Navigating benign gynecological care in a pandemic: A qualitative exploration of patient experiences during COVID-19

This study aimed to explore how women experienced benign gynecological care during the initial phase of the COVID-19 pandemic in the Netherlands, when healthcare capacity was constrained and elective services were often postponed or restructured. By focusing on the patient perspective, we sought to identify which adaptations were acceptable, which were perceived as inadequate, and what patients considered "good enough" care during a period of absolute scarcity.

We conducted online focus group discussions (FGDs) with patients from five hospitals, covering three care pathways: heavy menstrual bleeding, uterine fibroids, and prolapse. Data were analyzed using reflexive thematic analysis to identify patterns in patient experiences.

Analysis identified five themes: insecurity, loneliness, efficiency and focus, mutual understanding, and communication. Negative experiences included uncertainty about treatment timing, feelings of abandonment, and isolation due to restrictions on accompaniment. Positive experiences involved shorter waiting times, more focused consultations, and practical benefits of digital appointments. Neutral experiences reflected empathy for healthcare pressures, despite personal inconvenience. Communication emerged as the decisive factor shaping perceptions of care. Consistent, honest, and empathetic communication fostered trust and acceptance, while vague or fragmented information heightened distress.

Patients demonstrated considerable understanding of systemic constraints. Yet, delays, reduced relational continuity and lack of clarity had significant emotional impact. In times of scarcity, appropriate care is defined not only by clinical feasibility but by the quality of engagement, information, and emotional support.

Embedding open, responsive communication as a core component of care may help maintain patient trust and acceptance during times of limited capacity. These insights extend beyond pandemic conditions, offering guidance for managing care under structural staff shortages and rising demand in healthcare systems.