Page 36 - Diagnostic delay of endometriosis

Abstract
Objective
To identify strengths and weaknesses in the current diagnostic process of endometriosis from the patients’ experience
Design
Qualitative study
Setting
Group interviews throughout the country
Population: Women between 18 and 45 years old who had been diagnosed with endometriosis in the past five years.
Methods
Semi-structured focus group discussions, audio recorded and fully transcribed. Grounded theory methodology was applied for data analysis.
Main outcome measures
Factors related to the diagnostic delay of endometriose and possible interventions to reduce the delay
Results
23 women participated in six focus groups. Mean time from start of symptoms to diagnosis was 101.7 months. Dominant themes were knowledge about normal menstruation and endometriosis in both the general population, being believed and acknowledged by medical staff, and collaboration between health care providers including fast referral to a gynaecologist. Barriers to a timely referral and diagnosis were young age, normalisation of symptoms and a lack of awareness in general practitioners. Facilitating factors were adequate knowledge and skills of the general practitioner, a desire for pregnancy and persisting in a request for specialist consultation by the patient.
Conclusions
The diagnostic process in endometriosis is hampered by late presentation of symptoms to a medical professional, inadequate appraisal of symptoms and the interaction between patients and medical professionals. Efforts should be made to increase awareness in the general population, and to provide
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