{"paper_id":"5db7cd94-a6db-4e3e-ada6-53b3f4c1e8f7","body_text":"Strathclyde Institute of Pharmacy and Biomedical Sciences \n \n   \n  \nKhalid Alzahrani \n4-7-2025 \n \nSupervisors: \nDr. Tanja Mueller \nDr. Natalie Weir \n \nExploring the knowledge, \nattitudes, and perceptions towards \nendometriosis among both \npatients and healthcare providers: \na scoping review protocol \n\n\n2 \n \nAbstract ................................................................................................................................. 3 \n1.Scoping review  .................................................................................................................... 4 \n1.1Protocol for scoping review ............................................................................................. 4 \n1.1.1Title ......................................................................................................................... 4 \n1.1.2Authors ................................................................................................................... 4 \n1.1.3Introduction ............................................................................................................. 4 \n1.1.4Rationale for scoping review ..................................................................................... 5 \n1.1.5Review question ....................................................................................................... 7 \n1.1.6Inclusion criteria ....................................................................................................... 7 \n1.1.6.1Participants ....................................................................................................... 7 \n1.1.6.2Concept ............................................................................................................. 8 \n1.1.6.3Context ............................................................................................................. 9 \n1.1.7Types of sources ..................................................................................................... 10 \n1.1.8Methods ................................................................................................................ 12 \n1.1.8.1Search strategy ................................................................................................ 12 \n1.1.8.2Study/Source of evidence selection ................................................................... 14 \n1.1.8.3Data extraction ................................................................................................ 14 \n1.1.8.4Data analysis and presentation .......................................................................... 15 \n1.1.9Acknowledgements ................................................................................................ 15 \n1.1.10Funding ................................................................................................................ 16 \n1.1.11Conflicts of interest ............................................................................................... 16 \n2.References ........................................................................................................................ 17 \n3.Appendices ........................................................................................................................ 19 \nAppendix I: Search strategy ................................................................................................ 19 \nAppendix II Grey literature ................................................................................................. 28 \nAppendix III: Data extraction form ...................................................................................... 29 \nData extraction form ......................................................................................................... 29 \n  \n\n3 \n \nAbstract \nObjective: \nThis scoping review aims to systematically map the existing literature on the knowledge, attitudes, \nand perceptions (KAP) of endometriosis among both patients and healthcare providers. \nIntroduction: \nEndometriosis is a chronic and often debilitating condition affecting an estimated 10% of \nreproductive-aged individuals globally. Despite its significant impact, diagnosis is frequently delayed \nby years due to a combination of patient, provider, and system ic factors. Previous research suggests \nthat gaps in knowledge, negative attitudes, and misconceptions among both patients and healthcare \nprofessionals contribute to these delays and to suboptimal care. However, the evidence base remains \nfragmented, with studies varying in scope, methodology, and focus. There is currently no \ncomprehensive synthesis that explores how KAP influences the endometriosis care pathway across \ndifferent populations and health systems. \nInclusion Criteria: \nThis review will consider all primary research studies (qualitative, quantitative, and mixed methods) \nexploring knowledge, attitudes, or perceptions of endometriosis among patients diagnosed with the \ncondition and healthcare providers directly involved in their care. Studies will be included if they \nreport on KAP regarding symptoms, diagnosis, treatment, or support, and are published in English. \nExcluded are studies focusing  on non -diagnosed individuals, healthcare professionals outside \nendometriosis care, and publications not presenting original data. \nMethods: \nThe review will follow the JBI methodology for scoping reviews and the PRISMA -ScR reporting \nframework. A comprehensive search will be conducted across multiple databases including PubMed, \nOvid MEDLINE, EMBASE, CINAHL, APA PsycINFO, Scopus, and Web of Science. Grey literature and \nreference list screening will be incorporated to ensure thorough coverage. Study selection and data \nextraction will be performed independently by two reviewers. Extracted data will be presented \nnarratively and in tabular form, thematically categorized by participant type (patients, providers) and \nKAP domains (knowledge, attitudes, perceptions). \nKeywords: \nEndometriosis; Knowledge; Attitudes; Perceptions; Healthcare providers; Patients; Diagnostic delay; \nScoping review \n \n\n4 \n \n1.Scoping review  \n1.1Protocol for scoping review  \n1.1.1Title  \nExploring the knowledge, attitudes, and perceptions towards endometriosis among both patients and healthcare \nproviders: a scoping review protocol \n \n1.1.2Authors \nKhalid Alzahrani1,2, Tanja Mueller1, Natalie Weir1 \n1. Strathclyde Institute of pharmacy and Biomedical Science, University of Strathclyde \nGlasgow. \n2. University of Hail, Hail, Saudi Arabia \n \n1.1.3Introduction \nEndometriosis is a chronic gynaecological condition affecting approximately 10% of reproductive-aged \nindividuals worldwide. It is characterized by the presence of endometrial -like tissue outside the \nuterus, leading to symptoms such as dysmenorrhea, chronic  pelvic pain, dyspareunia, and infertility. \nDespite its significant impact on quality of life, diagnosis is often delayed by several years due to a \ncombination of medical, social, and systemic factors[1, 2]. Among the key barriers to timely diagnosis \nand effective management is the level of knowledge, attitudes, and perceptions (KAP) held by both \npatients and healthcare providers (HCPs). \nEvidence from a range of international studies suggests that diagnostic delay and inadequate \nendometriosis care are global issues, although the extent and nature of these challenges vary across \ncountries. In high -income countries such as the United Kingdom, Australia, and the United States , \nstudies often highlight provider dismissal, limited diagnostic tools, and fragmented care pathways[3-\n8]. Conversely, research from middle- and low-income countries ( including Lebanon, Pakistan, and \nBrazil) tends to emphasize low public awareness, limited access to specialist services, and cultural \nstigma surrounding menstruation and reproductive health[9-11]. These differences indicate that while \ndelayed diagnosis is a widespread phenomenon, the underlying causes and healthcare responses \ndiffer considerably across sociocultural and healthcare contexts. \n\n5 \n \nThe existing body of literature on knowledge, attitudes, and perceptions (KAP) toward endometriosis \npresents a diverse yet fragmented landscape, both geographically and thematically. Studies extend \nover a wide range of countries (including Australia, the UK, Italy, Poland, Lebanon, Pakistan, Finland, \nIsrael, and the United States ) reflecting global concern but also revealing notable disparities in \nresearch emphasis and depth[3-8, 12-15]. For instance, while Western European nations and Australia \ncontribute richly to qualitative insights around lived experiences and healthcare interactions, studies \nfrom the Middle East and South Asia (e.g., Lebanon, Pakistan) tend to focus on public awareness and \nthe impact of brief educational interventions. Despite this geographical breadth, there is limited cross-\ncultural comparison, and certain regions  (particularly low - and middle -income countries) remain \nunderrepresented. Thematically, the literature  includes studies focused on patients, healthcare \nproviders, and the general public, yet these efforts are largely siloed, lacking a unified synthesis. This \nfragmented evidence base highlights a pressing need to integrate and contextualize diverse \nperspectives to inform global approaches to endometriosis care. \nA growing body of literature highlights that patients with endometriosis frequently encounter \nmisdiagnosis, delays in care, and inadequate support due to gaps in knowledge among both the \ngeneral public and medical professionals [5, 16]. Studies suggest that many healthcare providers lack \nsufficient training on recognizing endometriosis symptoms, leading to dismissive attitudes and \nineffective treatment strategies [2, 17] . Simultaneously, many patients experience difficulty \narticulating their symptoms, which, coupled with societal normalization of menstrual pain, further \ncontributes to diagnostic delays[18, 19]. These barriers create a significant unmet need for improving \nboth awareness and the quality of patient-provider interactions in endometriosis care. \n1.1.4Rationale for scoping review  \nWhile there have been numerous studies on specific aspects of KAP regarding endometriosis, a \npreliminary search of MEDLINE, the Cochrane Database of Systematic Reviews and JBI Evidence \nSynthesis was conducted and no current or underway systematic reviews o r scoping reviews on the \ntopic were identified.  There is currently no comprehensive synthesis of what is known about the \nsubject across different populations and healthcare settings. Existing research varies in focus, \nmethodology, and scope, making it diff icult to  identify key areas where interventions are most \nneeded. \nSome recent reviews have explored related but distinct aspects of endometriosis care. For example, \nCromeens et al. (2021) proposed a scoping review protocol to examine pathways, timing, and delays \nin diagnosis [20]. While valuable in highlighting the consequences of diagnostic delay and its \n\n6 \n \nassociation with patient outcomes, the review did not investigate the attitudinal or perceptual factors \nthat influence these delays. Fryer et al. (2024) provided the first synthesis of evidence explicitly \nexamining where and why diagnostic delays occur, re vealing system-level issues such as healthcare \nprovider knowledge gaps and the frequent dismissal of patients’ symptoms[2]. However, their review \nfocused primarily on structural and process-related barriers rather than exploring the deeper cognitive \nand behavioural mechanisms that shape clinician responses and patient experiences. \nSimilarly, Westwood et al. (2023) conducted a scoping review on disparities in endometriosis diagnosis \nand surgical management within the United States (U.S.) , demonstrating that racial and ethnic \nminority women face increased risks of surgical complications and reduced access to minimally \ninvasive procedures [21]. This review underscored the presence of systemic inequities but did not \naddress how healthcare providers’ knowledge and perceptions may contribute to such disparities. \nTogether, these reviews underscore the importance of understanding diagnostic delay and inequities \nin care, but none offer a holistic synthesis of how knowledge, attitudes, and perceptions shape the \ndiagnosis, treatment, and support experiences of people w ith endometriosis. This scoping review \nbuilds upon the work of Fryer et al. (2024) by investigating the broader contextual and systemic KAP \nfactors (particularly among healthcare providers) that underpin diagnostic delays and fragmented \ncare. It directly a ddresses the research priorities outlined by the James Lind Alliance Priority Setting \nPartnership, as reported by Graham et al. (2020) and Horne et al. (2017), which identified reducing \ndiagnostic delay and improving education and awareness among healthcar e professionals as top \nresearch priorities[22, 23]. \nA scoping review is therefore necessary to systematically map the available evidence, identify \nrecurring themes, and highlight areas where further research or educational initiatives are needed. By \nsynthesizing findings from diverse studies, this review wi ll provide a clearer understanding of how \nknowledge, attitudes, and perceptions shape the experiences of both patients and healthcare \nproviders, ultimately guiding future strategies for improving endometriosis management and support. \nThis scoping review aims to map the existing literature on the knowledge, attitudes, and perceptions \n(KAP) of endometriosis among both patients and healthcare providers, highlighting trends, gaps, and \nareas for improvement. By synthesizing existing research, the review will pro vide insights into the \nknowledge levels among different stakeholders, identify misconceptions, and suggest future research \narea. The findings will help inform interventions to enhance early recognition, improve patient -\nprovider communication, and probably lead to better healthcare outcomes for individuals affected by \nendometriosis. \n \n\n7 \n \nThe objectives of this scoping review are: \n1. To identify the current level of knowledge, attitudes, and perceptions about endometriosis \namong patients and healthcare providers. \n2. To identify patients’ attitudes toward the disease, medical management and support, and \ngauges feelings, beliefs, or predispositions healthcare system  \n3. To identify Healthcare providers’ attitudes toward the disease, medical support, and \navailable treatments \n4. To explore how patients and healthcare providers perceive the symptoms, diagnosis, and \ntreatment of endometriosis. \n5. To explore existing barriers related to endometriosis care from both patient and provider \nperspectives. \n6. To identify gaps in research and suggest areas for future studies or interventions aimed at \nimproving knowledge and support for endometriosis management. \n1.1.5Review question \nWhat is known about the knowledge, attitudes, and perceptions (KAP) of endometriosis among \npatients and healthcare providers? \n1.1.6Inclusion criteria \nThis scoping review will be conducted in accordance with the Joanna Briggs Institute (JBI) methodology \nfor scoping reviews. The inclusion criteria have been developed based on the PCC framework \n(Participants, Concept, Context), which provides a structured approach for determining eligibility and \ndeveloping an effective search strategy. \n1.1.6.1Participants \nThis review will include peer-reviewed and grey literature that involve the following participant \ngroups: \n• Patients diagnosed with endometriosis , across all age groups and demographics. This \nincludes adolescents, reproductive -age individuals, and those diagnosed later in life, \nregardless of the disease stage or severity. Moreover, in recognition of the significant \ndiagnostic delay often experienced in endometriosis, the review will also consider studies \n\n8 \n \ninvolving individuals who self-identify or self-diagnose with the condition, acknowledging that \nmany may experience symptoms for years before receiving a formal diagnosis. \n• Healthcare providers (HCPs) who interact with and manage endometriosis patients, \nincluding: \no General practitioners \no Gynaecologists \no Nurses \no Psychotherapists \no Nutritionists \no Pharmacists \nThese groups are selected due to their direct involvement in the experience, diagnosis, and \nmanagement of endometriosis. \nExclusion Criteria: \n• Studies focusing on non-diagnosed individuals (e.g., general population or those with self-\nreported symptoms but no formal diagnosis). \n• Healthcare professionals not involved in endometriosis care, such as administrative staff or \nthose in unrelated specialties (e.g., dermatologists, radiologists, etc.). \n• Family members, partners, or the general public unless they are the primary participants \nproviding data on the KAP of diagnosed individuals or relevant healthcare professionals. \n1.1.6.2Concept \nThe central concept of this review is the knowledge, attitudes, and perceptions (KAP) of endometriosis \namong the included participant groups. The review will include literature that discusses any of the \nfollowing: \n• Knowledge: Refers to factual, cognitive understanding of endometriosis. For healthcare \nproviders, this includes knowledge of clinical features (e.g., symptoms, diagnosis criteria, and \ntreatment options). For patients, it includes awareness and understanding of the c ondition, \nits management, and its implications on health and daily life. \n• Attitudes: Refers to feelings, beliefs, and values toward endometriosis. This may include \nstigmas, perceived severity, or perceived legitimacy of the condition by patients or healthcare \nproviders. \n\n9 \n \n• Perceptions: Refers to how individuals interpret or make sense of endometriosis based on \npersonal experience, clinical exposure, societal influence, or cultural norms. This may include \nperceived barriers to care, treatment expectations, and perceived quality of life impacts. \nExclusion Criteria: \n• Studies that do not address any aspect of knowledge, attitudes, or perceptions  of \nendometriosis. \n• Literature focusing solely on clinical, biochemical, or molecular aspects  of endometriosis \nwithout exploring the subjective or experiential dimensions related to KAP. \n• Studies that focus on awareness campaigns or education programs  without assessing the \nactual perceptions, attitudes, or knowledge among patients or providers. \n1.1.6.3Context \nThe review will focus on literature discussing the symptoms, diagnosis, management, and support \nsystems for endometriosis within the context of KAP. \n• Geographical Scope: International. Studies from all countries and healthcare systems will be \nconsidered to capture global perspectives. \n• Settings: No restriction will be placed on the healthcare setting (e.g., hospitals, clinics, \ncommunity health centres), as long as the study addresses relevant KAP components. \n• Cultural and Social Contexts: Studies across all cultures, ethnicities, and socio-demographic \nsettings will be included to reflect diverse interpretations and experiences of endometriosis. \n• Language: Only studies published in English will be considered. While this may limit the \nbreadth of international perspectives, the decision is methodologically justified. Many of the \nincluded studies are qualitative in nature and contain conceptually rich data, including \nnuanced themes and partici pant expressions that are deeply embedded in specific cultural \nand linguistic contexts. Widely available translation tools and services may not adequately \ncapture the subtleties of such data, potentially leading t o misinterpretation or loss of \nmeaning. Therefore, restricting the review to English language publications ensures greater \nreliability in understanding and interpreting the findings, particularly in studies involving \ncomplex qualitative themes. \nExclusion Criteria: \n• Studies published in languages other than English. \n\n10 \n \n• Studies that do not provide adequate contextual information regarding endometriosis \ndiagnosis, symptom experience, management, or support in relation to KAP. \nTable 1. Inclusion and exclusion criteria \nCategory Inclusion Exclusion \nParticipants - Patients diagnosed with \nendometriosis across all age \ngroups  \n- Healthcare providers (GPs, \ngynaecologists, nurses, \npsychotherapists, etc.) \n- Public, family members, or \nHCPs not directly involved with \ndiagnosed patients  \n- Non-diagnosed individuals \nType of Study Studies assessing knowledge, \nattitudes, or perceptions about \nendometriosis \nStudies assessing KAP \nunrelated to endometriosis \nType of Publication / \nMethodology \nPrimary research studies \nincluding qualitative, \nquantitative, and mixed \nmethods designs \nReviews, case studies, posters, \nconference abstracts, \nabstracts without full text, \nreports, study protocols \nLanguage English Any language other than \nEnglish \nContext Focus on diagnosis, symptoms, \nmanagement, or support \nsystems related to \nendometriosis in any \ninternational context \nStudies unrelated to these \naspects or lacking context in \nrelation to endometriosis and \nKAP \n \n1.1.7Types of sources \nThis scoping review will include a broad range of original primary research studies to comprehensively \nmap the existing literature related to the KAP of endometriosis among patients and healthcare \nproviders. The selection of sources will adhere to the JBI methodology for scoping reviews, which \nemphasizes inclusivity in order to capture the breadth and depth of existing evidence. \n\n11 \n \nIncluded Source Types \nThe review will consider all original primary research studies , regardless of methodological \norientation. This includes: \n• Qualitative studies (e.g., interviews, focus groups, ethnographic studies): These provide in -\ndepth understanding of personal experiences, beliefs, and interpretations relating to \nendometriosis. \n• Quantitative studies  (e.g., cross -sectional surveys, cohort studies): These measure and \ndescribe levels of knowledge, attitudes, or perceptions in various populations and can offer \ncomparative insights. \n• Mixed methods studies: These combine qualitative and quantitative approaches to provide a \nmore comprehensive perspective on the research question. \n• Grey literature, including theses, dissertations, and reports from reputable organizations, will \nbe included where they report relevant primary research findings. These sources are valuable \nfor capturing emerging or less formally published data. \nOnly studies presenting empirical data related to KAP will be included. This ensures the review is \ngrounded in documented experiences and measurable findings relevant to the research question. \nExcluded Source Types \nThe following types of sources will be excluded from the review: \n• Opinion papers, editorials, or commentary articles : These are typically based on anecdotal \nevidence or author viewpoints and do not present systematically collected data. \n• Narrative reviews, systematic reviews, meta-analyses: While valuable for broader evidence \nsynthesis, these are not considered original sources of primary data and will be excluded to \navoid duplication. \n• Case reports or case series : These often provide isolated clinical observations without \ngeneralizable data on KAP. \n• Conference abstracts, posters, and presentations : These will be excluded unless \naccompanied by a full-text version of the study due to the limited detail they offer. \n• Study protocols: These outlines intended research but do not contain data or findings and are \ntherefore outside the scope of this review. \n\n12 \n \nThis selective inclusion of source types is intended to ensure that the evidence synthesized is grounded \nin empirical research, relevant to the PCC framework, and useful for identifying gaps and informing \nfuture studies or interventions aimed at improving endometriosis care. \n1.1.8Methods \nThe proposed scoping review will be conducted in accordance with the Joanna Briggs Institute (JBI) \nmethodology for scoping reviews with the guidance of the Preferred Reporting Item for Systematic \nReview and Meta-Analysis extension for scoping review (PRISMA-ScR) checklist.  \n1.1.8.1Search strategy \nSpecific search strategy was developed through initial limited search of one database to identify \narticles on the topic. The text words contained in the titles and abstract of the relevant retrieved \narticles and the index terms in each article were used to develop a full search strategy for this review \n(see Appendix 1). Published studies on this topic will be identified using the agreed search strategy on \nmultiple databases including PubMed, Ovid MEDLINE, EMBASE, CINAHL, APA PsycInfo, Scopus, and \nWeb of science . Each database contributes unique strengths and perspectives, allowing for a \nmultidisciplinary understanding of the topic. PubMed and Ovid MEDLINE  serve as foundational \nsources for biomedical and clinical research, offering extensive coverage of peer -reviewed literature \nin medicine, epidemiology, and healthcare deli very. These databases are particularly well -suited for \nidentifying studies focused on healthcare providers’ clinical knowledge and patient care experiences \nrelated to endometriosis. In contrast, EMBASE complements MEDLINE by including a broader range \nof international and European journals, as well as conference abstracts and grey literature. EMBASE \nalso offers more detailed indexing, which supports the identification of studies involving nuanced \nhealthcare practices and patient perspectives that may not be captured in MEDLINE alone. While \nPubMed, MEDLINE,  and EMBASE focus primarily on clinical and biomedical literature, CINAHL \n(Cumulative Index to Nursing and Allied Health Literature) brings a valuable focus on nursing and allied \nhealth professions. Given that this review includes perspectives from nurses, psychotherapists, and \nnutritionists, CINAHL ensures representation of literature that addresses their roles and experiences \nin endometriosis care—areas that are less emphasized in the biomedical databases. To further capture \nthe psychosocial dimensions of endometriosis, APA PsycINFO is included for its strength in indexing \npsychological and mental health literature. This database is particularly important for exploring \npatients’ attitudes, beliefs, stigma, and emotional well -being, as well as healthcare providers' \nperceptions from a psychological standpoint dimension often underrepresented in strictly medical \ndatabases. In addition to subject -specific databases, Scopus and Web of Science  provide broad \n\n13 \n \nmultidisciplinary coverage and strong citation tracking capabilities. Both databases include literature \nfrom the health sciences, social sciences, and humanities, supporting the identification of research \nthat spans public health, health communication, and  systemic healthcare issues. While Scopus is \nknown for its wide journal coverage and advanced search features, Web of Science  enhances the \nreview’s ability to trace citation networks and uncover high -impact studies that may influence how \nendometriosis is p erceived and managed across different contexts. Together, they ensure the \ninclusion of cross -cutting perspectives essential to understanding the sociocultural and systemic \nfactors that shape endometriosis -related knowledge and care. By combining these data bases, the \nreview is positioned to capture a comprehensive and diverse range of evidence, reflecting the \ncomplexity of endometriosis from clinical, psychological, allied health, and sociocultural perspectives. \nGrey literature will be included in this scoping review to ensure a comprehensive and balanced \nunderstanding of the existing KAP toward endometriosis among patients and healthcare providers. \nGiven the evolving nature of endometriosis research and the poten tial for delayed or selective \npublication of studies in peer-reviewed journals, grey literature sources (such as government reports, \npolicy documents, organizational guidelines, conference proceedings, and unpublished theses) can \noffer timely, relevant, an d often practice -oriented insights. Moreover, grey literature helps reduce \npublication bias and captures data from a wider range of stakeholders, including professional bodies \nand patient advocacy groups. This is particularly important in the context of en dometriosis, where \ngaps in care and policy are often highlighted outside traditional academic channels. Including grey \nliterature therefore enriches the review by integrating diverse perspectives and ensuring that less \nvisible but highly relevant informati on is not overlooked. To identify relevant grey literature, the \nagreed search strategy was applied across multiple platforms, including the Networked Digital Library \nof Theses and Dissertations ( http://search.ndltd.org/ ), Policy Commons \n(https://policycommons.net/modules/global-think-tanks ), medRxiv ( https://www.medrxiv.org/ ), \nResearch Square ( https://www.researchsquare.com/ ), SSRN ( https://papers.ssrn.com/ ), and the \nOpen Science Framework (https://osf.io ). The keywords will be (endometriosis, knowledge, believe, \nbelief, attitude, and perception). \nFurthermore, the reference lists of all included articles will be screened to identify additional relevant \npublications that may not have been captured through the initial database search. This process, often \nreferred to as 'citation chasing' or 'snowballi ng', helps ensure a comprehensive review by including \nstudies that are pertinent but may be indexed differently or published in journals not included in the \nsearched databases. It increases the likelihood of identifying key or foundational literature, as well as \nmore recent or region-specific studies that are crucial for mapping the breadth and depth of the topic. \n\n14 \n \nThe search will not be limited by geographic region in order to provide a comprehensive overview of \nknowledge, attitudes, and perceptions (KAP) related to endometriosis across diverse healthcare \nsystems, cultures, and populations. This global scope is esse ntial for identifying common challenges, \nvariations in care, and potential areas for improvement in the management of endometriosis \nworldwide. Databases will be searched from inception up to the date of the final search. No lower \ndate limit will be applied  to ensure a comprehensive and inclusive overview of the literature on \nendometriosis. This approach allows the identification of foundational studies, the evolution of \nknowledge, and shifts in diagnostic criteria, clinical management, and healthcare provider awareness \nover time. Including older research also helps contextualize current understandings within their \nhistorical development and may reveal long-standing gaps or persistent misconceptions in the field. \n1.1.8.2Study/Source of evidence selection \nFollowing the searching step, all retrieved studies will be imported into EndNote reference manager \nsoftware and Covidence software to manage the processes of this review, and the duplicates will be \nremoved by the primary reviewer Khalid Alzahrani (KA) before being assessed for eligibility. After \ndeduplication, the remaining studies will be screened by the primary reviewer (KA) and another \nindependent reviewer Hisham Alshammari (HA) first, by title and by abstract, then the full text \nscreening will be performed to be assessed for eligibility and to exclude studies that cannot satisfy the \ninclusion criteria. Reasons for excluding any study after the f ull-text assessment will be reported in \nthe scoping review report. The selection process will be undertaken also by the primary and secondary \nindependent reviewers (KA and HA) and supported by experienced reviewers Tanja Mueller (TM), and \nNatalie Weir (NW) to resolve any conflict that arises. A Preferred Reporting Item for Systematic Review \nand Meta-Analysis extension for scoping review (PRISMA-ScR) flow diagram will be used to report the \nnumber of studies identified and screened at each stage and illustrat e the inclusion and exclusion \nprocess[24]. \n1.1.8.3Data extraction \nData will be extracted by two independent reviewers (KA and HA) using a data extraction form \ngenerated and piloted by the primary reviewer (KA) ( see Appendix 2 ). The form was designed to \nextract a comprehensive and detailed information including author name, year of publication, purpose \nof the study, study design, Country, Participants’ type and number of participants, KAP Focus, detailed \ninformation about the c oncept, and context of the study, the study findings, conclusion, and \nrecommendations relevant to  the review. The drafted data extraction form will be revised and \n\n15 \n \nmodified throughout the extraction process as necessary. Any modification will be clarified in the final \nscoping review.  \n \n \nParticipants Concept Context \nPopulation \n-Participants’ type: patients, \nHCPs, or both \n-Number of participants  \n \nKAP Focus \n-knowledge, attitudes, \nperceptions \nKey Findings \n- symptoms  \n- diagnosis \n- treatment  \n- Conclusion \nGeographical Scope \n-Studies across all cultures \n- Settings: No restriction will be \nplaced on the healthcare \nsetting/ worldwide \n1.1.8.4Data analysis and presentation \nThe extracted data will be presented in a tabular form accompanied by a narrative descriptive \nsummary of the evidence that align with the review question and objectives. The followed framework \nto organise and present the data will be decided on the final review, depending on the content of the \nextracted data. For example, the data might be grouped according to the Participants’ type or to the \nKAP Focus such as study’s focus on knowledge, attitude, and perception.  \n \n knowledge knowledge knowledge attitudes attitudes attitudes perceptions perceptions perceptions \n symptoms diagnosis treatment symptoms diagnosis treatment symptoms diagnosis treatment \nPatients          \nHCPs          \n \n1.1.9Acknowledgements \nI would like to acknowledge Elaine Blair from the Faculty Librarian Science at University of \nStrathclyde for her assistance with the development of the search strategy; this review is to \n\n16 \n \ncontribute towards a (KA) PhD degree.  \n \n1.1.10Funding \nKA is supported by scholarship from KA’s employer (university of Hail). However, University of Hail \nhas no role to this review process. \n \n1.1.11Conflicts of interest \nThe authors declare no conflict of interest. \n \n  \n\n17 \n \n2.References \n1. Zondervan, K.T., et al., Endometriosis Classification Systems: An International Survey to Map \nCurrent Knowledge and Uptake. Journal of Minimally Invasive Gynecology, 2022. 29(6): p. \n716-716. \n2. Fryer, J., A.J. Mason-Jones, and A. Woodward, Understanding diagnostic delay for \nendometriosis: A scoping review using the social-ecological framework. Health Care for \nWomen International, 2024: p. 1-17. \n3. Moore, C., D.N. Cogan, and D.L. Williams, A qualitative exploration into the role of illness \nperceptions in endometriosis-related quality of life. medRxiv, 2023. \n4. Young, K., J. Fisher, and M. Kirkman, Partners instead of patients: Women negotiating power \nand knowledge within medical encounters for endometriosis. Feminism & Psychology, 2020. \n30(1): p. 22-41. \n5. Moradi, M., et al., Impact of endometriosis on women’s lives: a qualitative study. BMC \nWomen's Health, 2014. 14(1): p. 123. \n6. Luo, Y., et al., Love Thy Neighbor? Exploring Gastroenterology Attitudes Toward \nEndometriosis Screening. Digestive Diseases and Sciences, 2024. \n7. Sullender, R.T., et al., Perception and Comfort with Endometriosis Management Among \nOB/GYN Residents. International journal of women's health, 2023. 15: p. 1801-1809. \n8. Redmond, R., et al., Naturopathic knowledge and approaches to managing endometriosis: a \ncross-sectional survey of naturopaths with experience in endometriosis care. Journal of \nComplementary & Integrative Medicine, 2023. 20(1): p. 153-164. \n9. Kazan, Z., et al., Knowledge and concern towards endometriosis among Lebanese women: a \ncross-sectional study. BMC Women's Health, 2024. 24(1): p. 1-9. \n10. Saad, M., et al., Addressing the Endometriosis Knowledge Gap for Improved Clinical Care-A \nCross-Sectional Pre- and Post-Educational-Intervention Study among Pakistani Women. \nHealthcare (Basel, Switzerland), 2023. 11(6). \n11. Mellado, B.H., et al., Social isolation in women with endometriosis and chronic pelvic pain. \nInternational Journal of Gynecology & Obstetrics, 2016. 133(2): p. 199-201. \n12. Bogusz, A. and M. Gornicka, Low Diet Quality and Nutritional Knowledge in Women with \nEndometriosis: A Pilot Study (vol 12, 673, 2024). HEALTHCARE, 2024. 12(10). \n13. Heresco, L., et al., Pain perception and analgesic use after cesarean delivery among women \nwith endometriosis. European Journal of Obstetrics & Gynecology & Reproductive Biology, \n2024. 294: p. 71-75. \n14. Helosvuori, E. and V. Oikkonen, Sensing pain: Embodied knowledge in endometriosis. Health: \nAn Interdisciplinary Journal for the Social Study of Health, Illness & Medicine, 2024. 28(6): p. \n937-952. \n15. Cofini, V., et al., Factors associated with chronic pelvic pain in women with endometriosis: A \nnational study on clinical and sociodemographic characteristics, lifestyles, quality of life, and \nperceptions of quality of care, during the COVID-19 pandemic. Women's Health (17455057), \n2024: p. 1-8. \n16. Young, K., J. Fisher, and M. Kirkman, Clinicians' perceptions of women's experiences of \nendometriosis and of psychosocial care for endometriosis. Australian & New Zealand Journal \nof Obstetrics & Gynaecology, 2017. 57(1): p. 87-92. \n17. Pickett, C., W.G. Foster, and S. Agarwal, Current endometriosis care and opportunities for \nimprovement. Reprod Fertil, 2023. 4(3). \n18. Kocas, H.D., L.R. Rubin, and M. Lobel, Stigma and mental health in endometriosis. Eur J \nObstet Gynecol Reprod Biol X, 2023. 19: p. 100228. \n19. Wiggleton-Little, J., \"Just\" a painful period: A philosophical perspective review of the \ndismissal of menstrual pain. Womens Health (Lond), 2024. 20: p. 17455057241255646. \n20. Cromeens, M.G., et al., Timing, delays and pathways to diagnosis of endometriosis: a scoping \nreview protocol. BMJ Open, 2021. 11(6): p. e049390. \n\n18 \n \n21. Westwood, S., et al., Disparities in Women With Endometriosis Regarding Access to Care, \nDiagnosis, Treatment, and Management in the United States: A Scoping Review. Cureus, \n2023. \n22. Graham, L., et al., Research priority setting in women’s health: a systematic review. BJOG: An \nInternational Journal of Obstetrics &amp; Gynaecology, 2020. 127(6): p. 694-700. \n23. Horne, A.W., et al., Top ten endometriosis research priorities in the UK and Ireland. The \nLancet, 2017. 389(10085): p. 2191-2192. \n24. Tricco, A.C., et al., PRISMA Extension for Scoping Reviews (PRISMA-ScR): Checklist and \nExplanation. Annals of Internal Medicine, 2018. 169(7): p. 467-473. \n \n \n  \n\n19 \n \n3.Appendices \nAppendix I: Search strategy \nPubMed 2,443 \nSearch \nnumber \nQuery Sort \nBy \nFilters Search Details Results Time \n11 ((\"endometriosis\"[MeSH Terms] OR \n\"endometriosis\"[Title/Abstract]) AND (((((\"awareness\"[MeSH \nTerms] OR \"aware*\"[Title/Abstract]) OR \n(\"knowledge\"[Title/Abstract] OR \"knowledge\"[MeSH Terms])) \nOR (\"attitude\"[MeSH Terms] OR \"attitude*\"[Title/Abstract])) \nOR (\"belie*\"[Title/Abstract])) OR \n(\"perception*\"[Title/Abstract] OR \"perception\"[MeSH \nTerms]))) NOT (\"scoping review\"[Title/Abstract] OR \n\"systematic review\"[Title/Abstract]) \nMost Recent ((\"endometriosis\"[MeSH Terms] OR \n\"endometriosis\"[Title/Abstract]) AND (\"awareness\"[MeSH \nTerms] OR \"aware*\"[Title/Abstract] OR \n(\"knowledge\"[Title/Abstract] OR \"knowledge\"[MeSH Terms]) \nOR (\"attitude\"[MeSH Terms] OR \"attitude*\"[Title/Abstract]) \nOR \"belie*\"[Title/Abstract] OR (\"perception*\"[Title/Abstract] \nOR \"perception\"[MeSH Terms]))) NOT (\"scoping \nreview\"[Title/Abstract] OR \"systematic \nreview\"[Title/Abstract]) \n2,443 11:06:19 \n10 \"scoping review\"[Title/Abstract] OR \"systematic \nreview\"[Title/Abstract] \nMost Recent \"scoping review\"[Title/Abstract] OR \"systematic \nreview\"[Title/Abstract] \n377,668 11:06:01 \n9 (\"endometriosis\"[MeSH Terms] OR \n\"endometriosis\"[Title/Abstract]) AND (((((\"awareness\"[MeSH \nTerms] OR \"aware*\"[Title/Abstract]) OR \n(\"knowledge\"[Title/Abstract] OR \"knowledge\"[MeSH Terms])) \nOR (\"attitude\"[MeSH Terms] OR \"attitude*\"[Title/Abstract])) \nOR (\"belie*\"[Title/Abstract])) OR \n(\"perception*\"[Title/Abstract] OR \"perception\"[MeSH \nTerms])) \nMost Recent (\"endometriosis\"[MeSH Terms] OR \n\"endometriosis\"[Title/Abstract]) AND (\"awareness\"[MeSH \nTerms] OR \"aware*\"[Title/Abstract] OR \n(\"knowledge\"[Title/Abstract] OR \"knowledge\"[MeSH Terms]) \nOR (\"attitude\"[MeSH Terms] OR \"attitude*\"[Title/Abstract]) \nOR \"belie*\"[Title/Abstract] OR (\"perception*\"[Title/Abstract] \nOR \"perception\"[MeSH Terms])) \n2,550 11:05:28 \n8 ((((\"awareness\"[MeSH Terms] OR \"aware*\"[Title/Abstract]) \nOR (\"knowledge\"[Title/Abstract] OR \"knowledge\"[MeSH \nTerms])) OR (\"attitude\"[MeSH Terms] OR \n\"attitude*\"[Title/Abstract])) OR (\"belie*\"[Title/Abstract])) OR \n(\"perception*\"[Title/Abstract] OR \"perception\"[MeSH Terms]) \nMost Recent \"awareness\"[MeSH Terms] OR \"aware*\"[Title/Abstract] OR \n\"knowledge\"[Title/Abstract] OR \"knowledge\"[MeSH Terms] \nOR \"attitude\"[MeSH Terms] OR \"attitude*\"[Title/Abstract] OR \n\"belie*\"[Title/Abstract] OR \"perception*\"[Title/Abstract] OR \n\"perception\"[MeSH Terms] \n2,893,520 11:05:18 \n7 \"perception*\"[Title/Abstract] OR \"perception\"[MeSH Terms] Most Recent \"perception*\"[Title/Abstract] OR \"perception\"[MeSH Terms] 784,802 11:05:01 \n6 \"belie*\"[Title/Abstract] Most Recent \"belie*\"[Title/Abstract] 386,022 11:04:43 \n5 \"attitude\"[MeSH Terms] OR \"attitude*\"[Title/Abstract] Most Recent \"attitude\"[MeSH Terms] OR \"attitude*\"[Title/Abstract] 827,744 11:04:26 \n4 \"knowledge\"[Title/Abstract] OR \"knowledge\"[MeSH Terms] Most Recent \"knowledge\"[Title/Abstract] OR \"knowledge\"[MeSH Terms] 1,043,398 11:04:13 \n3 \"awareness\"[MeSH Terms] OR \"aware*\"[Title/Abstract] Most Recent \"awareness\"[MeSH Terms] OR \"aware*\"[Title/Abstract] 358,269 11:04:00 \n2 \"endometriosis\"[MeSH Terms] OR \n\"endometriosis\"[Title/Abstract] \nMost Recent \"endometriosis\"[MeSH Terms] OR \n\"endometriosis\"[Title/Abstract] \n36,650 11:03:30 \n  \n\n20 \n \nEmbase Classic+Embase <1947 to 2025 March 31> \n \n1 aware*.ti,ab. 495065 \n2 knowledge.ti,ab. 1303518 \n3 attitude*.ti,ab. 270948 \n4 belie*.ti,ab. 516447 \n5 perception*.ti,ab. 452805 \n6 1 or 2 or 3 or 4 or 5 2627062 \n7 endometriosis.ti,ab. 47774 \n8 endometriosis/ 54886 \n9 7 or 8 59618 \n10 6 and 9 4020 \n11 (\"systematic review\" or \"scoping review\").ti. 353922 \n12 10 not 11 3907 \n\n21 \n \n \nOvid MEDLINE(R) ALL <1946 to March 31, 2025> \n \n1 aware*.ti,ab. 348043 \n2 knowledge.ti,ab. 1033542 \n3 attitude*.ti,ab. 212083 \n4 belie*.ti,ab. 384540 \n5 perception*.ti,ab. 369945 \n6 1 or 2 or 3 or 4 or 5 2037549 \n7 endometriosis.ti,ab. 31127 \n8 Endometriosis/ 27490 \n9 7 or 8 36294 \n10 6 and 9 2215 \n11 (\"systematic review\" or \"scoping review\").ti. 311359 \n12 10 not 11 2132 \n\n22 \n \nCINAHL 477 \n \n  \n\n\n23 \n \nAPA PsycInfo  110 \n  \n\n\n24 \n \nScopus  \n \n( ( ( ( TITLE-ABS ( aware* ) OR TITLE-ABS ( attitude* ) OR TITLE-ABS ( belie* ) OR TITLE-ABS ( perception* ) OR TITLE-ABS ( knowledge ) ) AND TITLE-ABS \n( endometriosis ) ) AND NOT TITLE ( \"systematic review\" OR \"scoping review\" ) ) ) \n2392 \n  \n\n\n25 \n \nWeb of science 2431 \n \n \n\n\n26 \n \nEnti\ntle\nmen\nts \n# Search Query Da\ntab\nas\ne \nRe\nsul\nts \nDa\nte \nRu\nn \n \n- WOS: 1900 to 2 025  \n- BCI: 192 6 to 2025 \n- BI OSIS: 1969 to 2008  \n- CCC: 19 98 to 202 5 \n- DRCI: 190 0 to 2025  \n- DIIDW : 1966 to 2 025 \n- GRANTS : 1953 to 2 025 \n- KJD: 198 0 to 2025 \n- MEDLI NE: 19 50 to 202 5 \n- PCI : 1950 to 2 025 \n- PPRN: 1 991 to 20 25 \n- PQD T: 163 7 to 2025 \n- SCIELO: 20 02 to 20 25 \n- ZOOREC: 1864 to 2025  \n1 (((TI=(aware*)) OR AB=(aware*))) Editions: \nWOS.IC,WOS.CCR,WOS.SCI,WOS.AHCI,WOS.BHCI,WOS.BSCI,WOS.ESCI,WOS.ISTP,WOS.SSCI,WOS.ISSHP,BCI.BCI,BIOSIS.PREVIEWS,CCC.CCCA,CCC.CCCB,CCC.CCCC,CCC.CCCP,C\nCC.CCCS,CCC.CCCT,CCC.CCCY,CCC.CCCBC,CCC.CCCEC,DRCI.DSCI,DRCI.DSSHCI,DIIDW.CDerwent,DIIDW.EDerwent,DIIDW.MDerwent,GRANTS.GRANTS,KJD.KJD,PCI.PCI,PPRN.PP\nRN,PQDT.PQDT,SCIELO.SCIELO,ZOOREC.RECORDS  \nAll Databases  \n10\n44\n82\n6 \nTue Apr 01 202 5 15:3 8:14 \nGMT+0100 (Britis h Summer Ti me) \n \n- WOS: 1900 to 2 025  \n- BCI: 192 6 to 2025 \n- BI OSIS: 1969 to 2008  \n- CCC: 19 98 to 202 5 \n- DRCI: 190 0 to 2025  \n- DIIDW : 1966 to 2 025 \n- GRANTS : 1953 to 2 025 \n- KJD: 198 0 to 2025 \n- MEDLI NE: 19 50 to 202 5 \n- PCI : 1950 to 2 025 \n- PPRN: 1 991 to 20 25 \n- PQD T: 163 7 to 2025 \n- SCIELO: 20 02 to 20 25 \n- ZOOREC: 1864 to 2025  \n2 (((TI=(knowledge)) OR AB=(knowledge))) Editions: \nWOS.IC,WOS.CCR,WOS.SCI,WOS.AHCI,WOS.BHCI,WOS.BSCI,WOS.ESCI,WOS.ISTP,WOS.SSCI,WOS.ISSHP,BCI.BCI,BIOSIS.PREVIEWS,CCC.CCCA,CCC.CCCB,CCC.CCCC,CCC.CCCP,C\nCC.CCCS,CCC.CCCT,CCC.CCCY,CCC.CCCBC,CCC.CCCEC,DRCI.DSCI,DRCI.DSSHCI,DIIDW.CDerwent,DIIDW.EDerwent,DIIDW.MDerwent,GRANTS.GRANTS,KJD.KJD,PCI.PCI,PPRN.PP\nRN,PQDT.PQDT,SCIELO.SCIELO,ZOOREC.RECORDS  \nAll Databases  \n34\n75\n78\n6 \nTue Apr 01 202 5 15:3 8:56 \nGMT+0100 (Britis h Summer Ti me) \n \n- WOS: 1900 to 2 025  \n- BCI: 192 6 to 2025 \n- BI OSIS: 1969 to 2008  \n- CCC: 19 98 to 202 5 \n- DRCI: 190 0 to 2025  \n- DIIDW : 1966 to 2 025 \n- GRANTS : 1953 to 2 025 \n- KJD: 198 0 to 2025 \n- MEDLI NE: 19 50 to 202 5 \n- PCI : 1950 to 2 025 \n- PPRN: 1 991 to 20 25 \n- PQD T: 163 7 to 2025 \n- SCIELO: 20 02 to 20 25 \n- ZOOREC: 1864 to 2025  \n3 (((TI=(attitude*)) OR AB=(attitude*))) Editions: \nWOS.IC,WOS.CCR,WOS.SCI,WOS.AHCI,WOS.BHCI,WOS.BSCI,WOS.ESCI,WOS.ISTP,WOS.SSCI,WOS.ISSHP,BCI.BCI,BIOSIS.PREVIEWS,CCC.CCCA,CCC.CCCB,CCC.CCCC,CCC.CCCP,C\nCC.CCCS,CCC.CCCT,CCC.CCCY,CCC.CCCBC,CCC.CCCEC,DRCI.DSCI,DRCI.DSSHCI,DIIDW.CDerwent,DIIDW.EDerwent,DIIDW.MDerwent,GRANTS.GRANTS,KJD.KJD,PCI.PCI,PPRN.PP\nRN,PQDT.PQDT,SCIELO.SCIELO,ZOOREC.RECORDS  \nAll Databases  \n88\n90\n04 \nTue Apr 01 202 5 15:3 9:50 \nGMT+0100 (Britis h Summer Ti me) \n \n- WOS: 1900 to 2 025  \n- BCI: 192 6 to 2025 \n- BI OSIS: 1969 to 2008  \n- CCC: 19 98 to 202 5 \n- DRCI: 190 0 to 2025  \n- DIIDW : 1966 to 2 025 \n- GRANTS : 1953 to 2 025 \n- KJD: 198 0 to 2025 \n- MEDLI NE: 19 50 to 202 5 \n- PCI : 1950 to 2 025 \n- PPRN: 1 991 to 20 25 \n- PQD T: 163 7 to 2025 \n- SCIELO: 20 02 to 20 25 \n- ZOOREC: 1864 to 2025  \n4 (((TI=(belie*)) OR AB=(belie*))) Editions: \nWOS.IC,WOS.CCR,WOS.SCI,WOS.AHCI,WOS.BHCI,WOS.BSCI,WOS.ESCI,WOS.ISTP,WOS.SSCI,WOS.ISSHP,BCI.BCI,BIOSIS.PREVIEWS,CCC.CCCA,CCC.CCCB,CCC.CCCC,CCC.CCCP,C\nCC.CCCS,CCC.CCCT,CCC.CCCY,CCC.CCCBC,CCC.CCCEC,DRCI.DSCI,DRCI.DSSHCI,DIIDW.CDerwent,DIIDW.EDerwent,DIIDW.MDerwent,GRANTS.GRANTS,KJD.KJD,PCI.PCI,PPRN.PP\nRN,PQDT.PQDT,SCIELO.SCIELO,ZOOREC.RECORDS  \nAll Databases  \n12\n48\n91\n9 \nTue Apr 01 202 5 15:4 0:23 \nGMT+0100 (Britis h Summer Ti me) \n \n- WOS: 1900 to 2 025  \n- BCI: 192 6 to 2025 \n- BI OSIS: 1969 to 2008  \n- CCC: 19 98 to 202 5 \n- DRCI: 190 0 to 2025  \n- DIIDW : 1966 to 2 025 \n- GRANTS : 1953 to 2 025 \n- KJD: 198 0 to 2025 \n- MEDLI NE: 19 50 to 202 5 \n- PCI : 1950 to 2 025 \n- PPRN: 1 991 to 20 25 \n- PQD T: 163 7 to 2025 \n- SCIELO: 20 02 to 20 25 \n- ZOOREC: 1864 to 2025  \n5 (((TI=(perception*)) OR AB=(perception*))) Editions: \nWOS.IC,WOS.CCR,WOS.SCI,WOS.AHCI,WOS.BHCI,WOS.BSCI,WOS.ESCI,WOS.ISTP,WOS.SSCI,WOS.ISSHP,BCI.BCI,BIOSIS.PREVIEWS,CCC.CCCA,CCC.CCCB,CCC.CCCC,CCC.CCCP,C\nCC.CCCS,CCC.CCCT,CCC.CCCY,CCC.CCCBC,CCC.CCCEC,DRCI.DSCI,DRCI.DSSHCI,DIIDW.CDerwent,DIIDW.EDerwent,DIIDW.MDerwent,GRANTS.GRANTS,KJD.KJD,PCI.PCI,PPRN.PP\nRN,PQDT.PQDT,SCIELO.SCIELO,ZOOREC.RECORDS  \nAll Databases  \n13\n15\n39\n6 \nTue Apr 01 202 5 15:4 0:48 \nGMT+0100 (Britis h Summer Ti me) \n \n- WOS: 1900 to 2 025  \n- BCI: 192 6 to 2025 \n- BI OSIS: 1969 to 2008  \n- CCC: 19 98 to 202 5 \n- DRCI: 190 0 to 2025  \n- DIIDW : 1966 to 2 025 \n- GRANTS : 1953 to 2 025 \n- KJD: 198 0 to 2025 \n- MEDLI NE: 19 50 to 202 5 \n- PCI : 1950 to 2 025 \n- PPRN: 1 991 to 20 25 \n- PQD T: 163 7 to 2025 \n- SCIELO: 20 02 to 20 25 \n- ZOOREC: 1864 to 2025  \n6 ((#5 OR #4 OR #3 OR #2 OR #1)) Editions: \nWOS.IC,WOS.CCR,WOS.SCI,WOS.AHCI,WOS.BHCI,WOS.BSCI,WOS.ESCI,WOS.ISTP,WOS.SSCI,WOS.ISSHP,BCI.BCI,BIOSIS.PREVIEWS,CCC.CCCA,CCC.CCCB,CCC.CCCC,CCC.CCCP,C\nCC.CCCS,CCC.CCCT,CCC.CCCY,CCC.CCCBC,CCC.CCCEC,DRCI.DSCI,DRCI.DSSHCI,DIIDW.CDerwent,DIIDW.EDerwent,DIIDW.MDerwent,GRANTS.GRANTS,KJD.KJD,PCI.PCI,PPRN.PP\nRN,PQDT.PQDT,SCIELO.SCIELO,ZOOREC.RECORDS  \nAll Databases  \n70\n14\n08\n5 \nTue Apr 01 202 5 15:4 1:22 \nGMT+0100 (Britis h Summer Ti me) \n \n- WOS: 1900 to 2 025  \n- BCI: 192 6 to 2025 \n- BI OSIS: 1969 to 2008  \n- CCC: 19 98 to 202 5 \n- DRCI: 190 0 to 2025  \n- DIIDW : 1966 to 2 025 \n- GRANTS : 1953 to 2 025 \n- KJD: 198 0 to 2025 \n- MEDLI NE: 19 50 to 202 5 \n- PCI : 1950 to 2 025 \n- PPRN: 1 991 to 20 25 \n- PQD T: 163 7 to 2025 \n- SCIELO: 20 02 to 20 25 \n- ZOOREC: 1864 to 2025  \n7 (((TI=(endometriosis)) OR AB=(endometriosis))) Editions: \nWOS.IC,WOS.CCR,WOS.SCI,WOS.AHCI,WOS.BHCI,WOS.BSCI,WOS.ESCI,WOS.ISTP,WOS.SSCI,WOS.ISSHP,BCI.BCI,BIOSIS.PREVIEWS,CCC.CCCA,CCC.CCCB,CCC.CCCC,CCC.CCCP,C\nCC.CCCS,CCC.CCCT,CCC.CCCY,CCC.CCCBC,CCC.CCCEC,DRCI.DSCI,DRCI.DSSHCI,DIIDW.CDerwent,DIIDW.EDerwent,DIIDW.MDerwent,GRANTS.GRANTS,KJD.KJD,PCI.PCI,PPRN.PP\nRN,PQDT.PQDT,SCIELO.SCIELO,ZOOREC.RECORDS  \nAll Databases  \n48\n10\n6 \nTue Apr 01 202 5 15:4 1:55 \nGMT+0100 (Britis h Summer Ti me) \n\n27 \n \n \n- WOS: 1900 to 2 025  \n- BCI: 192 6 to 2025 \n- BI OSIS: 1969 to 2008  \n- CCC: 19 98 to 202 5 \n- DRCI: 190 0 to 2025  \n- DIIDW : 1966 to 2 025 \n- GRANTS : 1953 to 2 025 \n- KJD: 198 0 to 2025 \n- MEDLI NE: 19 50 to 202 5 \n- PCI : 1950 to 2 025 \n- PPRN: 1 991 to 20 25 \n- PQD T: 163 7 to 2025 \n- SCIELO: 20 02 to 20 25 \n- ZOOREC: 1864 to 2025  \n8 ((#6 AND #7)) Editions: \nWOS.IC,WOS.CCR,WOS.SCI,WOS.AHCI,WOS.BHCI,WOS.BSCI,WOS.ESCI,WOS.ISTP,WOS.SSCI,WOS.ISSHP,BCI.BCI,BIOSIS.PREVIEWS,CCC.CCCA,CCC.CCCB,CCC.CCCC,CCC.CCCP,C\nCC.CCCS,CCC.CCCT,CCC.CCCY,CCC.CCCBC,CCC.CCCEC,DRCI.DSCI,DRCI.DSSHCI,DIIDW.CDerwent,DIIDW.EDerwent,DIIDW.MDerwent,GRANTS.GRANTS,KJD.KJD,PCI.PCI,PPRN.PP\nRN,PQDT.PQDT,SCIELO.SCIELO,ZOOREC.RECORDS  \nAll Databases  \n25\n20 \nTue Apr 01 202 5 15:4 2:37 \nGMT+0100 (Britis h Summer Ti me) \n \n- WOS: 1900 to 2 025  \n- BCI: 192 6 to 2025 \n- BI OSIS: 1969 to 2008  \n- CCC: 19 98 to 202 5 \n- DRCI: 190 0 to 2025  \n- DIIDW : 1966 to 2 025 \n- GRANTS : 1953 to 2 025 \n- KJD: 198 0 to 2025 \n- MEDLI NE: 19 50 to 202 5 \n- PCI : 1950 to 2 025 \n- PPRN: 1 991 to 20 25 \n- PQD T: 163 7 to 2025 \n- SCIELO: 20 02 to 20 25 \n- ZOOREC: 1864 to 2025  \n9 (((TI=(\"systematic review\")) OR TI=(\"scoping review\"))) Editions: \nWOS.IC,WOS.CCR,WOS.SCI,WOS.AHCI,WOS.BHCI,WOS.BSCI,WOS.ESCI,WOS.ISTP,WOS.SSCI,WOS.ISSHP,BCI.BCI,BIOSIS.PREVIEWS,CCC.CCCA,CCC.CCCB,CCC.CCCC,CCC.CCCP,C\nCC.CCCS,CCC.CCCT,CCC.CCCY,CCC.CCCBC,CCC.CCCEC,DRCI.DSCI,DRCI.DSSHCI,DIIDW.CDerwent,DIIDW.EDerwent,DIIDW.MDerwent,GRANTS.GRANTS,KJD.KJD,PCI.PCI,PPRN.PP\nRN,PQDT.PQDT,SCIELO.SCIELO,ZOOREC.RECORDS  \nAll Databases  \n41\n39\n20 \nTue Apr 01 202 5 15:4 3:08 \nGMT+0100 (Britis h Summer Ti me) \n \n- WOS: 1900 to 2 025  \n- BCI: 192 6 to 2025 \n- BI OSIS: 1969 to 2008  \n- CCC: 19 98 to 202 5 \n- DRCI: 190 0 to 2025  \n- DIIDW : 1966 to 2 025 \n- GRANTS : 1953 to 2 025 \n- KJD: 198 0 to 2025 \n- MEDLI NE: 19 50 to 202 5 \n- PCI : 1950 to 2 025 \n- PPRN: 1 991 to 20 25 \n- PQD T: 163 7 to 2025 \n- SCIELO: 20 02 to 20 25 \n- ZOOREC: 1864 to 2025  \n1\n0 \n((((#8) NOT #9))) Editions: \nWOS.IC,WOS.CCR,WOS.SCI,WOS.AHCI,WOS.BHCI,WOS.BSCI,WOS.ESCI,WOS.ISTP,WOS.SSCI,WOS.ISSHP,BCI.BCI,BIOSIS.PREVIEWS,CCC.CCCA,CCC.CCCB,CCC.CCCC,CCC.CCCP,C\nCC.CCCS,CCC.CCCT,CCC.CCCY,CCC.CCCBC,CCC.CCCEC,DRCI.DSCI,DRCI.DSSHCI,DIIDW.CDerwent,DIIDW.EDerwent,DIIDW.MDerwent,GRANTS.GRANTS,KJD.KJD,PCI.PCI,PPRN.PP\nRN,PQDT.PQDT,SCIELO.SCIELO,ZOOREC.RECORDS  \nAll Databases  \n24\n31 \nTue Apr 01 202 5 15:4 3:34 \nGMT+0100 (Britis h Summer Ti me) \n \n  \n\n28 \n \nAppendix II Grey literature  \nExample for grey literature \nhttps://www.medrxiv.org/  \nThe ELEMI healthcare professional Study \nhttps://www.medrxiv.org/content/10.1101/2023.03.18.23287312v1  \nEndometriosis Online Communities: A Quantitative Analysis \nhttps://www.medrxiv.org/content/10.1101/2024.02.27.24303445v1  \nhttps://www.researchsquare.com/  \nBridging the gap: Can a patient questionnaire together with staff education increase diagnostics of endometriosis in primary care? -A pilot study \nhttps://www.researchsquare.com/article/rs-2258804/v1  \nFertility Preservation Counselling for Women With Endometriosis: A European Online Survey \nhttps://www.researchsquare.com/article/rs-966804/v1  \nTrends among patients with endometriosis over a 7-year period and the impact of the COVID-19 pandemic. Experience from an academic high level endometriosis \ncentre in Germany. \nhttps://www.researchsquare.com/article/rs-1784980/v1  \n‘A day to day struggle’: A comparative qualitative study on experiences of women with endometriosis and chronic pelvic pain \nhttps://www.researchsquare.com/article/rs-289745/v1  \nSex, Pain & Endometriosis: The development of a patient-centred e-health resource for those affected by endometriosis-associated dyspareunia \nhttps://www.researchsquare.com/article/rs-1946310/v1  \nhttps://papers.ssrn.com/  \nPerceived Effectiveness and Use of Naturopathic Treatments for Endometriosis: A Cross-Sectional Survey of Australian Naturopaths Experienced in Endometriosis \nManagement \nhttps://papers.ssrn.com/sol3/papers.cfm?abstract_id=4102851  \nEndometriosis is More than a Painful Period. Period \nhttps://papers.ssrn.com/sol3/papers.cfm?abstract_id=4907532  \nhttps://osf.io  \n“My body is out to wreck everything I have”: A qualitative study of how women with endometriosis feel about their bodies \nhttps://osf.io/preprints/psyarxiv/awrgx_v1  \nAre people with chronic pain more diverse than we think? An investigation of ergodicity \nhttps://osf.io/preprints/psyarxiv/5nrje_v1  \n  \n\n29 \n \nAppendix III: Data extraction form  \nData extraction form \nStudy  \n-Author \nname (year \nof \npublication)  \n \nPurpose of \nstudy \nAim/objectives \nStudy \ndesign  \n \nCountry Population \n-Participants’ \ntype: patients, \nHCPs, or both \n-Number of \nparticipants  \n \nKAP \nFocus \nAssessment tool/s  \n(+ validated Y/N) \nKey Findings \n-related to:  \n *Symptoms  \n *Diagnosis \n *Treatment  \n-Conclusion \n \nFuture \nrecommendation  \n \nLimitations","source_license":"CC0","license_restricted":false}