Exploring Qualitative Experiences of Premenstrual Dysphoric Disorder within the US Healthcare System Pubblico
Chan, Kiera (Spring 2022)
Published
Abstract
Premenstrual Dysphoric Disorder is a premenstrual condition that affects 3-8% of the US population, yet knowledge on treatment and consistent diagnostic testing is lacking. It is a clinical disorder defined by the presence of cognitive-affective and physical symptoms presented in the week before menses. Historically, PMDD has been a controversial diagnosis due to ambiguity around diagnostic criteria and gaps in provider knowledge, leading to delays in diagnosis. While research concerning the epidemiology and pharmaceutical treatments for this condition has increased, there is a lack of qualitative studies on the experiences of patients who live with this condition. Understanding the main experiences and barriers to diagnosis will lead to an increase of appropriately diagnosed cases and, eventually, the delivery of proper treatment. The aim of this study was to explore the diagnostic and treatment experiences of PMDD patients in the U.S. healthcare system and identify barriers to diagnosis and treatment. This study uses a feminist framework with qualitative phenomenological methods. We recruited participants who identified as having PMDD, regardless of official diagnosis, through online forums within the U.S. PMDD community. The study conducted 32 in depth interviews with participants on their experiences with PMDD diagnosis and treatment. Analysis methods using constructivist grounded theory revealed key barriers within the diagnostic and care process including patient, provider, and societal barriers. This study presents a PMDD Care Continuum that represents the timeline of participant experiences beginning from symptom onset towards official diagnosis, treatments, and ongoing management of the condition. Participant experiences demonstrated that the majority of the diagnostic and treatment process was burdened on the patient, and that successful navigation within the healthcare system was dependent on high levels of self advocacy. This study concluded that an official diagnosis did not result in doctors being able to treat PMDD. Instead, participants had to be reevaluated and diagnosed again with every new provider they saw. This was the first study of its nature to describe the qualitative experiences of patients who identified as having PMDD in the U.S. Further research is needed to refine and operationalize diagnostic criteria and treatment guidelines for PMDD.
Table of Contents
Chapter 1 – Introduction……………………………………………………………..Page 1
Statement of the Problem………………………………………………………Page 1
Significance Statement…………………………………………………………Page 3
Chapter 2 – Literature Review………………………………………………………Page 4
Overview of PMDD……………………………………………………………Page 5
Etiology of PMDD……………………………………………………………..Page 5
History of PMDD………………………………………………………………Page 6
Diagnosis of PMDD……………………………………………………………Page 7
Controversies with the DSM…………………………………………………...Page 7
Diagnostic Tools and Their Challenges………………………………………..Page 8
Barriers to Diagnosis…………………………………………………………...Page 9
Gender Bias as a Barrier to Diagnosis…………………………………………Page 9
Consequences of Underdiagnosis of PMDD…………………..………………Page 11
Treatment of PMDD…………………………...………………………………Page 12
Current Issues with Treatment Options……………………………..…………Page 13
Barriers to Management……………..…………………………………………Page 15
Methodological Framework……………………………………………………Page 16
Chapter 3- Study Methods…………………………………………………………...Page 17
Population and Sample…………………………………………………………Page 17
Procedures…………………………...…………………………………………Page 18
Methodological Framework……………………………………………………Page 16
Chapter 4- Results
Sample Description…………………………………………………………….Page 25
PMDD Symptoms/ Experiences……………………………………………….Page 26
Patient Delay…………………………………..……………………………….Page 28
Diagnostic Delay……………………..………………………………………...Page 40
Treatment Delay………………………………………………………………..Page 45
Condition Management Delay
Chapter 5- Discussion…………………………………………………………...…….Page 50
Chapter 6- Conclusion……………………………………………………………….. Page 56
References…………………………………………………………………………….. Page 58
Appendix A: Interview Guide……………………………………………………….. Page 78
Appendix B: Codebook………………………………………………………………. Page 81
About this Master's Thesis
School | |
---|---|
Department | |
Degree | |
Submission | |
Language |
|
Research Field | |
Parola chiave | |
Committee Chair / Thesis Advisor | |
Committee Members |
Primary PDF
Thumbnail | Title | Date Uploaded | Actions |
---|---|---|---|
|
Exploring Qualitative Experiences of Premenstrual Dysphoric Disorder within the US Healthcare System () | 2022-04-18 15:24:04 -0400 |
|
Supplemental Files
Thumbnail | Title | Date Uploaded | Actions |
---|