Physical pain and emotion regulation as the main predictive factors of health-related quality of life in women living with endometriosis

Gabriella Márki, Attila Bokor, J. Rigó, Adrien Rigó

Research output: Contribution to journalArticle

14 Citations (Scopus)

Abstract

STUDY QUESTION To what extent are pain symptoms, psychological variables (anxiety, depression and distress) and emotion regulation associated with women's health in endometriosis? SUMMARY ANSWER Physical pain symptoms and emotion regulation difficulties via psychological stress negatively affect the health-related quality of life (HRQoL) of women living with endometriosis. WHAT IS KNOWN ALREADY There are some missing links in the definitive treatment and recovery from endometriosis. Women with chronic pain report a decrease in HRQoL and an increase in the frequency of psychological problems, but little is known about the complex relationship between these variables in the context of endometriosis. STUDY DESIGN, SIZE, DURATION This cross-sectional study was conducted between October 2014 and October 2015 on 193 women living with endometriosis. PARTICIPANTS/MATERIALS, SETTING, METHODS The sample consisted of women with a medically confirmed diagnosis of endometriosis who received treatment at the participating clinic. All participants completed the Short Form Health Survey (SF-36), the Hospital Anxiety and Depression Scale, the Perceived Stress Scale and the Difficulties in Emotion Regulation Scale. Spearman's rank correlation was used to explore the associations between the measured variables, and structural equation modeling was used to test the proposed mediation models. MAIN RESULTS AND THE ROLE OF CHANCE The response rate was 46%. In this study, 54.79% of the participants presented with anxiety and 20.3% with depressive symptoms. Pain symptoms, psychological variables and difficulties in emotion regulation were negatively associated with HRQoL. Mediation models revealed that physical pain, psychological stress and difficulties in emotion regulation explained 55% of the variance in the overall HRQoL, 41% of the variation in physical and 55% of the variation in mental HRQoL. Accordingly, severe physical pain (β = 1) was directly, and difficulties in emotion regulation (β = '0.38, P < 0.001) was indirectly related to deterioration in overall HRQoL. Physical pain had a higher direct standardized effect (β = '0.51, P < 0.001) on physical HRQoL, and had no significant direct effect on mental HRQoL. Furthermore, both physical pain (β = '0.07, P < 0.001) and difficulties in emotion regulation (β = '0.46, P < 0.001) had a significant indirect effect on mental HRQoL. LIMITATIONS, REASONS FOR CAUTION The data were heterogeneous with regard to the severity of endometriosis. The validity of this cross-sectional study is limited to correlations; therefore, further longitudinal studies using a more representative sample are needed to explore valid causal relationships. WIDER IMPLICATIONS OF THE FINDINGS The results of this study indicate that HRQoL can be improved through pain management and emotion regulation strategies. The authors believe that HRQoL would increase with concomitant application of physical treatment and psychological care. STUDY FUNDING/COMPETING INTEREST(S) There were no external funding sources for this study, and the authors have no conflicts of interest to declare. TRIAL REGISTRATION NUMBER Not applicable.

Original languageEnglish
Pages (from-to)1432-1438
Number of pages7
JournalHuman Reproduction
Volume32
Issue number7
DOIs
Publication statusPublished - Jul 1 2017

Fingerprint

Endometriosis
Emotions
Quality of Life
Pain
Psychology
Mental Health
Anxiety
Depression
Psychological Stress
Cross-Sectional Studies
Conflict of Interest
Women's Health
Pain Management
Health Surveys
Chronic Pain
Longitudinal Studies
Therapeutics

Keywords

  • emotion regulation
  • endometriosis
  • health-related quality of life
  • pain
  • psychological stress

ASJC Scopus subject areas

  • Reproductive Medicine
  • Rehabilitation
  • Obstetrics and Gynaecology

Cite this

Physical pain and emotion regulation as the main predictive factors of health-related quality of life in women living with endometriosis. / Márki, Gabriella; Bokor, Attila; Rigó, J.; Rigó, Adrien.

In: Human Reproduction, Vol. 32, No. 7, 01.07.2017, p. 1432-1438.

Research output: Contribution to journalArticle

@article{4d186804519e46728b7e13f7828e8b78,
title = "Physical pain and emotion regulation as the main predictive factors of health-related quality of life in women living with endometriosis",
abstract = "STUDY QUESTION To what extent are pain symptoms, psychological variables (anxiety, depression and distress) and emotion regulation associated with women's health in endometriosis? SUMMARY ANSWER Physical pain symptoms and emotion regulation difficulties via psychological stress negatively affect the health-related quality of life (HRQoL) of women living with endometriosis. WHAT IS KNOWN ALREADY There are some missing links in the definitive treatment and recovery from endometriosis. Women with chronic pain report a decrease in HRQoL and an increase in the frequency of psychological problems, but little is known about the complex relationship between these variables in the context of endometriosis. STUDY DESIGN, SIZE, DURATION This cross-sectional study was conducted between October 2014 and October 2015 on 193 women living with endometriosis. PARTICIPANTS/MATERIALS, SETTING, METHODS The sample consisted of women with a medically confirmed diagnosis of endometriosis who received treatment at the participating clinic. All participants completed the Short Form Health Survey (SF-36), the Hospital Anxiety and Depression Scale, the Perceived Stress Scale and the Difficulties in Emotion Regulation Scale. Spearman's rank correlation was used to explore the associations between the measured variables, and structural equation modeling was used to test the proposed mediation models. MAIN RESULTS AND THE ROLE OF CHANCE The response rate was 46{\%}. In this study, 54.79{\%} of the participants presented with anxiety and 20.3{\%} with depressive symptoms. Pain symptoms, psychological variables and difficulties in emotion regulation were negatively associated with HRQoL. Mediation models revealed that physical pain, psychological stress and difficulties in emotion regulation explained 55{\%} of the variance in the overall HRQoL, 41{\%} of the variation in physical and 55{\%} of the variation in mental HRQoL. Accordingly, severe physical pain (β = 1) was directly, and difficulties in emotion regulation (β = '0.38, P < 0.001) was indirectly related to deterioration in overall HRQoL. Physical pain had a higher direct standardized effect (β = '0.51, P < 0.001) on physical HRQoL, and had no significant direct effect on mental HRQoL. Furthermore, both physical pain (β = '0.07, P < 0.001) and difficulties in emotion regulation (β = '0.46, P < 0.001) had a significant indirect effect on mental HRQoL. LIMITATIONS, REASONS FOR CAUTION The data were heterogeneous with regard to the severity of endometriosis. The validity of this cross-sectional study is limited to correlations; therefore, further longitudinal studies using a more representative sample are needed to explore valid causal relationships. WIDER IMPLICATIONS OF THE FINDINGS The results of this study indicate that HRQoL can be improved through pain management and emotion regulation strategies. The authors believe that HRQoL would increase with concomitant application of physical treatment and psychological care. STUDY FUNDING/COMPETING INTEREST(S) There were no external funding sources for this study, and the authors have no conflicts of interest to declare. TRIAL REGISTRATION NUMBER Not applicable.",
keywords = "emotion regulation, endometriosis, health-related quality of life, pain, psychological stress",
author = "Gabriella M{\'a}rki and Attila Bokor and J. Rig{\'o} and Adrien Rig{\'o}",
year = "2017",
month = "7",
day = "1",
doi = "10.1093/humrep/dex091",
language = "English",
volume = "32",
pages = "1432--1438",
journal = "Human Reproduction",
issn = "0268-1161",
publisher = "Oxford University Press",
number = "7",

}

TY - JOUR

T1 - Physical pain and emotion regulation as the main predictive factors of health-related quality of life in women living with endometriosis

AU - Márki, Gabriella

AU - Bokor, Attila

AU - Rigó, J.

AU - Rigó, Adrien

PY - 2017/7/1

Y1 - 2017/7/1

N2 - STUDY QUESTION To what extent are pain symptoms, psychological variables (anxiety, depression and distress) and emotion regulation associated with women's health in endometriosis? SUMMARY ANSWER Physical pain symptoms and emotion regulation difficulties via psychological stress negatively affect the health-related quality of life (HRQoL) of women living with endometriosis. WHAT IS KNOWN ALREADY There are some missing links in the definitive treatment and recovery from endometriosis. Women with chronic pain report a decrease in HRQoL and an increase in the frequency of psychological problems, but little is known about the complex relationship between these variables in the context of endometriosis. STUDY DESIGN, SIZE, DURATION This cross-sectional study was conducted between October 2014 and October 2015 on 193 women living with endometriosis. PARTICIPANTS/MATERIALS, SETTING, METHODS The sample consisted of women with a medically confirmed diagnosis of endometriosis who received treatment at the participating clinic. All participants completed the Short Form Health Survey (SF-36), the Hospital Anxiety and Depression Scale, the Perceived Stress Scale and the Difficulties in Emotion Regulation Scale. Spearman's rank correlation was used to explore the associations between the measured variables, and structural equation modeling was used to test the proposed mediation models. MAIN RESULTS AND THE ROLE OF CHANCE The response rate was 46%. In this study, 54.79% of the participants presented with anxiety and 20.3% with depressive symptoms. Pain symptoms, psychological variables and difficulties in emotion regulation were negatively associated with HRQoL. Mediation models revealed that physical pain, psychological stress and difficulties in emotion regulation explained 55% of the variance in the overall HRQoL, 41% of the variation in physical and 55% of the variation in mental HRQoL. Accordingly, severe physical pain (β = 1) was directly, and difficulties in emotion regulation (β = '0.38, P < 0.001) was indirectly related to deterioration in overall HRQoL. Physical pain had a higher direct standardized effect (β = '0.51, P < 0.001) on physical HRQoL, and had no significant direct effect on mental HRQoL. Furthermore, both physical pain (β = '0.07, P < 0.001) and difficulties in emotion regulation (β = '0.46, P < 0.001) had a significant indirect effect on mental HRQoL. LIMITATIONS, REASONS FOR CAUTION The data were heterogeneous with regard to the severity of endometriosis. The validity of this cross-sectional study is limited to correlations; therefore, further longitudinal studies using a more representative sample are needed to explore valid causal relationships. WIDER IMPLICATIONS OF THE FINDINGS The results of this study indicate that HRQoL can be improved through pain management and emotion regulation strategies. The authors believe that HRQoL would increase with concomitant application of physical treatment and psychological care. STUDY FUNDING/COMPETING INTEREST(S) There were no external funding sources for this study, and the authors have no conflicts of interest to declare. TRIAL REGISTRATION NUMBER Not applicable.

AB - STUDY QUESTION To what extent are pain symptoms, psychological variables (anxiety, depression and distress) and emotion regulation associated with women's health in endometriosis? SUMMARY ANSWER Physical pain symptoms and emotion regulation difficulties via psychological stress negatively affect the health-related quality of life (HRQoL) of women living with endometriosis. WHAT IS KNOWN ALREADY There are some missing links in the definitive treatment and recovery from endometriosis. Women with chronic pain report a decrease in HRQoL and an increase in the frequency of psychological problems, but little is known about the complex relationship between these variables in the context of endometriosis. STUDY DESIGN, SIZE, DURATION This cross-sectional study was conducted between October 2014 and October 2015 on 193 women living with endometriosis. PARTICIPANTS/MATERIALS, SETTING, METHODS The sample consisted of women with a medically confirmed diagnosis of endometriosis who received treatment at the participating clinic. All participants completed the Short Form Health Survey (SF-36), the Hospital Anxiety and Depression Scale, the Perceived Stress Scale and the Difficulties in Emotion Regulation Scale. Spearman's rank correlation was used to explore the associations between the measured variables, and structural equation modeling was used to test the proposed mediation models. MAIN RESULTS AND THE ROLE OF CHANCE The response rate was 46%. In this study, 54.79% of the participants presented with anxiety and 20.3% with depressive symptoms. Pain symptoms, psychological variables and difficulties in emotion regulation were negatively associated with HRQoL. Mediation models revealed that physical pain, psychological stress and difficulties in emotion regulation explained 55% of the variance in the overall HRQoL, 41% of the variation in physical and 55% of the variation in mental HRQoL. Accordingly, severe physical pain (β = 1) was directly, and difficulties in emotion regulation (β = '0.38, P < 0.001) was indirectly related to deterioration in overall HRQoL. Physical pain had a higher direct standardized effect (β = '0.51, P < 0.001) on physical HRQoL, and had no significant direct effect on mental HRQoL. Furthermore, both physical pain (β = '0.07, P < 0.001) and difficulties in emotion regulation (β = '0.46, P < 0.001) had a significant indirect effect on mental HRQoL. LIMITATIONS, REASONS FOR CAUTION The data were heterogeneous with regard to the severity of endometriosis. The validity of this cross-sectional study is limited to correlations; therefore, further longitudinal studies using a more representative sample are needed to explore valid causal relationships. WIDER IMPLICATIONS OF THE FINDINGS The results of this study indicate that HRQoL can be improved through pain management and emotion regulation strategies. The authors believe that HRQoL would increase with concomitant application of physical treatment and psychological care. STUDY FUNDING/COMPETING INTEREST(S) There were no external funding sources for this study, and the authors have no conflicts of interest to declare. TRIAL REGISTRATION NUMBER Not applicable.

KW - emotion regulation

KW - endometriosis

KW - health-related quality of life

KW - pain

KW - psychological stress

UR - http://www.scopus.com/inward/record.url?scp=85021812186&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=85021812186&partnerID=8YFLogxK

U2 - 10.1093/humrep/dex091

DO - 10.1093/humrep/dex091

M3 - Article

C2 - 28482063

AN - SCOPUS:85021812186

VL - 32

SP - 1432

EP - 1438

JO - Human Reproduction

JF - Human Reproduction

SN - 0268-1161

IS - 7

ER -