{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,22]],"date-time":"2026-10-22T16:51:54Z","timestamp":1792687914973,"version":"4.5.0"},"reference-count":67,"publisher":"MDPI AG","issue":"12","license":[{"start":{"date-parts":[[2025,6,16]],"date-time":"2025-06-16T00:00:00Z","timestamp":1750032000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JCM"],"abstract":"<jats:p>Background: Endometriosis is a chronic, estrogen-dependent inflammatory condition, that not only leads to significant physical symptoms but also exerts a profound psychological and social burden. This study aimed to asjsess the relationship between quality of life (QoL) in women with endometriosis and selected socio-demographic, diagnostic-therapeutic, and psychological factors, emphasizing self-efficacy and dispositional optimism as potential protective resources. Methods: A cross-sectional survey was conducted between 2020 and 2022 in healthcare facilities in eastern Poland. The study included 425 women diagnosed with endometriosis. The research tools were the Endometriosis Health Profile, the General Self-Efficacy Scale, and the Life Orientation Test-Revised, as well as an original socio-demographic and clinical questionnaire. Data were analyzed using descriptive statistics, linear regression, and hierarchical regression to assess the predictive role of psychological resources beyond sociodemographic and clinical variables. Results: A higher number of physicians from various specialties consulted before diagnosis was significantly associated with lower QoL in all EHP-30 domains except infertility (p &lt; 0.05). The perceived economic burden of treatment was significantly related to lower QoL across all domains (p &lt; 0.05). In contrast, higher levels of self-efficacy and dispositional optimism emerged as independent protective factors, positively associated with emotional well-being, social support, sexual functioning, and relationships with medical staff (p &lt; 0.05). Psychological variables accounted for an additional 8.1% of the variance in QoL beyond socio-demographic and clinical predictors. Conclusions: The findings support the relevance of a biopsychosocial framework in managing endometriosis. Psychological resources play a critical role in coping with the disease and should be integrated into personalized care strategies.<\/jats:p>","DOI":"10.3390\/jcm14124268","type":"journal-article","created":{"date-parts":[[2025,6,16]],"date-time":"2025-06-16T06:40:27Z","timestamp":1750056027000},"page":"4268","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":11,"title":["Quality of Life in Women with Endometriosis: The Importance of Socio-Demographic, Diagnostic-Therapeutic, and Psychological Factors"],"prefix":"10.3390","volume":"14","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-5268-6900","authenticated-orcid":false,"given":"Agnieszka","family":"Bie\u0144","sequence":"first","affiliation":[{"name":"Chair of Obstetrics Development, Faculty of Health Sciences, Medical University of Lublin, 20-081 Lublin, Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Aleksandra","family":"Pokropska","sequence":"additional","affiliation":[{"name":"GEMELLI Private Health Care Center of Gynecology and Obstetrics, 31-559 Cracow, Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4925-2044","authenticated-orcid":false,"given":"Joanna","family":"Grzesik-G\u0105sior","sequence":"additional","affiliation":[{"name":"State University of Applied Sciences in Krosno, 38-400 Krosno, Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Magdalena","family":"Kor\u017cy\u0144ska-Pi\u0119tas","sequence":"additional","affiliation":[{"name":"Chair of Obstetrics Development, Faculty of Health Sciences, Medical University of Lublin, 20-081 Lublin, Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3799-091X","authenticated-orcid":false,"given":"Agnieszka","family":"Pieczykolan","sequence":"additional","affiliation":[{"name":"Chair of Obstetrics Development, Faculty of Health Sciences, Medical University of Lublin, 20-081 Lublin, Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marta","family":"Zarajczyk","sequence":"additional","affiliation":[{"name":"Chair of Obstetrics Development, Faculty of Health Sciences, Medical University of Lublin, 20-081 Lublin, Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0004-1538-6011","authenticated-orcid":false,"given":"Roya","family":"Ali Pour","sequence":"additional","affiliation":[{"name":"Independent Researcher, 20-562 Lublin, Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Adrianna","family":"Frydrysiak-Brzozowska","sequence":"additional","affiliation":[{"name":"Institute of Nursing, Department of Integrated Medical Care, Faculty of Health Sciences, Collegium Medicum, The Masovian University in P\u0142ock, 09-402 P\u0142ock, Poland"},{"name":"Global Newborn Society, Clarksville, MD 21029, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6534-1100","authenticated-orcid":false,"given":"Ewa","family":"Rzo\u0144ca","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology Didactics, Faculty of Health Sciences, Medical University of Warsaw, 00-575 Warsaw, Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2025,6,16]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"e070750","DOI":"10.1136\/bmj-2022-070750","article-title":"Pathophysiology, Diagnosis, and Management of Endometriosis","volume":"379","author":"Horne","year":"2022","journal-title":"BMJ"},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"287","DOI":"10.1016\/j.jmig.2019.11.011","article-title":"Cellular Components Contributing to Fibrosis in Endometriosis: A Literature Review","volume":"27","author":"Ottolina","year":"2020","journal-title":"J. Minim. Invasive Gynecol."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"706","DOI":"10.1093\/humupd\/dmae023","article-title":"The Role of Fibrosis in Endometriosis: A Systematic Review","volume":"30","author":"Vissers","year":"2024","journal-title":"Hum. Reprod. Update"},{"key":"ref_4","doi-asserted-by":"crossref","unstructured":"Moradi, M., Parker, M., Sneddon, A., Lopez, V., and Ellwood, D. (2014). Impact of Endometriosis on Women\u2019s Lives: A Qualitative Study. BMC Womens Health, 14.","DOI":"10.1186\/1472-6874-14-123"},{"key":"ref_5","doi-asserted-by":"crossref","unstructured":"Mariadas, H., Chen, J.-H., and Chen, K.-H. (2025). The Molecular and Cellular Mechanisms of Endometriosis: From Basic Pathophysiology to Clinical Implications. Int. J. Mol. Sci., 26.","DOI":"10.3390\/ijms26062458"},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"135","DOI":"10.3109\/0167482X.2015.1074173","article-title":"Impact of Endometriosis on Quality of Life and Mental Health: Pelvic Pain Makes the Difference","volume":"36","author":"Facchin","year":"2015","journal-title":"J. Psychosom. Obstet. Gynaecol."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"186","DOI":"10.1093\/humupd\/dmad029","article-title":"A Systematic Review to Determine Use of the Endometriosis Health Profiles to Measure Quality of Life Outcomes in Women with Endometriosis","volume":"30","author":"Jones","year":"2024","journal-title":"Hum. Reprod. Update"},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"731","DOI":"10.1097\/OPX.0000000000000856","article-title":"Communication Predicts Medication Self-Efficacy in Glaucoma Patients","volume":"93","author":"Carpenter","year":"2016","journal-title":"Optom. Vis. Sci."},{"key":"ref_9","doi-asserted-by":"crossref","unstructured":"Wojcieszek, A., Kurowska, A., Majda, A., Ko\u0142odziej, K., Liszka, H., and G\u0105dek, A. (2023). Relationship between Optimism, Self-Efficacy and Quality of Life: A Cross-Sectional Study in Elderly People with Knee Osteoarthritis. Geriatrics, 8.","DOI":"10.3390\/geriatrics8050101"},{"key":"ref_10","doi-asserted-by":"crossref","unstructured":"Kupcewicz, E., Rachubi\u0144ska, K., Gaworska-Krzemi\u0144ska, A., Andruszkiewicz, A., Ku\u017amicz, I., Kozie\u0142, D., and Grochans, E. (2022). Loneliness and Optimism among Polish Nursing Students during the COVID-19 Pandemic: The Mediatory Role of Self-Efficacy. Healthcare, 10.","DOI":"10.3390\/healthcare10060971"},{"key":"ref_11","first-page":"258","article-title":"Development of an Endometriosis Quality-of-Life Instrument: The Endometriosis Health Profile-30","volume":"98","author":"Jones","year":"2001","journal-title":"Obstet. Gynecol."},{"key":"ref_12","unstructured":"Juczy\u0144ski, Z. (2012). Skala Uog\u00f3lnionej W\u0142asnej Satysfakcji\u2014GSES (Adaptation: Juczy\u0144ski, Z.). Narz\u0119dzia Pomiaru w Promocji i Psychologii Zdrowia, Pracownia Test\u00f3w Psychologicznych Polskiego Towarzystwa Psychologicznego."},{"key":"ref_13","unstructured":"Juczy\u0144ski, Z. (2012). Test Orientacji \u017byciowej\u2014LOT-R (Adaptation: Poprawa, R.; Juczy\u0144ski, Z.). Narz\u0119dzia Pomiaru w Promocji i Psychologii Zdrowia, Pracownia Test\u00f3w Psychologicznych Polskiego Towarzystwa Psychologicznego."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"238","DOI":"10.1080\/0167482X.2017.1289512","article-title":"The Burden of Endometriosis Symptoms on Health-Related Quality of Life in Women in the United States: A Cross-Sectional Study","volume":"38","author":"Soliman","year":"2017","journal-title":"J. Psychosom. Obstet. Gynaecol."},{"key":"ref_15","doi-asserted-by":"crossref","unstructured":"Pontoppidan, K., Olovsson, M., and Grundstr\u00f6m, H. (2023). Clinical Factors Associated with Quality of Life among Women with Endometriosis: A Cross-Sectional Study. BMC Womens Health, 23.","DOI":"10.1186\/s12905-023-02694-5"},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"197","DOI":"10.1016\/j.rbmo.2017.10.106","article-title":"The Association Between Experiences with Patient-Centred Care and Health-Related Quality of Life in Women with Endometriosis","volume":"36","author":"Apers","year":"2018","journal-title":"Reprod. Biomed. Online"},{"key":"ref_17","doi-asserted-by":"crossref","unstructured":"Adoamnei, E., Mor\u00e1n-S\u00e1nchez, I., S\u00e1nchez-Ferrer, M.L., Mendiola, J., Prieto-S\u00e1nchez, M.T., Mo\u00f1ino-Garc\u00eda, M., Palomar-Rodr\u00edguez, J.A., and Torres-Cantero, A.M. (2021). Health-related Quality of Life in Adult Spanish Women with Endometriomas or Deep Infiltrating Endometriosis: A Case-Control Study. Int. J. Environ. Res. Public Health, 18.","DOI":"10.3390\/ijerph18115586"},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"264","DOI":"10.1093\/humrep\/deab257","article-title":"Predictors of Self-Compassion in Endometriosis: The Role of Psychological Health and Endometriosis Symptom Burden","volume":"37","author":"Johnstone","year":"2022","journal-title":"Hum. Reprod."},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"1157","DOI":"10.1177\/13591053231183230","article-title":"A Qualitative Investigation into the Role of Illness Perceptions in Endometriosis-Related Quality of Life","volume":"28","author":"Moore","year":"2023","journal-title":"J. Health Psychol."},{"key":"ref_20","doi-asserted-by":"crossref","unstructured":"Schwab, R., Stewen, K., Kottmann, T., Anic, K., Schmidt, M.W., Elger, T., Theis, S., Kalb, S.R., Brenner, W., and Hasenburg, A. (2022). Mental Health and Social Support Are Key Predictors of Resilience in German Women with Endometriosis during the COVID-19 Pandemic. J. Clin. Med., 11.","DOI":"10.3390\/jcm11133684"},{"key":"ref_21","doi-asserted-by":"crossref","unstructured":"Hern\u00e1ndez, A., Mu\u00f1oz, E., Ramiro-Cortijo, D., Spagnolo, E., Lopez, A., Sanz, A., Redondo, C., Salas, P., and Cristobal, I. (2022). Quality of Life in Women after Deep Endometriosis Surgery: Comparison with Spanish Standardized Values. J. Clin. Med., 11.","DOI":"10.3390\/jcm11206192"},{"key":"ref_22","first-page":"e70214","article-title":"Exploring Patient Preferences Related to Shared Decision-Making in Chronic Disease Management","volume":"16","author":"Alanzi","year":"2024","journal-title":"Cureus"},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"55","DOI":"10.5539\/gjhs.v6n3p55","article-title":"Association between Awareness of Patient Rights and Patient\u2019s Education, Seeing Bill, and Age: A Cross-Sectional Study","volume":"6","author":"Yaghobian","year":"2014","journal-title":"Glob. J. Health Sci."},{"key":"ref_24","doi-asserted-by":"crossref","unstructured":"Nicolas-Boluda, A., Oppenheimer, A., Bouaziz, J., and Fauconnier, A. (2021). Patient-Reported Outcome Measures in Endometriosis. J. Clin. Med., 10.","DOI":"10.3390\/jcm10215106"},{"key":"ref_25","doi-asserted-by":"crossref","unstructured":"Pessoa de Farias Rodrigues, M., Lima Vilarino, F., de Souza Barbeiro Munhoz, A., da Silva Paiva, L., de Alcantara Sousa, L.V., Zaia, V., and Barbosa, C.P. (2020). Clinical Aspects and the Quality of Life among Women with Endometriosis and Infertility: A Cross-Sectional Study. BMC Womens Health, 20.","DOI":"10.1186\/s12905-020-00987-7"},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"379","DOI":"10.1016\/j.fertnstert.2024.01.013","article-title":"Depression, Anxiety, Quality of Life, and Infertility: A global Lens on the Last Decade of Research","volume":"121","author":"Braverman","year":"2024","journal-title":"Fertil. Steril."},{"key":"ref_27","first-page":"100216","article-title":"The Impact of Motherhood on the Course of Women\u2019s Psychological Wellbeing","volume":"6","author":"Kuipers","year":"2021","journal-title":"J. Affect. Disord. Rep."},{"key":"ref_28","doi-asserted-by":"crossref","unstructured":"Della Corte, L., Di Filippo, C., Gabrielli, O., Reppuccia, S., La Rosa, V.L., Ragusa, R., Fichera, M., Commodari, E., Bifulco, G., and Giampaolino, P. (2020). The Burden of Endometriosis on Women\u2019s Lifespan: A Narrative Overview on Quality of Life and Psychosocial Wellbeing. Int. J. Environ. Res. Public Health, 17.","DOI":"10.3390\/ijerph17134683"},{"key":"ref_29","first-page":"356","article-title":"The Impact of Endometriosis on the Quality of Women\u2019s Life","volume":"95","author":"Baczek","year":"2024","journal-title":"Ginekol. Pol."},{"key":"ref_30","first-page":"OC13","article-title":"Effect of Infertility on the Quality of Life, A Cross-Sectional Study","volume":"8","author":"Delpisheh","year":"2014","journal-title":"J. Clin. Diagn. Res."},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"571","DOI":"10.1097\/AOG.0000000000005255","article-title":"Barriers to a Timely Diagnosis of Endometriosis: A Qualitative Systematic Review","volume":"142","author":"Davenport","year":"2023","journal-title":"Obstet. Gynecol."},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"10","DOI":"10.1080\/13625187.2022.2128644","article-title":"\u201cBetter Late than Never but Never Late is Better\u201d, Especially in Young Women. A Multicenter Italian Study on Diagnostic Delay for Symptomatic Endometriosis","volume":"28","author":"Pino","year":"2023","journal-title":"Eur. J. Contracept. Reprod. Health Care"},{"key":"ref_33","doi-asserted-by":"crossref","unstructured":"Armour, M., Sinclair, J., Ng, C.H.M., Hyman, M.S., Lawson, K., Smith, C.A., and Abbott, J. (2020). Endometriosis and Chronic Pelvic Pain Have Similar Impact on Women, but Time to Diagnosis is Decreasing: An Australian Survey. Sci. Rep., 10.","DOI":"10.1038\/s41598-020-73389-2"},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"280","DOI":"10.1093\/humrep\/deae273","article-title":"Exploring Pre-Diagnosis Hospital Contacts in Women with Endometriosis Using ICD-10: A Danish Case-Control Study","volume":"40","author":"Melgaard","year":"2025","journal-title":"Hum. Reprod."},{"key":"ref_35","doi-asserted-by":"crossref","unstructured":"Agarwal, S.K., Antunez-Flores, O., Foster, W.G., Hermes, A., Golshan, S., Soliman, A.M., Arnold, A., and Luna, R. (2021). Real-World Characteristics of Women with Endometriosis-Related Pain Entering a Multidisciplinary Endometriosis Program. BMC Womens Health, 21.","DOI":"10.1186\/s12905-020-01139-7"},{"key":"ref_36","doi-asserted-by":"crossref","first-page":"1981","DOI":"10.1080\/10410236.2022.2048468","article-title":"Healthcare Providers\u2019 Impact on the Care Experiences of Patients with Endometriosis: The Value of Trust","volume":"38","author":"Mikesell","year":"2023","journal-title":"Health Commun."},{"key":"ref_37","doi-asserted-by":"crossref","first-page":"174","DOI":"10.1080\/10810730.2023.2299003","article-title":"A COM-B and Theoretical Domains Framework Mapping of the Barriers and Facilitators to Effective Communication and Help-Seeking among People with, or Seeking a Diagnosis of, Endometriosis","volume":"29","author":"Hearn","year":"2024","journal-title":"J. Health Commun."},{"key":"ref_38","doi-asserted-by":"crossref","first-page":"1910","DOI":"10.1093\/humrep\/dead164","article-title":"Utilization of Healthcare Prior to Endometriosis Diagnosis: A Danish Case-Control Study","volume":"38","author":"Melgaard","year":"2023","journal-title":"Hum. Reprod."},{"key":"ref_39","doi-asserted-by":"crossref","first-page":"1292","DOI":"10.1093\/humrep\/des073","article-title":"The Burden of Endometriosis: Costs and Quality of Life of Women with Endometriosis and Treated in Referral Centres","volume":"27","author":"Simoens","year":"2012","journal-title":"Hum. Reprod."},{"key":"ref_40","doi-asserted-by":"crossref","unstructured":"Armour, M., Lawson, K., Wood, A., Smith, C.A., and Abbott, J. (2019). The Cost of Illness and Economic Burden of Endometriosis and Chronic Pelvic Pain in Australia: A National Online Survey. PLoS ONE, 14.","DOI":"10.1371\/journal.pone.0223316"},{"key":"ref_41","doi-asserted-by":"crossref","first-page":"1108","DOI":"10.1111\/iwj.12767","article-title":"The Financial and Quality-of-Life Cost to Patients Living with a Chronic Wound in the Community","volume":"14","author":"Kapp","year":"2017","journal-title":"Int. Wound J."},{"key":"ref_42","doi-asserted-by":"crossref","first-page":"366","DOI":"10.1016\/j.fertnstert.2011.05.090","article-title":"Impact of Endometriosis on Quality of Life and Work Productivity: A Multicenter Study Across Ten Countries","volume":"96","author":"Nnoaham","year":"2011","journal-title":"Fertil. Steril."},{"key":"ref_43","doi-asserted-by":"crossref","first-page":"1330","DOI":"10.1016\/j.jogc.2020.04.013","article-title":"Cross-sectional Survey of the Impact of Endometriosis Symptoms on Health-Related Quality of Life in Canadian Women","volume":"42","author":"Soliman","year":"2020","journal-title":"J. Obstet. Gynaecol. Can."},{"key":"ref_44","doi-asserted-by":"crossref","first-page":"2170","DOI":"10.1093\/humrep\/deab138","article-title":"Delineating Sociodemographic, Medical and Quality of Life Factors Associated with Psychological Distress in Individuals with Endometriosis","volume":"36","author":"Sherman","year":"2021","journal-title":"Hum. Reprod."},{"key":"ref_45","doi-asserted-by":"crossref","unstructured":"Maulenkul, T., Kuandyk, A., Makhadiyeva, D., Dautova, A., Terzic, M., Oshibayeva, A., Moldaliyev, I., Ayazbekov, A., Maimakov, T., and Saruarov, Y. (2024). Understanding the Impact of Endometriosis on Women\u2019s Life: An Integrative Review of Systematic Reviews. BMC Womens Health, 24.","DOI":"10.1186\/s12905-024-03369-5"},{"key":"ref_46","doi-asserted-by":"crossref","first-page":"50","DOI":"10.1080\/0167482X.2020.1729732","article-title":"Is Dispositional Optimism Associated with Endometriomas and Deep Infiltrating Endometriosis?","volume":"42","author":"Adoamnei","year":"2021","journal-title":"J. Psychosom. Obstet. Gynaecol."},{"key":"ref_47","doi-asserted-by":"crossref","first-page":"410","DOI":"10.1007\/s12144-016-9429-z","article-title":"Direct and Indirect Effects of Self-Efficacy on Depression: The Mediating Role of Dispositional Optimism","volume":"36","author":"Pu","year":"2017","journal-title":"Curr. Psychol."},{"key":"ref_48","doi-asserted-by":"crossref","first-page":"849","DOI":"10.1093\/jjco\/hyx079","article-title":"Optimism, Pessimism and Self-Efficacy in Female Cancer Patients","volume":"47","author":"Thieme","year":"2017","journal-title":"Jpn. J. Clin. Oncol."},{"key":"ref_49","doi-asserted-by":"crossref","unstructured":"Vargas-Rom\u00e1n, K., Tovar-G\u00e1lvez, M.I., Li\u00f1\u00e1n-Gonz\u00e1lez, A., Ca\u00f1adas de la Fuente, G.A., de la Fuente-Solana, E.I., and D\u00edaz-Rodr\u00edguez, L. (2022). Coping Strategies in Elderly Colorectal Cancer Patients. Cancers, 14.","DOI":"10.3390\/cancers14030608"},{"key":"ref_50","doi-asserted-by":"crossref","first-page":"1855","DOI":"10.1093\/humrep\/dex249","article-title":"Mental Health in Women with Endometriosis: Searching for Predictors of Psychological Distress","volume":"32","author":"Facchin","year":"2017","journal-title":"Hum. Reprod."},{"key":"ref_51","doi-asserted-by":"crossref","first-page":"58","DOI":"10.1080\/0167482X.2020.1784874","article-title":"Psychological Variables and Quality of Life in Women with Endometriosis","volume":"43","author":"Rees","year":"2022","journal-title":"J. Psychosom. Obstet. Gynaecol."},{"key":"ref_52","doi-asserted-by":"crossref","unstructured":"Bergen, S., Murimi, D., Gruer, C., Munene, G., Nyachieo, A., Owiti, M., and Sommer, M. (2023). Living with Endometriosis: A Narrative Analysis of the Experiences of Kenyan Women. Int. J. Environ. Res. Public Health, 20.","DOI":"10.3390\/ijerph20054125"},{"key":"ref_53","doi-asserted-by":"crossref","unstructured":"Bonavina, G., and Taylor, H.S. (2022). Endometriosis-Associated Infertility: From Pathophysiology to Tailored Treatment. Front. Endocrinol., 13.","DOI":"10.3389\/fendo.2022.1020827"},{"key":"ref_54","doi-asserted-by":"crossref","first-page":"279","DOI":"10.1093\/humupd\/dmp002","article-title":"The Efficacy of Psychological Interventions for Infertile Patients: A Meta-Analysis Examining Mental Health and Pregnancy Rate","volume":"15","author":"Znoj","year":"2009","journal-title":"Hum. Reprod. Update"},{"key":"ref_55","doi-asserted-by":"crossref","first-page":"100027","DOI":"10.1016\/j.jeud.2023.100027","article-title":"A Patient-Oriented Workshop on Sexual Pain and Pndometriosis: Preliminary Evidence for Improvements in Painful Intercourse Self-Efficacy","volume":"2","author":"Orr","year":"2023","journal-title":"J. Endometr. Uterine Disord."},{"key":"ref_56","doi-asserted-by":"crossref","unstructured":"Magari\u00f1os L\u00f3pez, M., Lobato Rodr\u00edguez, M.J., Men\u00e9ndez Garc\u00eda, \u00c1., Garc\u00eda-Cid, S., Royuela, A., and Pereira, A. (2022). Psychological Profile in Women with Chronic Pelvic Pain. J. Clin. Med., 11.","DOI":"10.3390\/jcm11216345"},{"key":"ref_57","doi-asserted-by":"crossref","first-page":"1827","DOI":"10.1002\/ejp.2006","article-title":"Psychosocial Factors Associated with Pain and Health-Related Quality of Life in Endometriosis: A Systematic Review","volume":"26","author":"Kalfas","year":"2022","journal-title":"Eur. J. Pain"},{"key":"ref_58","doi-asserted-by":"crossref","first-page":"1515","DOI":"10.1093\/humrep\/dew108","article-title":"Personality in Women with Endometriosis: Temperament and Character Dimensions and Pelvic Pain","volume":"31","author":"Facchin","year":"2016","journal-title":"Hum. Reprod."},{"key":"ref_59","doi-asserted-by":"crossref","first-page":"815","DOI":"10.1093\/abm\/kaab001","article-title":"Hope, Optimism, and Clinical Pain: A Meta-Analysis","volume":"55","author":"Shanahan","year":"2021","journal-title":"Ann. Behav. Med."},{"key":"ref_60","doi-asserted-by":"crossref","unstructured":"Ruiz-Rodr\u00edguez, I., Hombrados-Mendieta, I., Melguizo-Gar\u00edn, A., and Martos-M\u00e9ndez, M.J. (2022). The Importance of Social Support, Optimism and Resilience on the Quality of Life of Cancer Patients. Front. Psychol., 13.","DOI":"10.3389\/fpsyg.2022.833176"},{"key":"ref_61","doi-asserted-by":"crossref","first-page":"221","DOI":"10.1111\/ajco.14079","article-title":"Association of Optimism and Social Support with Health-Related Quality of Life among Australian Women Cancer Survivors\u2014A Cohort Study","volume":"21","author":"Rahman","year":"2025","journal-title":"Asia-Pac. J. Clin. Oncol."},{"key":"ref_62","doi-asserted-by":"crossref","first-page":"1119","DOI":"10.1161\/CIRCRESAHA.117.310828","article-title":"Is Optimism Associated With Healthier Cardiovascular-Related Behavior? Meta-Analyses of 3 Health Behaviors","volume":"122","author":"Boehm","year":"2018","journal-title":"Circ. Res."},{"key":"ref_63","doi-asserted-by":"crossref","first-page":"486","DOI":"10.1111\/papr.12297","article-title":"Pain and Personality: Do Individuals with Different Forms of Chronic Pain Exhibit a Mutual Personality?","volume":"16","author":"Gustin","year":"2016","journal-title":"Pain Pract."},{"key":"ref_64","doi-asserted-by":"crossref","first-page":"874","DOI":"10.1111\/jocn.15633","article-title":"Predictor of Self-Efficacy in Individuals with Chronic Disease: Stress-Coping Strategies","volume":"30","author":"Bakan","year":"2021","journal-title":"J. Clin. Nurs."},{"key":"ref_65","doi-asserted-by":"crossref","first-page":"1609","DOI":"10.21873\/anticanres.11491","article-title":"Self-efficacy for Coping Moderates the Effects of Distress on Quality of Life in Palliative Cancer Care","volume":"37","author":"Chirico","year":"2017","journal-title":"Anticancer Res."},{"key":"ref_66","first-page":"1","article-title":"Clinical Factors Affecting the Quality of Life of Women with Endometriosis","volume":"11","author":"Pokropska","year":"2024","journal-title":"J. Adv. Nurs."},{"key":"ref_67","doi-asserted-by":"crossref","first-page":"383","DOI":"10.1016\/j.cbpra.2024.01.005","article-title":"The Application of Cognitive Behavioral Therapy for Adolescent Patients With Endometriosis: A Topical Review","volume":"31","author":"Lunde","year":"2024","journal-title":"Cogn. Behav. Pract."}],"container-title":["Journal of Clinical Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2077-0383\/14\/12\/4268\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,9]],"date-time":"2025-10-09T17:52:35Z","timestamp":1760032355000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2077-0383\/14\/12\/4268"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,6,16]]},"references-count":67,"journal-issue":{"issue":"12","published-online":{"date-parts":[[2025,6]]}},"alternative-id":["jcm14124268"],"URL":"https:\/\/doi.org\/10.3390\/jcm14124268","relation":{},"ISSN":["2077-0383"],"issn-type":[{"value":"2077-0383","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,6,16]]}}}