Literature DB >> 28318358

Assessing Abnormal Uterine Bleeding: Are Physicians Taking a Meaningful Clinical History?

Christina Lam1, Britta Anderson2, Vrishali Lopes1, Jay Schulkin2, Kristen Matteson1.   

Abstract

INTRODUCTION: Women with abnormal uterine bleeding (AUB) report significant reductions in quality of life (QOL), which can be attributed in many cases to the fear of embarrassing episodes of bleeding. We performed this study to determine whether or not during clinical encounters physicians addressed the impact of AUB on patient-reported QOL.
MATERIALS AND METHODS: Between October 2008 and May 2009, we conducted a cross-sectional study of members of the American College of Obstetricians and Gynecologists. Surveys were distributed using a mixed method (web- and mail-based) and included questions about physician characteristics and types of questions used when obtaining a clinical history from a patient with AUB. We calculated the proportion of physicians who endorsed asking each type of clinical question with 95% confidence intervals (CIs).
RESULTS: Four hundred seventeen questionnaires were returned (52%). Ninety-nine percent (95% CI 98.4%-99.9%) reported always asking a bleeding heaviness question, 87.2% (95% CI 83.2%-90.5%) reported always asking a QOL question, and 17.5% (95% CI 13.6%-21.9%) reported always asking a mood associated with bleeding question. Seventy-eight percent specifically asked patients about bleeding through their clothes, and 55% asked about changing social plans because of bleeding. Only 18% endorsed that asking about QOL was most essential for the evaluation of women with AUB. No physician characteristics such as years since completing residency, geography, or gender were associated with how commonly providers reported asking questions regarding impact of bleeding on QOL.
CONCLUSIONS: Physicians may not be optimizing patient-provider interactions during menstrual history taking with patients with AUB by failing to assess impact of AUB on QOL in a way that is meaningful to patients.

Entities:  

Keywords:  abnormal uterine bleeding; clinical history; physician survey; quality of life

Mesh:

Year:  2017        PMID: 28318358      PMCID: PMC5512463          DOI: 10.1089/jwh.2016.6155

Source DB:  PubMed          Journal:  J Womens Health (Larchmt)        ISSN: 1540-9996            Impact factor:   2.681


  19 in total

1.  Role of menstrual blood loss measurements in management of complaints of excessive menstrual bleeding.

Authors:  M C Rees
Journal:  Br J Obstet Gynaecol       Date:  1991-03

Review 2.  Abnormal uterine bleeding during the reproductive years.

Authors:  Bridget R Davidson; Christina M Dipiero; Kara D Govoni; Susan S Littleton; Jeremy L Neal
Journal:  J Midwifery Womens Health       Date:  2012 May-Jun       Impact factor: 2.388

Review 3.  The experience of heavy menstrual bleeding: a systematic review and meta-ethnography of qualitative studies.

Authors:  Ruth Garside; Nicky Britten; Ken Stein
Journal:  J Adv Nurs       Date:  2008-09       Impact factor: 3.187

4.  Work loss associated with increased menstrual loss in the United States.

Authors:  Isabelle Côté; Philip Jacobs; David Cumming
Journal:  Obstet Gynecol       Date:  2002-10       Impact factor: 7.661

Review 5.  Mechanisms of abnormal uterine bleeding.

Authors:  Mark Livingstone; Ian S Fraser
Journal:  Hum Reprod Update       Date:  2002 Jan-Feb       Impact factor: 15.610

6.  Discrepancy in patient and physician perception of patient's quality of life related to urinary symptoms.

Authors:  Larissa V Rodríguez; Daniel S Blander; Frederick Dorey; Shlomo Raz; Philippe Zimmern
Journal:  Urology       Date:  2003-07       Impact factor: 2.649

7.  Assessment of patients with menorrhagia: how valid is a structured clinical history as a measure of health status?

Authors:  D A Ruta; A M Garratt; Y C Chadha; G M Flett; M H Hall; I T Russell
Journal:  Qual Life Res       Date:  1995-02       Impact factor: 4.147

8.  Health status among women with menstrual symptoms.

Authors:  Karen Barnard; Susan M Frayne; Katherine M Skinner; Lisa M Sullivan
Journal:  J Womens Health (Larchmt)       Date:  2003-11       Impact factor: 2.681

9.  Abnormal uterine bleeding in pre-menopausal women.

Authors:  Sukhbir Singh; Carolyn Best; Sheila Dunn; Nicholas Leyland; Wendy Lynn Wolfman
Journal:  J Obstet Gynaecol Can       Date:  2013-05

10.  Listening to patients with unexplained menstrual symptoms: what do they tell the gynaecologist?

Authors:  Dawn Echlin; Anne S Garden; Peter Salmon
Journal:  BJOG       Date:  2002-12       Impact factor: 6.531

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  2 in total

1.  Barriers to seeking consultation for abnormal uterine bleeding: systematic review of qualitative research.

Authors:  Claire Henry; Alec Ekeroma; Sara Filoche
Journal:  BMC Womens Health       Date:  2020-06-12       Impact factor: 2.809

2.  High prevalence of abnormal menstruation among women living with HIV in Canada.

Authors:  Christina Valiaveettil; Mona Loutfy; V Logan Kennedy; Sheila Caddy; Mark Yudin; Tracey Conway; Erin Ding; Paul Sereda; Alexandra de Pokomandy; Angela Kaida
Journal:  PLoS One       Date:  2019-12-27       Impact factor: 3.240

  2 in total

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