The Perception of the Quality of Professional Healthcare Assistance for the Management of Endometriosis: Findings from a National Survey in Italy
Abstract
:1. Introduction
2. Materials and Methods
- ➔
- perceived quality of healthcare (Organizational, Environmental, and Relational quality).
- ➔
- knowledge about endometriosis (disease duration, time of diagnosis).
- ➔
- management of endometriosis (therapeutic and surgical treatments).
- ➔
- perceived mental and physical well-being.
- ➔
- perceived changes in quality of care due to the COVID-19 pandemic.
2.1. Participants and Recruitments
2.2. Tools
2.3. Sample Size
2.4. Statistical Analysis
3. Results
4. Discussion
5. Conclusions
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Acknowledgments
Conflicts of Interest
References
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Characteristics | Mean (SD) or N (%) |
---|---|
Age | 34 (7.6) |
Residence | |
| 320 (37) |
| 187 (21) |
| 368 (42) |
Nationality | |
| 857 (98) |
| 18 (2) |
Marital status | |
| 271 (40) |
| 227 (26) |
| 346 (31) |
| 2 (0) |
| 29 (3) |
Living alone | |
| 776 (89) |
| 99 (11) |
Educational qualification | |
| 113 (13) |
| 286 (33) |
| 390 (44) |
| 85 (10) |
| 1 (0) |
Do you currently have a job? | |
| 420 (48) |
| 155 (18) |
| 160 (18) |
| 89 (10) |
| 51 (6) |
| 0 (0) |
Body Mass Index, categories (kg/m2) | |
| 112 (13) |
| 526 (61) |
| 156 (18) |
| 72 (8) |
Do you do physical activity? | |
| 335 (39) |
| 29 (3) |
| 484 (55) |
| 27 (3) |
Smoking habit: currently you: | |
| 183 (21) |
| 47 (5) |
| 214 (25) |
| 431 (49) |
Do you ever drink a unit of alcohol (1 glass of beer or 1 glass of wine or spirits)? | |
| 373 (43) |
| 101 (12) |
| 71 (8) |
| 38 (4) |
| 9 (1) |
| 283 (32) |
Duration of the disease (years) | |
| 478 (55) |
| 223 (25) |
| 174 (20) |
Time from symptoms to diagnosis (years) | |
| 167 (19) |
| 208 (24) |
| 197 (22) |
| 303 (35) |
Hormonal treatments (lifetime perspective) | |
| 598 (68) |
| 277 (32) |
Therapies (Do you take other medicines not prescribed or recommended by a doctor for problems related to endometriosis?) | |
| 360 (41) |
| 192 (22) |
| 8 (1) |
| 10 (1) |
| 187 (21) |
| 118 (14) |
Clinical complications related to endometriosis | |
| 687 (79) |
| 188 (21) |
Surgical intervention for endometriosis and/or complications * | |
| 527 (60) |
| 348 (40) |
Complications | |
| 305 (34.9) |
| 598 (68.3) |
| 443 (50.6) |
| 34 (3.9) |
| 273 (31.2) |
| 316 (36.1) |
| 101 (11.5) |
| 489 (55.9) |
Comorbidities ** | |
| 485 (55) |
| 390 (45) |
Health Status (SF-36 score) | |
| 38.7 (10.5) |
| 34.2 (11.2) |
Centres/Hospitals/Professionals Chosen for the Treatment of One’s Illness | N (%) |
Centre or doctor specialised in endometriosis treatment | 698 (80) |
Gynaecologist | 75 (9) |
Family Doctor | 54 (6) |
Hospital | 35 (4) |
Other | 13 (1) |
Organizational Quality of centre/hospital/clinic visited | N (%) |
Appointment waits times (≤6 months) | 871 (88) |
Waiting time from arrival to medical visit (≤30 min) | 585 (67) |
Appointment scheduled (yes) | 174 (20) |
Healthcare professionals consulted during the last year for complications related to endometriosis | N (%) |
Endocrinologist (yes) | 131 (20) |
Gastroenterologist (yes) | 189 (28) |
Proctologist (yes) | 71 (11) |
Urologist (yes) | 90 (13) |
Radiologist (yes) | 247 (37) |
Pain specialist (pain therapy) (yes) | 44 (7) |
Physiatrist (yes) | 56 (8) |
Physiotherapist (yes) | 183 (27) |
Sexologist (yes) | 21 (3) |
Psychologist (yes) | 155 (23) |
Nutritionist (yes) | 299 (45) |
Psychiatrist (yes) | 38 (6) |
Dependent: Visit Hours n, %, [95%CI] 751, 86%, [83–88] | OR | p-Value | 95%CI |
Age | 1.00 | 0.692 | 0.98–1.03 |
Residence (rif: Southern Italy) | |||
Central Italy | 1.56 | 0.117 | 0.89–2.73 |
Northern Italy | 1.13 | 0.575 | 0.73–1.76 |
Occupational status (rif: employed) | 0.93 | 0.759 | 0.60–1.45 |
Educational level (rif: high) | 0.70 | 0.092 | 0.44–1.06 |
Marital status (rif: single) | 1.24 | 0.315 | 0.82–1.87 |
Health Service (rif: non-specialised centre or doctor) | 1.56 | 0.058 | 0.98–2.46 |
Comorbidities (rif: no) | 0.67 | 0.066 | 0.44–1.03 |
Complications (rif: no) | 0.69 | 0.150 | 0.41–1.14 |
PCS | 1.02 | 0.034 | 1.00–1.04 |
MCS | 1.03 | 0.001 | 1.01–1.05 |
Dependent: Accessibility n, %, [95%CI] 831, 95%, [93–96] | OR | p-Value | 95%CI |
Age | 1.02 | 0.308 | 0.98–1.07 |
Residence (rif: Southern Italy) | |||
Central Italy | 1.17 | 0.702 | 0.53–2.58 |
Northern Italy | 1.93 | 0.76 | 0.93–4.02 |
Occupational status (rif: employed) | 0.96 | 0.904 | 0.48–1.90 |
Educational level (rif: high) | 0.89 | 0.738 | 0.46–1.74 |
Marital status (rif: single) | 1.16 | 0.652 | 0.60–2.24 |
Health Service (rif: non-specialised centre or doctor) | 1.57 | 0.213 | 0.77–3.18 |
Comorbidities (rif: no) | 0.73 | 0.366 | 0.38–1.43 |
Complications (rif: no) | 0.39 | 0.054 | 0.15–1.02 |
PCS | 1.05 | 0.006 | 1.01–1.08 |
MCS | 0.99 | 0.519 | 0.96–1.02 |
Dependent: Cleaning n, %, [95%CI] 828, 95%, [93–96] | OR | p-Value | 95%CI |
Age | 0.97 | 0.179 | 0.93–1.01 |
Residence (rif: Southern Italy) | |||
Central Italy | 0.78 | 0.504 | 0.38–1.60 |
Northern Italy | 1.99 | 0.076 | 0.93–4.26 |
Occupational status (rif: employed) | 0.83 | 0.599 | 0.41–1.67 |
Educational level (rif: high) | 1.08 | 0.821 | 0.57–2.05 |
Marital status (rif: single) | 1.13 | 0.715 | 0.59–2.13 |
Health Service (rif: non-specialised centre or doctor) | 3.46 | <0.001 | 1.85–6.47 |
Comorbidities (rif: no) | 0.98 | 0.959 | 0.53–1.54 |
Complications (rif: no) | 0.32 | 0.022 | 0.12–0.85 |
PCS | 1.00 | 0.930 | 0.97–1.03 |
MCS | 1.02 | 0.091 | 1.00–1.05 |
Dependent: Professional’s Courtesy n, %, [95%CI] 748, 85%, [83–88] | OR | p-Value | 95%CI |
Age | 1.00 | 0.823 | 0.97–1.03 |
Residence (rif: Southern Italy) | |||
Central Italy | 0.62 | 0.071 | 0.34–1.01 |
Northern Italy | 0.71 | 0.153 | 0.45–1.13 |
Occupational status (rif: employed) | 1.14 | 0.535 | 0.74–1.76 |
Educational level (rif: high) | 0.72 | 0.113 | 0.48–1.08 |
Marital status (rif: single) | 0.96 | 0.838 | 0.63–1.45 |
Health Service (rif: non-specialised centre or doctor) | 1.47 | 0.096 | 0.93–2.33 |
Comorbidities (rif: no) | 0.94 | 0.789 | 0.63–1.42 |
Complications (rif: no) | 1.18 | 0.487 | 0.74–1.87 |
PCS | 1.03 | 0.015 | 1.01–10.5 |
MCS | 1.04 | <0.001 | 1.02–1.06 |
Dependent: Clarity of information n, %, [95%CI] 707, 81%, [78–83] | OR | p-Value | 95%CI |
Age | 1.02 | 0.132 | 0.99–1.04 |
Residence (rif: Southern Italy) | |||
Central Italy | 1.26 | 0.349 | 0.78–2.04 |
Northern Italy | 1.12 | 0.573 | 0.75–1.67 |
Occupational status (rif: employed) | 0.91 | 0.659 | 0.62–1.35 |
Educational level (rif: high) | 1.06 | 0.736 | 0.73–1.54 |
Marital status (rif: single) | 1.67 | 0.413 | 0.80–1.69 |
Health Service (rif: non-specialised centre or doctor) | 1.80 | 0.004 | 1.20–2.69 |
Comorbidities (rif: no) | 0.91 | 0.609 | 0.63–1.31 |
Complications (rif: no) | 1.16 | 0.471 | 0.77–1.77 |
PCS | 1.03 | <0.001 | 1.02–1.06 |
MCS | 1.03 | <0.001 | 1.02–1.05 |
Dependent: Availability to Listen n, %, [95%CI] 640, 73%, [70–76] | OR | p-Value | 95%CI |
Age | 1.02 | 0.037 | 1.00–1.05 |
Residence (rif: Southern Italy) | |||
Central Italy | 0.94 | 0.760 | 0.61–1.43 |
Northern Italy | 1.02 | 0.909 | 0.71–1.47 |
Occupational status (rif: Unemployed) | 1.07 | 0.686 | 0.76–1.52 |
Educational level (rif: low) | 0.82 | 0.248 | 0.59–1.14 |
Marital status (rif: single) | 0.78 | 0.159 | 0.56–1.10 |
Health Service (rif: non-specialised centre or doctor) | 1.42 | 0.067 | 0.97–2.07 |
Comorbidities (rif: no) | 0.83 | 0.257 | 0.59–1.15 |
Complications (rif: no) | 1.46 | 0.044 | 1.01–2.11 |
PCS | 1.03 | <0.001 | 1.02–1.05 |
MCS | 1.03 | <0.001 | 1.02–1.05 |
Dependent: Cooperation n, %, [95%CI] 480, 55%, [51–58] | OR | p-Value | 95%CI |
---|---|---|---|
Age | 0.99 | 0.349 | 0.97–1.01 |
Residence (rif: Southern Italy) | |||
Central Italy | 0.95 | 0.798 | 0.65–1.39 |
Northern Italy | 0.97 | 0.839 | 0.70–1.33 |
Occupational status (rif: employed) | 0.93 | 0.652 | 0.68–1.28 |
Educational level (rif: low) | 0.62 | 0.002 | 0.46–0.84 |
Marital status (rif: single) | 1.04 | 0.769 | 0.78–1.41 |
Health Service (rif: non-specialised centre or doctor) | 1.85 | 0.001 | 1.30–2.63 |
Comorbidities (rif: no) | 0.88 | 0.384 | 0.65–1.18 |
Complications (rif: no) | 1.03 | 0.881 | 0.73–1.44 |
PCS | 1.03 | <0.001 | 1.01–1.04 |
MCS | 1.03 | <0.001 | 1.02–1.05 |
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Cofini, V.; Muselli, M.; Limoncin, E.; Lolli, C.; Pelaccia, E.; Guido, M.; Fabiani, L.; Necozione, S. The Perception of the Quality of Professional Healthcare Assistance for the Management of Endometriosis: Findings from a National Survey in Italy. Int. J. Environ. Res. Public Health 2023, 20, 6978. https://doi.org/10.3390/ijerph20216978
Cofini V, Muselli M, Limoncin E, Lolli C, Pelaccia E, Guido M, Fabiani L, Necozione S. The Perception of the Quality of Professional Healthcare Assistance for the Management of Endometriosis: Findings from a National Survey in Italy. International Journal of Environmental Research and Public Health. 2023; 20(21):6978. https://doi.org/10.3390/ijerph20216978
Chicago/Turabian StyleCofini, Vincenza, Mario Muselli, Erika Limoncin, Chiara Lolli, Erika Pelaccia, Maurizio Guido, Leila Fabiani, and Stefano Necozione. 2023. "The Perception of the Quality of Professional Healthcare Assistance for the Management of Endometriosis: Findings from a National Survey in Italy" International Journal of Environmental Research and Public Health 20, no. 21: 6978. https://doi.org/10.3390/ijerph20216978