Understanding women's decisions to seek an endometriosis diagnosis: A Health Belief Model approach

Early diagnosis of endometriosis is crucial, yet limited literature exists on factors influencing women's decisions to seek diagnosis. This study explores the role of symptoms, health beliefs, and social influences in this decision-making process. A cross-sectional online survey was completed by 388 women (median age = 22 years; interquartile range = 10; range = 18-50). Data included sociodemographic characteristics, medical information, and Health Belief Model constructs. Multivariable regression analyses were conducted to identify predictors of the intention to schedule an appointment and of actual appointment scheduling. Intention to schedule an appointment was primarily predicted by dysmenorrhea (β = 0.16, p = .007) and perceived susceptibility (β = 0.31, p < .001), with weaker contributions from dyschezia (β = 0.10, p = .061) and social cues to action (β = 0.10, p = .076). Actual appointment scheduling was predicted by dysuria (OR = 3.26, 95 percent CI [1.28-8.32], p = .014), perceived susceptibility (OR = 1.60, 95 percent CI [1.14-2.24], p = .006), perceived self-efficacy (OR = 1.71, 95 percent CI [1.25-2.35], p < .001), and social cues to action (OR = 4.43, 95 percent CI [2.25-8.73], p < .001). Women's decision to consult for diagnosis is shaped not only by physical symptoms but also by health beliefs and social influences, with distinct factors influencing intention and behavior. These findings highlight the relevance of a biopsychosocial approach to promote earlier diagnosis and improve support for women with suspected endometriosis.