Understanding Physical Activity for Women with Endometriosis Symptoms (PAWES): interplay of barriers, benefits and experiences in women from diverse..

. .背景。跨学科的方法。子宫内膜异位症是一种类似子宫内膜的组织开始在卵巢和输卵管等其他地方生长的情况，引起（通常严重的）不适、疼痛和残疾。所有育龄妇女中有10%患有子宫内膜异位症，在英国约有150万。然而，可能还有更多的人没有被诊断出来，目前从症状出现到通过腹腔镜确诊平均需要7.5年。2020年，子宫内膜异位症跨党派议会小组（APPG）与英国子宫内膜异位症合作，进行了一项调查，其中包括英国10000名子宫内膜异位症女性的经历。该报告的建议包括增加研究经费，以了解、治疗和管理子宫内膜异位症，并解决社会经济和种族差异。考虑到子宫内膜异位症的总体患病率及其对工作和休闲期间的日常功能、关系和心理健康以及生活质量（QoL）的影响，子宫内膜异位症的人类成本是巨大的。此外，了解和实施子宫内膜异位症的管理策略最终将对生产力产生积极影响，子宫内膜异位症已被证明对工作场所的生产力有负面影响，由于使人衰弱的症状，英国经济每年损失80亿英镑。此外，患病率似乎因种族背景而异，白人女性比黑人女性更容易被诊断出来，亚洲女性比白人女性更容易被诊断出来。这是不同种族患病率的真实代表，还是由于医疗保健系统的隐性偏见，仍然未知。该病对社会影响的社会人口差异也强调了其作为健康不平等驱动因素的重要性。子宫内膜异位症的治疗通常包括腹腔镜子宫内膜切除术，然而50%的女性在手术后5年内会再次发生子宫内膜异位症，而其他药物治疗会导致严重的副作用。因此，患有子宫内膜异位症的妇女经常求助于补充治疗和改变生活方式来控制症状，但由于缺乏科学证据基础，目前没有卫生专业人员的指导或支持来帮助她们。体力活动已被证明是改善心理健康和生活质量的重要治疗工具，并减少许多患有其他慢性疾病的成年人的疼痛，因此它对控制子宫内膜异位症症状和改善患有这种疾病的女性的体验具有重要的潜力。然而，这一点从未被研究过。为了了解不同类型的体育活动（PA）对子宫内膜异位症的治疗潜力，并为卫生保健实践和政策提供信息，需要全面了解子宫内膜异位症的诊断、症状和对日常功能的影响，以及子宫内膜异位症妇女中PA的社会人口统计学和文化驱动因素。详细了解子宫内膜异位症的患病率、症状、日常PA模式以及它们如何根据社会人口因素而不同，需要使用先进的定量方法对高质量的次要数据进行精确分析。然而，为了真正的了解；1)子宫内膜异位症女性的不同经历，2)她们如何生活和管理这种疾病，3)PA行为的复杂社会文化和环境驱动因素，以及4)不同体育活动的感知益处和/或危害，有必要与受这种疾病影响的女性一起进行深入而详细的定性探索。拟议的跨学科博士项目将利用社会流行病学和统计学的先进定量方法，以及定性社会科学方法，首次详细了解PA作为子宫内膜异位症治疗工具的潜力。

..backgrounds. An interdisciplinary approach.Endometriosis is a condition where tissue similar to the lining of the womb starts to grow in other places, such as the ovaries and fallopian tubes, causing (often severe) discomfort, pain and disability. For all women of reproductive age 10% will have endometriosis, representing around 1.5million in the UK. However, there are likely many more that are undiagnosed, it currently takes an average of 7.5years from onset of symptoms for a conclusive diagnosis, through a laparoscopy. In 2020 the All-Party Parliamentary Group (APPG) on Endometriosis, in collaboration with Endometriosis UK, conducted a survey which included the experiences of 10000 women with endometriosis in the UK. Recommendations from the report included increasing research funding to understand, treat and manage endometriosis, and addressing socioeconomic and ethnic differences. The human cost of endometriosis is substantial, given its overall prevalence, and its impact on day-to-day function during work and leisure, relational and mental health and quality of life(QoL). Furthermore, understanding and implementing management strategies for endometriosis will ultimately have a positive impact on productivity, endometriosis has been shown to have a negative effect on productivity in the workplace due to debilitating symptoms, costing the UK economy £8billion per year. Moreover, prevalence appears to differ according to ethnic background with white women more likely to be diagnosed than black women, and Asian women more likely than white women. Whether it is a true representation of prevalence in different ethnicities or due to implicit biases in the healthcare system, remains unknown. The sociodemographic differences in the condition's impact on society, also underscore its importance as a driver of health inequalities. Treatment for endometriosis most often involves a laparoscopic excision of the endometrium,however 50% of women will develop endometriosis again within 5years of surgery, while other medical treatments lead to significant side-effects. As a result, women with endometriosis often turn to complementary treatments and lifestyle changes to manage their symptoms, however there is currently no guidance or support from health professionals to assist them due to the absence of a scientific evidence base. Being physically active has been shown to be an important therapeutic tool for improving mental health and QoL, and reducing pain in many adults with other chronic conditions, therefore it has significant potential for managing endometriosis symptoms and improving the experience of women with this condition. However, this has never been examined. In order to understand the therapeutic potential of different types of physical activity(PA) for endometriosis and to inform healthcare practice and policy, a comprehensive understanding of the prevalence of endometriosis diagnosis, its symptoms and impact on daily function, and the sociodemographic and cultural drivers of PA amongst women living with endometriosis, is required. Detailed understanding of endometriosis prevalence, symptoms, day-to-day PA patterns and how they differ according to sociodemographic factors, requires precise analysis of highquality secondary data using advance quantitative methods. However, in order to truly understand;1) the diverse experiences of women with endometriosis,2) how they live with and manage the condition,3) the complex sociocultural and environmental drivers of PA behaviours, and4) the perceived benefits and/or harm of different physical activities, a deep and detailed qualitative exploration, working with women affected by this condition, is necessary. The proposed interdisciplinary PhD project will draw on advanced quantitative methods from social epidemiology and statistics, and qualitative social science methods to provide the first detailed understanding of the potential for PA as a therapeutic tool for endometriosis.