Daily Life Restrictions of Women with Endometrioses: A Scoping Review Protocol

Review question / Objective What are the daily life restrictions of women with Endometriosis? What is the prevalence of daily life restrictions? How do they correlate with Endometriosis symptoms/severity? what is the relevance to intervention for improving daily life?

Endometriosis is a chronic condition characterized by the presence of endometrial-like tissue outside the uterus. This chronic condition and includes symptoms such as chronic pelvic pain, fatigue, infertility, all of which may significantly impact women’s daily life in various functional domains and therefore reduce quality of life and wellbeing. Despite the known physical symptoms, their implications on women’s real life is less studied, however critical for intervention in terms of elevating function, quality of life and wellbeing. The ICF framework of the World Health Organization emphasizes that health providers should refer to the interaction between the disease, impaired body functions and the person’s ability to function and participate in daily life to optimize intervention and people’s wellbeing. Rationale While research and practice of Endometriosis mainly focus on the physical symptoms and on clinical settings, there is a notable gap in the literature regarding the comprehensive impact of Endometriosis on women’s daily functioning in real life, outside the clinic – at home, at work, in social and intimate relationships etc. This knowledge is critical for improving intervention strategies, optimizing women’s engagement in therapy and improving their quality of life and wellbeing. This review aims to close this gap and provide a comprehensive perspective about Endometriosis impacts on women’s daily functioning, in all relevant domains (as work, social life), offering a holistic view of the condition’s impacts in real life settings. The review seeks to understand the daily life restrictions experienced by women with Endometriosis and their prevalence. It will also identify the most impacted functional domains and INPLASY 1 International Platform of Registered Systematic Review and Meta-analysis Protocols INPLASYDaily Life Restrictions of Women with Endometrioses: A Scoping Review Protocol Khatib, S; Hassan; H, Reiss, A; Engel-Yeger, B. Khatib et al. INPLASY protocol 202470101. doi:10.37766/inplasy2024.7.0101 Khatib et al. INPLASY protocol 202470101. doi:10.37766/inplasy2024.7.0101 Downloaded from https://inplasy.com/inplasy-2024-7-0101/ INPLASY202470101 doi: 10.37766/inplasy2024.7.0101 Received: 25 July 2024 Published: 25 July 2024 Corresponding author: Sewar Khatib [email protected] Author Affiliation: Department of Occupational Therapy, Faculty of Social Welfare and Health Sciences, University of Haifa, Israel. ADMINISTRATIVE INFORMATION Support - University of Haifa. Review Stage at time of this submission - The review has not yet started. Conflicts of interest - None declared. INPLASY registration number: INPLASY202470101 Amendments - This protocol was registered with the International Platform of Registered Systematic Review and Meta-Analysis Protocols (INPLASY) on 25 July 2024 and was last updated on 25 July 2024. examine how these impacts correlate with the severity and symptoms of Endometriosis. This scoping review seeks to map out the existing research on these domains, identify gaps, and highlight areas requiring further investigation. By doing so, it aims to highlight the potential for improving interventions that can be integrated into current healthcare models as the ICF . The insights gained will inform the development of targeted interventions and health models designed to enhance daily functioning and quality of life of women living with Endometriosis. Through this comprehensive approach, the review will contribute to a more nuanced understanding of the disease and support the creation of e ffective strategies to alleviate its multifaceted burdens.

Strategy of data synthesis The data synthesis for this scoping review will involve both qualitative and quantitative methods to provide a comprehensive understanding of the impact of Endometriosis on women's daily functioning. The process will be managed using Covidence. The following steps outline the strategy: 1.Summarize the characteristics of the included studies, such as study design, population demographics, types of Endometriosis, and specific domains of daily functioning assessed. Present key findings in tables and figures to provide a clear overview of the study characteristics. 2.Thematic analysis we will identify, and code recurring themes related to the impact of Endometriosis on daily functioning, including work, social life, intimate relationships, and overall quality of life. and organize the coded data into major themes and subthemes, providing a narrative summary of the identified themes. Then we will conduct quantitative synthesis and extract quantitative data related to the prevalence and severity of daily life restrictions caused by Endometriosis. We also will examine the correlations between the severity of Endometriosis symptoms and the impact on various domains of daily functioning. Then we will compare the findings across different types of Endometriosis to identify any differential impacts. We will integrate the qualitative and quantitative fin d i n g s t o p r o v i d e a c o m p r e h e n s i v e understanding of the overall impact of Endometriosis on women's daily lives, and then discuss the implications of the findings for clinical practice, policy, and future research, highlighting potential interventions and health models designed to enhance the quality of life for women with Endometriosis. Identify gaps in the existing literature and areas necessitating further investigation and propose future research directions based on the synthesized data, emphasizing the need for studies that address the identi fied gaps and explore novel intervention strategies. Data management: Data management will be conducted using Covidence, an online software platform designed to streamline the systematic review process. The steps involved include: importing references retrieved from the initial search into Covidence and ensure that duplicates are identified and removed automatically by Covidence. Then, we will conduct screening (conduct title and

screening within Covidence) each

will be independently reviewed by two reviewers. Conflicts will be flagged and resolved through discussion or by consulting a third reviewer if necessary. We will conduct full-text review by uploading full- text articles to Covidence for in-depth review, full- text screening to confirm eligibility, with two reviewers independently assessing each study. Differences will be resolved through discussion or by a third reviewer. We will use Covidence's data extraction tool to systematically extract relevant information from each included study and develop and use a standardized data extraction form to ensure consistency across reviewers, extracted data will include study characteristics, population details, types of Endometriosis, daily functioning impacts, and other relevant outcomes. We will synthesize the extracted data using Covidence’s tools to identify themes and patterns. Present the data in tabular and narrative formats for comprehensive analysis and reporting. The search strategy will be utilized across a combination of databases, including both those with and without a thesaurus. The databases and search terms are as follows: Databases without a thesaurus: Web of Science, Scopus, ProQuest Dissertation and Theses Databases with a thesaurus: PubMed, CINAHL, PsycINFO. Search Terms: We will integrate search terms across two primary concepts: "Endometriosis" and its synonyms (e.g., INPLASY 2Khatib et al. INPLASY protocol 202470101. doi:10.37766/inplasy2024.7.0101 Khatib et al. INPLASY protocol 202470101. doi:10.37766/inplasy2024.7.0101 Downloaded from https://inplasy.com/inplasy-2024-7-0101/ endometrima* ) and "daily life" and "functioning" along with their synonyms (e.g., daily activities, functional status). Eligibility criteria Cis gender women in reproductive age (15-49), with a diagnosis of Endometriosis. Women diagnosed with all types of Endometriosis: Superficial Peritoneal Endometriosis (SPE). Ovarian Endometriomas, also termed "chocolate cysts". Deep Infiltrating Endometriosis (DIE). Source of evidence screening and selection The source selection for this scoping review will follow a systematic process involving initial search and screening using predefined search terms in selected databases (Web of Science, Scopus, ProQuest Dissertation and Theses, PubMed, CINAHL, and PsycINFO). Screen titles and abstracts of the retrieved articles to identify potentially relevant studies. Full-text screening and the articles that pass the initial screening. Review the full texts to ensure they meet the eligibility criteria and extract relevant data from the selected studies using a standardized data extraction form. We will ensure consistency and accuracy in data extraction across all reviewers. And we will address the disagreements between reviewers at any stage of the selection process through discussion. then we will document the reasons for inclusion or exclusion of studies at each stage. We will report the selection process in the final review, including the number of studies screened, assessed for eligibility, and included in the review. Data management The data management will be conducted using Covidence, an online software platform designed to streamline the systematic review process. Reporting results / Analysis of the evidence The

of the scoping review will be reported in a PRISMA flow diagram that will detail the number of records identified, screened, and included. We will present a table summarizing the characteristics of the included studies, we will present thematic analysis results, identifying key themes and categories related to the impact of Endometriosis on daily life and functioning. Then we will adress gaps and areas needing further investigation.

and summary. Language restriction No language restriction. Country(ies) involved Israel.

Functional activities, women’s health, quality of life. Contributions of each author Author 1 - Sewar Khatib - first author - will conduct the literature search, search strategy, screen titles and abstracts, review full-text articles, extract data, draft the manuscript, and manage the overall project. Email: [email protected] Author 2 - Batya Engel -Yeger - PhD supervisor & author - Will provide guidance on the search strategy, offer feedback on the manuscript drafts, ensure the overall quality and rigor of the scoping review, and contribute to the professional writing of the manuscript. Email: [email protected] Author 3 - Haya Hassan - Will assist in screening titles and abstracts, reviewing full-text articles, and extracting data using Covidence, and will work collaboratively with the authors throughout the process. As a gynecology intern, will also provide professional insights into the clinical aspects of endometriosis. Email: [email protected] Author 4 - Ari Reiss - As a senior gynecologist, offers expert professional insights, particularly on the clinical aspects of endometriosis, and reviews the manuscript to ensure its accuracy. Email: [email protected] INPLASY 3Khatib et al. INPLASY protocol 202470101. doi:10.37766/inplasy2024.7.0101 Khatib et al. INPLASY protocol 202470101. doi:10.37766/inplasy2024.7.0101 Downloaded from https://inplasy.com/inplasy-2024-7-0101/