Behavioral, cognitive, and emotional coping strategies of women with endometriosis: a critical narrative review

Abstract

Endometriosis is a disabling and long-term medical condition affecting quality of life and mental health. Behavioral, cognitive, and emotional coping strategies, emotional intelligence, and metacognition could in part explain the link between the disease and impaired psychological and life functioning. This critical narrative review aimed at examining the state of the art of the relationships between endometriosis and these factors. According to PRISMA principles, we performed a systematic search for quantitative and qualitative studies on multiple electronic databases as regards coping strategies, emotional intelligence, and metacognition in women with endometriosis. Studies were subjected to interpretative and critical narrative synthesis. A total of 9 papers were included in the review. Three main categories were identified in thematic analysis and resumed in the manuscript. Findings suggested that (a) pain is considered the major stressor; (b) they usually use both adaptive and maladaptive coping strategies; (c) women with endometriosis and related chronic pain seem to repress emotions more likely than healthy ones; (d) suppressing own emotions, pain catastrophizing, and having a passive coping style are related to higher self-reported pain; and (e) emotional and avoidance coping styles are associated to poor mental status, while positive coping strategies focusing on the problem or on emotions, detached and rational styles are associated to better mental health. Few studies with mixed results and some methodological flaws have focused on coping strategies in women with endometriosis. No studies focusing on metacognition or emotional intelligence were found. Methodological biases, suggestions for future research, and implications for clinical practice were discussed.

‘So many women suffer in silence’: a thematic analysis of women’s written accounts of coping with endometriosis

“…Women's accounts did not support work by Altinbas et al (2015) who suggested that pain caused by endometriosis does not affect quality of women's lives; on the contrary, women's accounts showed that dealing with chronic pain was a constant struggle, and pain and fatigue impacted on women's lives on a day to day basis. Results support data from reviews by Young et al (2015) and Zarbo et al (2018) which showed that pain is the key negative experience reported by women with endometriosis. This pain and associated fatigue impacted on all domains of life, including employment and social life, supporting Facchin et al's (2015) suggestion that endometriosis with pelvic pain causes significant negative impacts on quality of life in women experiencing these symptoms.…”

Healthcare Consumption and Cost Estimates Concerning Swedish Women with Endometriosis

“…A possible explanation for our results is that the older women might have developed coping mechanisms over time that could decrease the impact of the symptoms. This has also been suggested earlier [19,20].…”

About me as a person not only the disease – piloting Guided Self‐Determination in an outpatient endometriosis setting

“…We believe that supporting women's abilities to cope with endometriosis and enabling integration of life and disease, based on personal values and preferences, remain key tasks for nurses. Positive coping strategies focusing on the problem or on emotions in relation to endometriosis were in a recent review found to be associated with better mental health (40).…”