Pre-operative expectations in patients with endometriosis - a qualitative interview study

Area of Science:

• Reproductive medicine
• Surgical outcomes
• Patient-centered care

Background:

• Endometriosis significantly impacts quality of life, with many surgically treated patients experiencing persistent symptoms.
• The role of patient expectations in endometriosis treatment outcomes is not well understood.
• Non-medical factors likely influence post-operative results in endometriosis.

Purpose of the Study:

• To explore pre-operative expectations of patients undergoing endometriosis treatment.
• To identify factors that facilitate positive treatment outcomes.
• To understand barriers to positive outcomes in endometriosis care.

Main Methods:

• Qualitative study involving interviews with 33 endometriosis patients before laparoscopy.
• Utilized a subsample from a larger mixed-method cohort study.
• Employed structured content analysis for data interpretation.

Main Results:

• Patients held both positive expectations (e.g., symptom resolution, diagnosis) and negative expectations (e.g., symptom persistence, pain).
• Positive expectations were perceived as facilitators, alongside better information and specialized care.
• Barriers included post-operative pain, insufficient rest, avoidance behaviors, and stress.

Conclusions:

• Coexisting positive and negative expectations highlight patient hopes and potential risks of nocebo effects.
• Patients clearly identified facilitators and barriers to their quality of life post-laparoscopy.
• Enhancing patient information is recommended to manage expectations and mitigate nocebo effects.