American Nurses Foundation Funds Study Exploring Pathways to Endometriosis Diagnosis

American Nurses Foundation Funds Study Exploring Pathways to Endometriosis Diagnosis

The American Nurses Foundation has awarded a $9,999 grant to Martha Grace Cromeens, a nurse at the University of North Carolina Hospital, to explore new pathways for diagnosing endometriosis among diverse groups of women.

The grant, supported by the Virginia Kelley Fund, will back Cromeens’ yearlong study, “Qualitative Inquiry into the Pathways to Diagnosis of Endometriosis Across a Diverse Sample of Women.” The study is expected to be concluded in August 2020.

Endometriosis can be a difficult-to-diagnose disease, often requiring invasive surgery to achieve a final diagnosis. For many women, that leads to years of struggling with chronic pelvic pain, menstrual irregularity, painful intercourse, and infertility, often without access to proper care.

In addition to its severe physical manifestations, endometriosis can represent a heavy economic burden for women and substantially diminish their quality of life. In many women, endometriosis significantly affects their work productivity, causes anxiety and depression, and results in high medical costs.

The scientific community has been working to find strategies that could prevent such delays in endometriosis diagnosis.

Cromeens, also a Hillman Scholar in Nursing Innovation, is joining this effort to better understand endometriosis and help all women affected by it.

She and her colleagues at the University of North Carolina will start by mapping the pathways for endometriosis diagnosis, according to a university press release. They will conduct qualitative interviews to acknowledge the experiences of women affected by the disorder, including detailed pathways for their symptom recognition, appraisal, and management.

Next, they will explore potential differences in these diagnosis pathways and experiences among a socioeconomically and racially diverse group of women.

As Cromeens noted in the project’s abstract, “women of lower socioeconomic status (SES) and minority races have been underrepresented in endometriosis research.”  Despite efforts made to overcome this problem, “there is a large gap in the literature regarding the diagnostic pathways women travel and the pre-diagnostic period especially among lower SES and non-white women.”

Cromeens also plans to determine what factors and symptoms are shared among women who perceive their endometriosis diagnosis as timely, and among those who have experience a delayed diagnosis.

This analysis may help better identify patterns of endometriosis symptoms and manifestations that could be useful for clinicians to expedite endometriosis diagnosis.

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Margarida graduated with a BS in Health Sciences from the University of Lisbon and a MSc in Biotechnology from Instituto Superior Técnico (IST-UL). She worked as a molecular biologist research associate at a Cambridge UK-based biotech company that discovers and develops therapeutic, fully human monoclonal antibodies.


  1. nancy petersen says:

    There are classic symptoms of endometriosis that should raise red flags at the time they show up, not 9 years later. It is not hard, and laparoscopy with expert excision should be the gold standard. To medically try to suppress endo does not work, thus removing uterus tubes and ovaries will not work either. Endo makes its own estrogen supply, and regardless of castrative surgeries disease can and does progress. Plus uterus tubes and ovaries are 7th and 9th in frequency of involvement so diagnostic laparoscopy that does not entail the POD (which cannot be done with one or two scope access points) will miss the disease nearly every time, further delaying dx. Trying to suppress estrogen with medical therapy exposes the patient to small vessel heart disease, bone loss and memory loss, all of which get pushed on down the patients life span so we don’t have to notice the damage in the here and now. Most care is based on ancient myths, not modern concepts and the patient suffers, not only now but later in life. Currently, I manage a patient education page with some 80,000 members gaining about 700 a week failing all gynecology. has. to offer except expert care based on modern concepts. When we refer then on to exceptional skill, their lives are restored where everything else failed them.

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