Abstract
What specific fears and concerns do patients with uterine fibroids have? How are these influenced by sociodemographic factors, duration of condition and level of knowledge among these women? Between January 2016 and January 2017 807 patients were consecutively surveyed at a university hospital speciality fibroid clinic using a two page locally developed and validated questionnaire focusing on fibroid-associated fears and concerns. The questionnaire was completed by 730 women (90.5%) the majority of whom reported fears/concerns mainly with regards to treatment (need to treat/side-effects/hysterectomy) and the fibroids themselves (increasing size and number). Various parameters influenced the type and severity of fears: Young patients (< 40 years) had concerns particularly with regard to pregnancy/birthing while older patients (> 40years) were more concerned about general health and significant blood loss. Time interval since diagnosis also affected fears with different concerns between patients with shorter duration of diagnosis (< 12 months) vs. longer duration (> 12 months). Overall only slight differences could be attributed to immigrant background. Higher level of education correlated with less anxiety. Proper information about fibroids relieved fears of malignant change in particular. Doctors and the internet were the most important sources of patient information. Due to the benign nature of uterine fibroids and their good treatability, fibroid-associated fears are generally unfounded. Precise knowledge of patient fears and concerns should be integrated into clinical care with targeted psychological support to help patients better understand their condition.
Highlights
With an incidence of 20 to 40 %, uterine fibroids are the most common solid benign tumours in women of reproductive age [1]
Study questions What specific fears and concerns do patients with uterine fibroids have? How are these influenced by sociodemographic factors, duration of condition and level of knowledge among these women? Methods Between January 2016 and January 2017 807 patients were consecutively surveyed at a university hospital speciality fibroid clinic using a two page locally developed and validated questionnaire focusing on fibroid-associated fears and concerns
The questionnaire was completed by 730 women (90.5 %) the majority of whom reported fears/concerns mainly with regards to treatment and the fibroids themselves
Summary
With an incidence of 20 to 40 %, uterine fibroids are the most common solid benign tumours in women of reproductive age [1]. Spies et al (2002) showed that symptomatic uterine fibroids can have a negative impact on health related quality of life (HRQL) through impairment of daily activities and anxiety, which may develop before and after diagnosis [5]. Helplessness in dealing with the diagnosis and treatment options, negative body image, effects on sexuality and a lack of support. They worry about appearing pregnant or overweight due to visible abdominal enlargement [7]. In 2005 Gallachio et al showed that in their questionnaire study collective of American women, almost 80 % of patients having a hysterectomy with a preoperative diagnosis of uterine fibroids reported fear of malignancy as the reason for their decision to undergo surgery [9]
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