Patients’ motives and considerations on treatment decision-making for heavy menstrual bleeding: a qualitative study

Abstract

Background Several treatment modalities for heavy menstrual bleeding are available. However, many women report being unsatisfied in their search for an appropriate and effective treatment. The aim of this study is to gain insights in the experienced impact of HMB and the motives and considerations of women during the decision-making process for different treatment options for heavy menstrual bleeding. Methods An interpretative qualitative study was performed, using in-depth interviews. In total, 14 semi-structured interviews were conducted with patients who consulted a physician for treatment of heavy menstrual bleeding. Participants were recruited via the Dutch Patient Federation (N = 10) or via the outpatient clinic in the Máxima Medical Centre (N = 4). The interviews were conducted by phone or online between February 2020 and March 2021. In the interviews three topics were addressed: 1) participants experience with heavy menstrual bleeding, 2) patient experience with treatment journey and 3) elaborating on alternative treatments for heavy menstrual bleeding. A thematic content analysis was conducted. Results Fourteen participants aged between 30 and 59 years old were interviewed. Three main themes emerged; “Considerations in taking the first step to seek help”, “Various sources of information can contribute, confuse or frighten decision-making process” and “A physician’s support and understanding is needed to guide the decision-making process”. Conclusion Our results show that women's considerations and decision making strongly depend on the obtained information and experience, the relationship with the physician, the influence of the social environment, the pre-visit expectations/ desires, the fear of treatment complications and uncertainty of the effect of the treatment. It’s a physicians roll to create a trusting and open atmosphere during consultation. Patient-centered communication is helpful to share knowledge, and gain inside into a patient’s hopes, fears and worries.