Physician Communication, Repeated Healthcare Encounters, and Diagnostic Delay in Endometriosis: An Exploratory Cross-Sectional Analysis.
6 affiliations
- 1Grigore T. Popa University of Medicine and Pharmacy Iasi, 700115 Iasi, Romania.
- 2Cuza Voda Clinical Hospital Obstetrics and Gynecology, 700038 Iasi, Romania.
- 3Department of Morpho-Functional Sciences I-Histology, "Grigore T. Popa" University of Medicine and Pharmacy, University Street 16, 700115 Iasi, Romania.
- 4Department of Biochemistry, "Grigore T. Popa" University of Medicine and Pharmacy, 16 Universitatii Street, 700115 Iasi, Romania.
- 5Biostatistics, Department of Preventive Medicine and Interdisciplinarity, "Grigore T. Popa" University of Medicine and Pharmacy, 700115 Iasi, Romania.
- 6Department of Dermatology, "Grigore T. Popa" University of Medicine and Pharmacy, 700115 Iasi, Romania.
Abstract
Background
Endometriosis is often diagnosed years after symptom onset, while communication-related factors remain poorly defined in Central and Eastern Europe.Methods
In this cross-sectional study, 150 Romanian women reporting surgically confirmed endometriosis completed an online questionnaire on diagnostic history and patient-physician communication, assessed with a seven-item Likert scale (Cronbach's α = 0.836).Results
Mean diagnostic delay was 9.1 years (median 8; IQR 4-13), with 5.2 physicians and 10.2 consultations before diagnosis. Delay was unrelated to symptom severity (r = 0.07, p = 0.43) but inversely related to age at symptom onset (r = -0.68). Adolescent-onset symptoms were followed by a 14.9-year delay versus 5.8 years for adult-onset symptoms. In multivariable analysis (adjusted R² = 0.49), earlier onset and more consultations remained independently associated with delay. Communication had an indirect association through consultation number (effect -0.68; 95% bootstrap CI -1.26 to -0.22), accounting for 38% of the total association; direction cannot be inferred from cross-sectional data. Symptom minimization (76%) was linked to more physicians and longer delays (10.0 vs. 6.0 years; d = 0.60).Conclusions
Earlier onset and repeated healthcare encounters were related to delay than symptom severity. The self-selected, urban, highly educated sample limits generalizability and causal interpretation.
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BibTeX
@article{mandici2026physician,
title = {{Physician Communication, Repeated Healthcare Encounters, and Diagnostic Delay in Endometriosis: An Exploratory Cross-Sectional Analysis.}},
author = {Cristina-Elena Mandici and Daniela Roxana Matasariu and Irina Draga Căruntu and Bogdan Doroftei and Daniela-Cristina Dimitriu and Liliana-Claudia Strat and Lucian Vasile Boiculese and Alexandra Ursache and Iuliana-Elena Bujor and Ioana-Adriana Popescu and Mihaela Grigore},
journal = {Healthcare (Basel, Switzerland)},
year = {2026},
month = oct,
doi = {10.3390/healthcare14193237},
url = {https://europepmc.org/article/MED/42881682},
note = {CC BY},
}
RIS
TY - JOUR
TI - Physician Communication, Repeated Healthcare Encounters, and Diagnostic Delay in Endometriosis: An Exploratory Cross-Sectional Analysis.
AU - Cristina-Elena Mandici
AU - Daniela Roxana Matasariu
AU - Irina Draga Căruntu
AU - Bogdan Doroftei
AU - Daniela-Cristina Dimitriu
AU - Liliana-Claudia Strat
AU - Lucian Vasile Boiculese
AU - Alexandra Ursache
AU - Iuliana-Elena Bujor
AU - Ioana-Adriana Popescu
AU - Mihaela Grigore
PY - 2026
DA - 2026/10/01
JO - Healthcare (Basel, Switzerland)
DO - 10.3390/healthcare14193237
UR - https://europepmc.org/article/MED/42881682
AB - Background Endometriosis is often diagnosed years after symptom onset, while communication-related factors remain poorly defined in Central and Eastern Europe.Methods In this cross-sectional study, 150 Romanian women reporting surgically confirmed endometriosis completed an online questionnaire on diagnostic history and patient-physician communication, assessed with a seven-item Likert scale (Cronbach's α = 0.836).Results Mean diagnostic delay was 9.1 years (median 8; IQR 4-13), with 5.2 physicians and 10.2 consultations before diagnosis. Delay was unrelated to symptom severity (r = 0.07, p = 0.43) but inversely related to age at symptom onset (r = -0.68). Adolescent-onset symptoms were followed by a 14.9-year delay versus 5.8 years for adult-onset symptoms. In multivariable analysis (adjusted R² = 0.49), earlier onset and more consultations remained independently associated with delay. Communication had an indirect association through consultation number (effect -0.68; 95% bootstrap CI -1.26 to -0.22), accounting for 38% of the total association; direction cannot be inferred from cross-sectional data. Symptom minimization (76%) was linked to more physicians and longer delays (10.0 vs. 6.0 years; d = 0.60).Conclusions Earlier onset and repeated healthcare encounters were related to delay than symptom severity. The self-selected, urban, highly educated sample limits generalizability and causal interpretation.
SN - 2227-9032
ER -