A Mixed-Methods Investigation of Coping, Adaptation and Health-Related Quality of Life in Individuals Experiencing Endometriosis

ObjectivesEndometriosis is associated with reduced health-related quality of life (HRQoL). Coping has been linked to HRQoL in this population but longitudinal research to establish the impact of coping on HRQoL over time is lacking. Additionally, limited research has examined coping and adaptation to endometriosis from an in-depth qualitative or mixed-methods perspective. Therefore, adopting a mixed-methods approach, the current research aimed to investigate how individuals experiencing endometriosis coped and adapted to their condition, and the extent to which coping predicted HRQoL over time. DesignA sequential, mixed-methods design incorporating a two-wave longitudinal survey and semi-structured interviews. Methods408 UK-based participants diagnosed with endometriosis completed the baseline survey, measuring demographics, clinical factors, and coping with 283 completing the follow-up survey assessing HRQoL a year later. Data was analysed through hierarchical regression analysis. Meanwhile, 30 semi-structured interviews were conducted and analysed using reflexive thematic analysis. Findings were integrated by considering points of convergence, divergence, and complementarity between the datasets. ResultsAnalysis of the quantitative data indicated an enduring impact of coping on HRQoL. Avoidant strategies and endometriosis-related information-seeking predicted reduced HRQoL, whilst trust in medical care exerted a protective function. Three themes were constructed from the qualitative data: disconnection from the body; balancing boundaries and self-care; and empowered adaptation. Integration of the datasets emphasised the significant impact of coping on HRQoL and wellbeing, revealing avoidance and positive adaptation as prominently employed coping strategies. ConclusionsThe results position coping as an important therapeutic target in endometriosis care, particularly through fostering empowerment and adaptation to support HRQoL.