The Experience of Psychological Care for Women with Endometriosis

Harpur, Samantha and Murray, Craig and Hardy, Claire (2022) The Experience of Psychological Care for Women with Endometriosis. PhD thesis, Lancaster University.

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Abstract

This thesis explores the experiences of women with endometriosis. A systematic literature review was conducted examining women’s experience of their healthcare encounters. On average in the United Kingdom, it takes 8 years to diagnose, and involves multiple healthcare encounters. Improved policy and awareness have led to an increase in research in endometriosis. A meta-ethnographic approach was adopted to analyse 23 papers. Two themes were identified; 1) Women are Dismissed (with the subtheme’s ‘women as hysterical’, ‘indifference to suffering’, and ‘a battle to be heard’). (2) Who is the expert? (With the subthemes ‘lack of knowledge’ and ‘expert patient’). The findings of this review highlight the troubled relationships between women with endometriosis and their Healthcare professional (HCPs). It recommends psychologists provide training for HCPs. The empirical paper in section two of this thesis explored the experiences of women who have accessed psychological care for support with their endometriosis. Data was collected via semi structured interviews with five women and was analysed using interpretative phenomenological analysis. Four themes were identified: (1) Therapeutic alliance, (2) Permission to speak; this was facilitated by the therapist’s ability to provide an adequate therapeutic frame, when this was not adequate, the women felt unable to speak about stigma, (3) Therapy can be empowering, (4) Managing endometriosis means managing mental health. Future research should consider the efficacy of psychological interventions, as well as individualised, culturally specific support. Section three of this thesis details a critical appraisal of the research project, making specific note my interest in the topic and details some of the steps taken to engage in reflexivity. This section also outlines some challenges to conducting research during a global pandemic and the steps taken to address these. Finally, this section concludes with consideration for the role of psychologists within the healthcare system in supporting women with endometriosis.