Study question: Which demographic and medical characteristics of woman are associated with their assessment of patient-centeredness in endometriosis care? Summary answer: A lower educational level, dyspareunia and membership of a patient-organization were found to be independently associated with patient-centeredness as experienced by women in endometriosis care. What is known already: Patient-centered care (PCC) is one of the six dimensions of quality of care. Indeed, focusing on improving patients' experiences with patient-centered care is necessary to improve quality of care. The patientcenteredness of endometriosis care can be measured with the validated and reliable Endocare Questionnaire (ECQ), generating patient-centeredness scores (PCS). Those PCS can subsequently facilitate the development of care improvement projects. A previous study found that a lower educational level was correlated with a higher overall PCS in patients from solely two tertiary clinics. Study design, size, duration: A cross-sectional study was conducted in surgically diagnosed patients with endometriosis. A total of 401 patients were eligible and received the ECQ in 2015 and 2016 and, if needed, two reminders were sent. Participants/materials, setting, methods: All patients were selected from a Dutch tertiary and a Dutch secondary clinic. All 401 patients underwent endometriosis surgery between 2013 and 2014. Univariate and multivariate regression analyses with a forward elimination procedure were conducted to identify variables associated with PCC. Main results and the role of chance: The overall response rate was 56.9%. In total, data from 209 patients was eligible for analysis. Univariate analyses showed 'educational level', 'membership of a patient organization', 'child wish in the future', 'subfertility', 'dysmenorrhea', 'dyspareunia', 'chronic pelvic pain' and 'the degree of which disease is suppressed' as potential determinants of PCC (all p <0.2). 'The degree of which disease is suppressed' was excluded from multivariate analysis due to the low response rate (n = 90). After adjustment for clinic, multivariate analysis showed a lower educational level (B=0.551, p = 0.027), presence of dyspareunia (B=0.790, p = 0.001) and a being member of a patient organization (B=1,670, p <0.001) to be independently associated with higher overall PCS (R2=0.21). Limitations, reasons for caution: Since endometriosis is a chronic disease and care is very dynamic, one cross-sectional study will not comprehend the possible change in patients' experiences to its fullest. A larger sample size would be valuable for identifying determinants of the overall PCS. Wider implications of the findings: The afore-mentioned determinants of PCC are of value for studies benchmarking clinics for their patientcenteredness. In addition, they help clinicians to determine how to tailor their care to their individual patients.
Original languageEnglish
Pages (from-to)i63
JournalHuman Reproduction
Publication statusPublished - 2017

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