What's the delay? A qualitative study of women's experiences of reaching a diagnosis of endometriosis
What's the delay? A qualitative study of women's experiences of reaching a diagnosis of endometriosis
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DOI：
10.1016/j.fertnstert.2006.04.054
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发表时间：
2006-11-01
影响因子：
6.7
通讯作者：
Wright, Jeremy
中科院分区：
文献类型：
--
作者：
Ballard, Karen;Lowton, Karen;Wright, Jeremy
目的：探讨女性延迟诊断子宫内膜异位症的原因及其影响。设计：对32名女性进行定性访谈研究，其中28人随后被诊断为子宫内膜异位症。地点：英格兰东南部。患者(S)：去看盆腔疼痛诊所的妇女。干预(S)：半结构化访谈。主要观察指标(S)：报告的子宫内膜异位症的诊断经验。结果(S)：子宫内膜异位症的诊断延迟发生在个体患者和医疗水平，因为妇女和家庭医生都将症状正常化，通过激素抑制症状，并依靠非歧视性的调查。女性受益于诊断，因为它提供了一种语言来讨论她们的情况，提供了可能的管理策略来控制症状，并提供了症状不是由癌症引起的保证。结论：尽管最近的慢性盆腔疼痛治疗指南建议，在治疗干预失败后，诊断性腹腔镜检查可能被认为是二次检查，但本研究强调了在未确诊的情况下，对遭受身体、情感和社会层面痛苦的女性进行早期诊断的重要性。
Objective: To investigate the reasons women experience delays in the diagnosis of endometriosis and the impact of this.Design: A qualitative interview-based study of 32 women, 28 of whom were subsequently diagnosed with endometriosis.Setting: Southeast England.Patient(s): Women attending a pelvic pain clinic.Intervention(s): Semistructured interviews.Main Outcome Measures(s): Women's reported experiences of being diagnosed with endometriosis.Results(s): Delays in the diagnosis of endometriosis occur at an individual patient level and a medical level, as both women and family doctors normalize symptoms, symptoms are suppressed through hormones, and nondiscriminatory investigations are relied upon. Women benefited from a diagnosis because it provided a language in which to discuss their condition, offered possible management strategies to control symptoms, and provided reassurance that symptoms were not due to cancer. Diagnosis also sanctioned women's access to social support and legitimized absences from social and work obligations.Conclusion(s): Although recent guidelines for the management of chronic pelvic pain suggest that diagnostic laparoscopy may be considered a secondary investigation after the failure of therapeutic interventions, the present study highlights the importance if an early diagnosis for women who suffer at physical emotional, and social levels when they remain undiagnosed.