title: "A challenge" - healthcare professionals' experiences when meeting women with symptoms that might indicate endometriosis.
abstract: OBJECTIVE
  The aim of the study was to identify and describe the experiences of healthcare professionals when meeting women with symptoms that might indicate endometriosis.
  
  
  METHODS
  Semi-structured interviews were conducted with 10 gynecologists, six general practitioners and nine midwives working at one university hospital, one central hospital, one private gynecology clinic and five healthcare centers in south-east Sweden. The interviews were recorded and transcribed verbatim and analyzed using qualitative conventional content analysis.
  
  
  RESULTS
  Three clusters were identified: the corroborating encounter, the normal variation of menstruation cycles, and the suspicion of endometriosis. The healthcare professionals tried to make a corroborating encounter by acknowledging the woman, taking time to listen, and giving an explanation for the problems. Healthcare professionals had different ways to determine what was normal as regards menstrual pain, ovulation pain and dyspareunia. They also needed to have the competence to act and react when the symptoms indicated endometriosis.
  
  
  CONCLUSIONS
  Meeting women with symptoms that might indicate endometriosis is challenging and demands a certain level of competence from healthcare professionals. Sometimes the symptoms are camouflaged as "normal" menstruation pain, making it hard to satisfy the needs of this patient group.
authors.affiliation: Department of Obstetrics and Gynecology, Vrinnevi Hospital, Norrköping 603 79, Sweden; Department of Medical and Health Sciences, Linköping University, Linköping 581 83, Sweden. Electronic address: hanna.grundstrom@liu.se.
authors.forename: Hanna
authors.initials: H
authors.lastname: Grundström
authors.affiliation: Department of Obstetrics and Gynecology, and Department of Clinical and Experimental Medicine, Linköping University, Linköping 581 83, Sweden.
authors.forename: Preben
authors.initials: P
authors.lastname: Kjølhede
authors.affiliation: Department of Medical and Health Sciences, Linköping University, Linköping 581 83, Sweden.
authors.forename: Carina
authors.initials: C
authors.lastname: Berterö
authors.affiliation: Department of Medical and Health Sciences, Linköping University, Linköping 581 83, Sweden.
authors.forename: Siw
authors.initials: S
authors.lastname: Alehagen
mesh_terms: D000328:Adult; D000368:Aged; D003695:Delivery of Health Care / Q000592:standards*; D004412:Dysmenorrhea / Q000175:diagnosis / Q000209:etiology; D004414:Dyspareunia / Q000175:diagnosis / Q000209:etiology; D004715:Endometriosis / Q000150:complications / Q000175:diagnosis*; D005260:Female; D006176:Gynecology; D006801:Humans; D008297:Male; D008598:Menstruation; D008875:Middle Aged; D009721:Nurse Midwives; D010060:Ovulation; D017699:Pelvic Pain / Q000175:diagnosis* / Q000209:etiology; D010820:Physicians; D011361:Professional Competence; D011369:Professional-Patient Relations; D013548:Sweden
keywords: Chronic pelvic pain; Dysmenorrhea; Endometriosis; Healthcare professional; Qualitative study