Endometriosis and its impact on patient’s quality of life, measured by Indonesian endometriosis health profile questionnaire
Creators: name: Wirawan, Florencia
name: Eni Widiastuti
name: Patricia, Maria
name: M. Luky Satria Marwali
name: Sitomurang, Herbert
Publisher: name: F1000Research
Year: 2017

description: INTRODUCTION<br>Endometriosis was a benign disease in which endometrium grows outside the uterus, most often found in the ovaries, fallopian tubes, and tissue around the uterus, ovaries, intestine. Bladder, ureter even further part of body such as lungs. Endometriosis contributed one third of chronic pelvic pain in endometriosis patients. Mostly characterized by dysmenorrhea which ranged from mild to severe one. Some of our patients were experiencing tremendous pain that they just only could lay back when menstrual cycle came. Endometriosis also contributed to low Infertility rate of endometriosis patients . American Society for Reproductive Medicine stated that endometriosis might be found in 24-50% of women who experience infertility. Both of these side effects cause by endometriosis could impact patient’s quality of life. <sup>1</sup><br>Endometriosis Health Profile (EHP-30)<sup>2,3,4</sup> was a Health Related Quality of Life patient self-report, used to measure the wide range of effects that endometriosis can have on women’s life. Many study had evaluating the questionnaire and showed a good internal consistency and construct validity which concluded that EHP-30<sup>1</sup> was a reliable and valid instrument for the measurement of health-related quality of life in women with endometriosis. In this study we wanted to know whether endometriosis really impact patient’s quality of life and how great the impact on them using EHP-30 Questionnaire.<sup>5</sup><br> <br>DESIGN, SUBJECT AND METHODS<br>A cross sectional study was done involving 200 women including 100 (50%) healthy and 100 (50%) endometriosis patient. Subjects filled the Endometriosis Health Profile – 30 online via Google Form application. A hypothesis (H0) was defined before data analysis : endometriosis did not impact patients’ quality of life, and tested using Mann-Whitney U test. Data gained from questionnaires were combined into one conclusion : the severity level on how endometriosis impact patient’s quality of life, which was ranged from none (never 0 ) ,low (rarely  1 – sometimes 2 )  until high impact ( often 3 – always  4). The result of Mann-Whitney U test will show whether the hypothesis rejected or not. The second part of the study was to explore deeper about the impact of endometriosis  in every part of their life including personal and social domain. Personal domain included core questionnaire such as pain, control and powerlessness, emotional well-being, social support, and self-images; whether social domain included modular questionnaire such as work, children, sexual intercourse, medical profession, treatment and infertility. Data will be classified as none (0), low impact (1-2) or high impact (3-4). All calculations were done by SPSS version 23.<br><br><br>RESULT<br>After being tested by Mann-Whitney U test, it was concluded that hypothesis was rejected (p = 0.000) which meant that “endometriosis did impact patients’ quality of life“ statement was statistically significant (p &lt; 0.005). The mean of overall “impact on quality of life” on endometriosis group was 3.14 with SD 0.351 which shows that endometriosis had a high impact on patient’s quality of life. As the study went deeper, the mean of endometriosis impact on personal (3.27 ± SD 0.359) and social domain (3.01 ± SD 0.343) were both high. In personal domain, endometriosis highly impacted on pain, control and powerlessness, emotional well being, social support issues but lowly impacted self image issue. Meanwhile on social domain, endometriosis highly impacted work, treatment and infertility issues but lowly impacted on children, sexual intercourse and medical profession issue.<br><br>CONCLUSION<br>Endometriosis was one of the disease that sometimes was considered frivolous.<sup>6</sup> It was stated that 1 of 10 women developed endometriosis, which meant that they are actually many women suffering in silence due to endometriosis. Doctors often took it easy, thought that it was some kind of normal condition for women and only treated endometriosis patients with painkiller, which made delay time of endometriosis diagnosis went longer.<sup>7</sup> For some cases, endometriosis extended to other anatomical part of body developing Deep Infiltrating Endometriosis which gave extra suffer for endometriosis patients such as dyspareunia, dysuria, dyschezia, or even silent hydronephosis and renal failure.<sup>8</sup> As this study showed that endometriosis impacted many aspects of patients’ life and significantly decreased their quality of life, more concern should be given to endometriosis patients.