Chapter V

Potential determinants of SDM were explored using regression analyses. Results: A total of 39 counseling consultations conducted by nine gynaecologists were analysed. Assessment of the counseling content revealed considerable variation in the information provided during consultations.

Surgical treatment was discussed comprehensively in most consultations, whereas counseling regarding hormonal treatment was less comprehensive. Observer-, patient-, and clinician-reported SDM all indicated a high level of SDM, with a median total OPTION(5) score of 75.0 (IQR 25.0), a median SDM-Q-9 score of 84.4, and a median SDM-Q-Doc score of 75.6. Consultation duration was positively associated with OPTION(5) scores.

Conclusion: Considerable variation was observed in the content of treatment counseling for patients with DE and bowel involvement in specialized Dutch endometriosis centers, particularly regarding hormonal treatment. Despite this variation, the overall level of SDM was high. Opportunities remain to improve the consistency and completeness of information provision while maintaining a high level of SDM.

Practice implications: Although SDM was well embedded in clinical practice, greater attention should be paid to ensuring consistent and comprehensive treatment information. Counseling tools and/or decision aids may support clinicians and patients in discussing all relevant treatment options, benefits, and risks while maintaining individualized care.