A MIXED METHODS APPROACH TO UNDERSTANDING PAIN AND MENTAL HEALTH IN ENDOMETRIOSIS SURGERY PATIENTS

Studies imply that endometriosis might be linked to several psychological risk factors such as: anxiety, depression, loneliness, pain catastrophizing, and childhood trauma. By comparing endometriosis patients with other patients with similar surgeries, we aim to contribute to create a better understanding of endometriosis patients’ pain, mental health and challenges with the condition, in addition to exploring clinicians’ perspectives for a broader interpretation. This led up to the research question: "How do patients with endometriosis differ from other surgery patients in terms of pain and mental health before and after surgery, and how do clinicians perceive these differences?" The study will be using a group based comparison mixed design, including both longitudinal quantitative data, as well as an open-end question and focus group interview. Quantitative: To explore this research question, we will be using secondary longitudinal quantitative data collected from NorOp study, with variables including pain, pain catastrophizing, anxiety, depression, loneliness, and childhood trauma, in addition to patient characteristics (age, sex, etc.), surgery type, diagnoses, medication use and other information relating to the study. The variables will be analyzed using simple descriptives and t-tests to compute statistical differences between the endometriosis patients and the comparison groups, as well as longitudinal linear mixed-effect models to analyze changes in pain, anxiety, depression over time in both patient groups. Qualitative: In response to an open-ended question, we will be using a thematic analysis to qualitatively examine how endometriosis patients are doing after surgery, and to identify any similarities with the quantitative reports, and any new and previously unexplored themes on the surgical experience that could direct new research avenues. To further explore the question about how clinicians perceive differences in endometriosis patients' pain and mental health, we will do a focus group interview with approximately 5 clinicians that are directly involved with patients who are undergoing laparoscopic surgery for endometriosis. This qualitative focus group study aims to understand clinicians experiences and perspectives on endometriosis patients pain and mental health during surgical treatment. The semi-structured interviews will explore: 1) Clinicians experiences with endometriosis patients, including pain and reoperation rates; 2) Perceptions of risk factors (mental health, social support) for ongoing pain in patients, and 3) Need for additional supports beyond surgery, such as psychosocial support and optimal timing. The project is scheduled to be completed in the spring of 2025, and approved in the summer of 2025.