Limitations in Activities of Daily Living Among Spanish Women Diagnosed With Endometriosis

Mario Lozano‐Lozano, Mario Lozano-Lozano, Antonio Mundo-López, Mundo-López A, Ainhoa P San-Sebastian, Ainhoa P. San-Sebastián, San-Sebastian AP, Noelia Galiano-Castillo, Noelia Galiano‐Castillo, Galiano-Castillo N, Fernandez-Lao C, Carolina Fernández‐Lao, Carolina Fernandez-Lao, Irene Cantarero-Villanueva, Irene Cantarero‐Villanueva, Manuel Arroyo‐Morales, Arroyo-Morales M, Manuel Arroyo-Morales, Ocón-Hernández O, Olga Ocón-Hernández, Olga Ocón‐Hernández, Francisco Artacho‐Cordón, Francisco Artacho-Cordón
The American journal of occupational therapy : official publication of the American Occupational Therapy Association · 2021 · vol. 75(6) · doi:10.5014/ajot.2021.044974 · PMID:34842913 · W3216857483
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This study found that women with endometriosis experience significant limitations in daily activities, with severe pelvic pain, chronic fatigue, and pain-catastrophizing thoughts contributing to these impairments.

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Abstract

IMPORTANCE: Understanding the impact of endometriosis symptoms on patients' activities of daily living (ADLs) is a priority to establish effective and personalized intervention programs. OBJECTIVE: To explore limitations in ADLs and instrumental ADLs (IADLs) and their association with pelvic pain (PP), chronic fatigue, and pain-catastrophizing thoughts among women with endometriosis. DESIGN: Cross-sectional study. SETTING: Spain. PARTICIPANTS: Two hundred thirty women with endometriosis. Outcomes and Measures: Information regarding performance of ADLs (Barthel Index) and IADLs (Lawton-Brody questionnaire), PP intensity (Numeric Rating Scale), chronic fatigue (Piper Fatigue Scale), and pain-catastrophizing thoughts (Pain Catastrophizing Scale) was gathered. Multivariate regression analyses were created, and mediating effects of fatigue and pain-catastrophizing thoughts on the association between PP and ADL and IADL limitations were assessed. RESULTS: The prevalence of limitations in at least one ADL and one IADL was 22.6% (95% confidence interval [CI] [17.2, 28.1]) and 39.1% (95% CI [32.8, 45.5]), respectively. Limitations in bowel continence, housework, shopping, and meal preparation were reported most frequently. Women reporting severe PP showed higher risk for ADL (odds ratio [OR] = 3.33, 95% CI [1.10, 10.10]) and IADL (OR = 7.99, 95% CI [2.86, 22.34]) limitations. Chronic fatigue and pain-catastrophizing thoughts were also positively related to ADL-IADL limitations, showing a mediating effect on the association between PP and ADL-IADL limitations. CONCLUSIONS AND RELEVANCE: This study reveals the widespread presence of difficulties in ADL-IADL performance among women with endometriosis, with some symptoms underlying these difficulties in occupational performance. This study points to the need for cost-effective occupational therapy interventions for affected women. What This Article Adds: This research shows that the occupational performance of women with endometriosis is frequently impaired; therefore, the effectiveness of occupational therapy interventions should be addressed in the near future.
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Limitations

in Activities of Daily Living Among Spanish Women Diagnosed With Endometriosis Metadata Show full item recordAuthor Lozano-Lozano, Mario; Mundo López, Antonio; San-Sebastian, Ainhoa P; Galiano-Castillo, Noelia; Fernández-Lao, Carolina; Cantarero-Villanueva, Irene; Arroyo-Morales, Manuel; Ocón Hernández, Olga; Artacho Cordón, FranciscoMateria Endometriosis Pain Fatigue catastrophization Date 2021-11-29Referencia bibliográfica Lozano-Lozano, M., Mundo-López, A., San-Sebastian, A. P., Galiano-Castillo, N., Fernandez-Lao, C., Cantarero-Villanueva, I., Arroyo-Morales, M., Ocón-Hernández, O., & Artacho-Cordón, F. (2021). Limitations in Activities of Daily Living Among Spanish Women Diagnosed With Endometriosis. The American journal of occupational therapy : official publication of the American Occupational Therapy Association, 75(6), 7506205050. https://doi.org/10.5014/ajot.2021.044974 Sponsorship This study was partially supported by Carlos III Health Institute Grant FIS PI17/01743, donations from women with endometriosis, and Paidi Group CTS-206 funds. This project is cofunded by the University of Granada, Plan Propio de Investigacion 2016, Actions of Excellence, and by the Junta de Andalucıa, Consejerıa de Conocimiento, Investigacion y Universidades, and the European Regional Development Fund (Ref. SOMM17/6107/UGR). This article was part of the doctoral thesis developed by A. Mundo-Lopez for the Of ficial Doctoral Programme in Clinical Medicine and Public Health at the University of Granada.Abstract Importance: Understanding the impact of endometriosis symptoms on patients' activities of daily living (ADLs) is a priority to establish effective and personalized intervention programs.

Objective

To explore limitations in ADLs and instrumental ADLs (IADLs) and their association with pelvic pain (PP), chronic fatigue, and pain-catastrophizing thoughts among women with endometriosis. Design: Cross-sectional study. Setting: Spain. Participants: Two hundred thirty women with endometriosis. Outcomes and Measures: Information regarding performance of ADLs (Barthel Index) and IADLs (Lawton-Brody questionnaire), PP intensity (Numeric Rating Scale), chronic fatigue (Piper Fatigue Scale), and pain-catastrophizing thoughts (Pain Catastrophizing Scale) was gathered. Multivariate regression analyses were created, and mediating effects of fatigue and pain-catastrophizing thoughts on the association between PP and ADL and IADL limitations were assessed.

Results

The prevalence of limitations in at least one ADL and one IADL was 22.6% (95% confidence interval [CI] [17.2, 28.1]) and 39.1% (95% CI [32.8, 45.5]), respectively. Limitations in bowel continence, housework, shopping, and meal preparation were reported most frequently. Women reporting severe PP showed higher risk for ADL (odds ratio [OR] = 3.33, 95% CI [1.10, 10.10]) and IADL (OR = 7.99, 95% CI [2.86, 22.34]) limitations. Chronic fatigue and pain-catastrophizing thoughts were also positively related to ADL-IADL limitations, showing a mediating effect on the association between PP and ADL-IADL limitations.

Conclusions

and relevance: This study reveals the widespread presence of difficulties in ADL-IADL performance among women with endometriosis, with some symptoms underlying these difficulties in occupational performance. This study points to the need for cost-effective occupational therapy interventions for affected women. What This Article Adds: This research shows that the occupational performance of women with endometriosis is frequently impaired; therefore, the effectiveness of occupational therapy interventions should be addressed in the near future.

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Condition tags

endometriosis

MeSH descriptors

Activities of Daily Living Endometriosis Endometriosis Cross-Sectional Studies Female Humans Pain Measurement Surveys and Questionnaires

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Papers in the corpus that this work cites (lower rings, blue) and that cite this one (upper rings, green). Dot size scales with the paper's in-corpus citation count — bigger dot = more influential within the endo/adeno field. Click a dot to open that paper. [ expand to 2 hops ] — adds papers reached through this work's immediate citers/citees. Heavier; up to 60 extra dots.

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