Impact of Endometriosis in Women of Arab Ancestry on: Health-Related Quality of Life, Work Productivity, and Diagnostic Delay
Introduction: Endometriosis has a negative effect on health-related quality of life (HRQoL), wellbeing and daily functioning. Endometriosis is an under-researched condition within non-western populations. Cultural representations are needed to understand the relative roles of societal norms, traditi...
| Main Authors: | , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Frontiers Media S.A.
2021-09-01
|
| Series: | Frontiers in Global Women's Health |
| Subjects: | |
| Online Access: | https://www.frontiersin.org/articles/10.3389/fgwh.2021.708410/full |
| _version_ | 1818641640798027776 |
|---|---|
| author | Mira Mousa Moamar Al-Jefout Moamar Al-Jefout Habiba Alsafar Habiba Alsafar Christian M. Becker Krina T. Zondervan Krina T. Zondervan Nilufer Rahmioglu Nilufer Rahmioglu |
| author_facet | Mira Mousa Moamar Al-Jefout Moamar Al-Jefout Habiba Alsafar Habiba Alsafar Christian M. Becker Krina T. Zondervan Krina T. Zondervan Nilufer Rahmioglu Nilufer Rahmioglu |
| author_sort | Mira Mousa |
| collection | DOAJ |
| description | Introduction: Endometriosis has a negative effect on health-related quality of life (HRQoL), wellbeing and daily functioning. Endometriosis is an under-researched condition within non-western populations. Cultural representations are needed to understand the relative roles of societal norms, traditional factors, and religious sensitivities on the impact of endometriosis on HRQoL in various populations. In particular, there is a lack of emphasis placed in understanding the association of HRQoL on endometriosis in Arab women.Method: In this prospective case-control study, 2,610 Arab ancestry women in the United Arab Emirates were recruited to investigate the impact of endometriosis on HRQoL, diagnostic delay, psychological co-morbidities, work productivity, and physical activity. Participants completed the following standardized, validated questionnaires: Short Form-36 version 2 questionnaire, the World Endometriosis Research Foundation EPHect minimum clinical questionnaire version, and Work Productivity and Activity Impairment questionnaire. Translations to the Arabic language, validated using the forward-backward translation method, of the questionnaires were utilized.Results: HRQoL scores were significantly impaired in women with endometriosis, as demonstrated in the Physical Composite Scores and Mental Composite Scores in the symptomatic control group (p = 0.001; p = 0.003, respectively) and the asymptomatic control group (p < 0.001; p < 0.001, respectively). Susceptibility and severity of multiple pain syndromes and infertility in women with endometriosis was the main indicator of lower HRQoL. Anxiety (p = 0.007) and depression (p = 0.005) were significantly associated with endometriosis, in comparison to symptomatic controls. The average diagnostic delay was 11.61 years, however single women experience 15.81 years of diagnosis delay, with approximately 18% (n = 15) of the single women experiencing more than a 20-year delay in diagnosis. The intensity of physical activity was not associated with endometriosis, when compared to symptomatic (p = 0.405) or asymptomatic controls (p = 0.144).Conclusion: For the first time, we provide evidence from a combined hospital, clinic, and population-based study that Arab women with endometriosis experience significant impacts on HRQoL, substantial diagnostic delay after the onset of symptoms, significant association to psychological disorders (anxiety and depression), and a negative impact on work productivity. Future research must focus on understanding the personal and culturally centered beliefs of Arab women to ensure a positive HRQoL trajectory by improving diagnosis and management strategies. |
| first_indexed | 2024-12-16T23:30:23Z |
| format | Article |
| id | doaj.art-90fd0bc7bcd8409c8ad660e57bdb6ac9 |
| institution | Directory Open Access Journal |
| issn | 2673-5059 |
| language | English |
| last_indexed | 2024-12-16T23:30:23Z |
| publishDate | 2021-09-01 |
| publisher | Frontiers Media S.A. |
| record_format | Article |
| series | Frontiers in Global Women's Health |
| spelling | doaj.art-90fd0bc7bcd8409c8ad660e57bdb6ac92022-12-21T22:11:54ZengFrontiers Media S.A.Frontiers in Global Women's Health2673-50592021-09-01210.3389/fgwh.2021.708410708410Impact of Endometriosis in Women of Arab Ancestry on: Health-Related Quality of Life, Work Productivity, and Diagnostic DelayMira Mousa0Moamar Al-Jefout1Moamar Al-Jefout2Habiba Alsafar3Habiba Alsafar4Christian M. Becker5Krina T. Zondervan6Krina T. Zondervan7Nilufer Rahmioglu8Nilufer Rahmioglu9Nuffield Department of Women's and Reproductive Health, Endometriosis CaRe Centre, University of Oxford, Oxford, United KingdomDepartment of Obstetrics and Gynaecology, College of Medical and Health Sciences, United Arab Emirates University, Al Ain, United Arab EmiratesDepartment of Obstetrics and Gynaecology, Mutah Medical Faculty, Mutah University, Al-Karak, JordanCenter for Biotechnology, Khalifa University of Science and Technology, Abu Dhabi, United Arab EmiratesDepartment of Genetics and Molecular Biology, College of Medicine and Health Sciences, Khalifa University of Science and Technology, Abu Dhabi, United Arab EmiratesNuffield Department of Women's and Reproductive Health, Endometriosis CaRe Centre, University of Oxford, Oxford, United KingdomNuffield Department of Women's and Reproductive Health, Endometriosis CaRe Centre, University of Oxford, Oxford, United KingdomWellcome Centre for Human Genetics, University of Oxford, Oxford, United KingdomNuffield Department of Women's and Reproductive Health, Endometriosis CaRe Centre, University of Oxford, Oxford, United KingdomWellcome Centre for Human Genetics, University of Oxford, Oxford, United KingdomIntroduction: Endometriosis has a negative effect on health-related quality of life (HRQoL), wellbeing and daily functioning. Endometriosis is an under-researched condition within non-western populations. Cultural representations are needed to understand the relative roles of societal norms, traditional factors, and religious sensitivities on the impact of endometriosis on HRQoL in various populations. In particular, there is a lack of emphasis placed in understanding the association of HRQoL on endometriosis in Arab women.Method: In this prospective case-control study, 2,610 Arab ancestry women in the United Arab Emirates were recruited to investigate the impact of endometriosis on HRQoL, diagnostic delay, psychological co-morbidities, work productivity, and physical activity. Participants completed the following standardized, validated questionnaires: Short Form-36 version 2 questionnaire, the World Endometriosis Research Foundation EPHect minimum clinical questionnaire version, and Work Productivity and Activity Impairment questionnaire. Translations to the Arabic language, validated using the forward-backward translation method, of the questionnaires were utilized.Results: HRQoL scores were significantly impaired in women with endometriosis, as demonstrated in the Physical Composite Scores and Mental Composite Scores in the symptomatic control group (p = 0.001; p = 0.003, respectively) and the asymptomatic control group (p < 0.001; p < 0.001, respectively). Susceptibility and severity of multiple pain syndromes and infertility in women with endometriosis was the main indicator of lower HRQoL. Anxiety (p = 0.007) and depression (p = 0.005) were significantly associated with endometriosis, in comparison to symptomatic controls. The average diagnostic delay was 11.61 years, however single women experience 15.81 years of diagnosis delay, with approximately 18% (n = 15) of the single women experiencing more than a 20-year delay in diagnosis. The intensity of physical activity was not associated with endometriosis, when compared to symptomatic (p = 0.405) or asymptomatic controls (p = 0.144).Conclusion: For the first time, we provide evidence from a combined hospital, clinic, and population-based study that Arab women with endometriosis experience significant impacts on HRQoL, substantial diagnostic delay after the onset of symptoms, significant association to psychological disorders (anxiety and depression), and a negative impact on work productivity. Future research must focus on understanding the personal and culturally centered beliefs of Arab women to ensure a positive HRQoL trajectory by improving diagnosis and management strategies.https://www.frontiersin.org/articles/10.3389/fgwh.2021.708410/fullquality of lifeendometriosisglobal healthwomen's healthMiddle EastArab women |
| spellingShingle | Mira Mousa Moamar Al-Jefout Moamar Al-Jefout Habiba Alsafar Habiba Alsafar Christian M. Becker Krina T. Zondervan Krina T. Zondervan Nilufer Rahmioglu Nilufer Rahmioglu Impact of Endometriosis in Women of Arab Ancestry on: Health-Related Quality of Life, Work Productivity, and Diagnostic Delay Frontiers in Global Women's Health quality of life endometriosis global health women's health Middle East Arab women |
| title | Impact of Endometriosis in Women of Arab Ancestry on: Health-Related Quality of Life, Work Productivity, and Diagnostic Delay |
| title_full | Impact of Endometriosis in Women of Arab Ancestry on: Health-Related Quality of Life, Work Productivity, and Diagnostic Delay |
| title_fullStr | Impact of Endometriosis in Women of Arab Ancestry on: Health-Related Quality of Life, Work Productivity, and Diagnostic Delay |
| title_full_unstemmed | Impact of Endometriosis in Women of Arab Ancestry on: Health-Related Quality of Life, Work Productivity, and Diagnostic Delay |
| title_short | Impact of Endometriosis in Women of Arab Ancestry on: Health-Related Quality of Life, Work Productivity, and Diagnostic Delay |
| title_sort | impact of endometriosis in women of arab ancestry on health related quality of life work productivity and diagnostic delay |
| topic | quality of life endometriosis global health women's health Middle East Arab women |
| url | https://www.frontiersin.org/articles/10.3389/fgwh.2021.708410/full |
| work_keys_str_mv | AT miramousa impactofendometriosisinwomenofarabancestryonhealthrelatedqualityoflifeworkproductivityanddiagnosticdelay AT moamaraljefout impactofendometriosisinwomenofarabancestryonhealthrelatedqualityoflifeworkproductivityanddiagnosticdelay AT moamaraljefout impactofendometriosisinwomenofarabancestryonhealthrelatedqualityoflifeworkproductivityanddiagnosticdelay AT habibaalsafar impactofendometriosisinwomenofarabancestryonhealthrelatedqualityoflifeworkproductivityanddiagnosticdelay AT habibaalsafar impactofendometriosisinwomenofarabancestryonhealthrelatedqualityoflifeworkproductivityanddiagnosticdelay AT christianmbecker impactofendometriosisinwomenofarabancestryonhealthrelatedqualityoflifeworkproductivityanddiagnosticdelay AT krinatzondervan impactofendometriosisinwomenofarabancestryonhealthrelatedqualityoflifeworkproductivityanddiagnosticdelay AT krinatzondervan impactofendometriosisinwomenofarabancestryonhealthrelatedqualityoflifeworkproductivityanddiagnosticdelay AT niluferrahmioglu impactofendometriosisinwomenofarabancestryonhealthrelatedqualityoflifeworkproductivityanddiagnosticdelay AT niluferrahmioglu impactofendometriosisinwomenofarabancestryonhealthrelatedqualityoflifeworkproductivityanddiagnosticdelay |