences, University of Aveiro (Campus Universitário de Santiago), Aveiro, Portugal
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Sweeney A, Kelly K, Kennedy A, Clement S, Ion M, Kothari G, Gillard S. Balancing closeness and distance through identity enactment: Psychological therapy assessments explored through the assessor-client dyad. QUALITATIVE RESEARCH IN PSYCHOLOGY 2020. [DOI: 10.1080/14780887.2020.1808748] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Affiliation(s)
- Angela Sweeney
- Service User Research Enterprise, Health Services and Population Research Department, King's College London, London, UK
| | - Katie Kelly
- Tower Hamlets Early Intervention Service, London, UK
| | - Angela Kennedy
- Department of Trauma Informed Care, Lanchester Road Hospital, Durham, UK
| | | | - Mary Ion
- South London and Maudsley NHS Foundation Trust, IAPT Lewisham, London, UK
| | - Gemma Kothari
- Department of Trauma Informed Care, Beckside Court, Batley, UK
| | - Steve Gillard
- School of Health Sciences, City, University of London, London, UK
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Hudson N, Law C, Culley L, Mitchell H, Denny E, Norton W, Raine-Fenning N. Men, chronic illness and healthwork: accounts from male partners of women with endometriosis. SOCIOLOGY OF HEALTH & ILLNESS 2020; 42:1532-1547. [PMID: 32589324 DOI: 10.1111/1467-9566.13144] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/09/2019] [Revised: 04/03/2020] [Accepted: 05/12/2020] [Indexed: 06/11/2023]
Abstract
Currently dominant in medical discourse, the concept of self-management sees the responsibility for health and illness shift from the state to the individual. However, while this emphasis on individual responsibility and management has burgeoned, the role and status of partners and other family members in the management of chronic illness remains under-theorised. While self-management privileges individual responsibility for the management of chronic illness, the role of partners remains unclear. This paper utilises data from a study of heterosexual couples' experiences of living with the chronic gynaecological condition endometriosis to explore how male partners engage in its day-to-day management. In all, 22 couples participated in in-depth, semi-structured interviews with each partner interviewed separately (n = 44). Data were analysed thematically and dyadically, informed by an interpretivist relational approach. The paper utilises the concept of healthwork to describe the illness work, everyday life work, biographical work and emotion work men engaged in. The paper demonstrates how the conceptual value of healthwork is enhanced by incorporating an analysis of the emotional effort required in managing chronic illness. The paper illustrates the value of investigating the role of partners in managing chronic illness to provide a fuller account of the distributed and relational nature of healthwork.
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Affiliation(s)
- Nicky Hudson
- Centre for Reproduction Research, De Montfort University, Leicester, UK
| | - Caroline Law
- Centre for Reproduction Research, De Montfort University, Leicester, UK
| | - Lorraine Culley
- Centre for Reproduction Research, De Montfort University, Leicester, UK
| | - Helene Mitchell
- Centre for Reproduction Research, De Montfort University, Leicester, UK
| | - Elaine Denny
- Faculty of Health, Education and Life Sciences, Birmingham City University, Birmingham, UK
| | - Wendy Norton
- Centre for Reproduction Research, De Montfort University, Leicester, UK
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Facchin F, Buggio L, Saita E. Partners' perspective in endometriosis research and treatment: A systematic review of qualitative and quantitative evidence. J Psychosom Res 2020; 137:110213. [PMID: 32781264 DOI: 10.1016/j.jpsychores.2020.110213] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/29/2020] [Revised: 07/27/2020] [Accepted: 08/02/2020] [Indexed: 12/14/2022]
Abstract
OBJECTIVE To summarize the available qualitative and quantitative evidence regarding the impact of endometriosis on women's partners. METHODS A systematic electronic search of PubMed and PsycINFO was conducted. All the available evidence regarding partners' psychological condition, quality of life, social and intimate relationships, and sexuality was included, and a narrative synthesis of the findings was provided. RESULTS Of 127 studies retrieved through electronic search, only 5 (3 qualitative/semi-qualitative and 2 quantitative studies) matched the inclusion criteria and were included in our review. In total, participants were 399 male partners. Endometriosis negatively affects partners' psychological wellbeing and quality of life, with significant individual differences. Partners of women with endometriosis may experience isolation and lack of engagement in treatment decision-making. Partners also experience the economic burden of the disease, with negative consequences on work functioning and daily life. Sexuality is also negatively affected, although with contradictory findings. Positive aspects of personal and relationship growth were also reported. CONCLUSION Endometriosis is an important cause of physical and psychological pain for women, but it may also have a negative impact on their partners. Although the effects of other chronic diseases on partners and caregivers have been largely explored, the small number of articles included in this review indicates that this topic remains understudied in endometriosis research. Endometriosis should be investigated and managed within a systemic framework, with a specific focus on the complex dynamic interaction between individual, relational, sociocultural and environmental factors.
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Affiliation(s)
- Federica Facchin
- Department of Psychology, Catholic University of the Sacred Heart, Milan, Italy.
| | - Laura Buggio
- Fondazione Istituto di Ricovero e Cura a Carattere Scientifico Ca' Granda - Ospedale Maggiore Policlinico, Milan, Italy
| | - Emanuela Saita
- Department of Psychology, Catholic University of the Sacred Heart, Milan, Italy
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