Pain self-efficacy mediates the relationship between illness perceptions and health-related quality of life in women with endometriosis

Endometriosis is a major health problem affecting about 190 million reproductive-aged women. There is no definite cure for endometriosis; however, there are many medical and surgical options for relieving the severity of the disease and improving the quality of life for these women. This study aims to examine the relationship between illness perception and health-related quality of life (HRQoL) among women who have been diagnosed with endometriosis, as well as examining the role of pain self-efficacy as a mediator between these two variables. A cross-sectional design was employed with 300 participants. Data were collected using a structured, self-administered questionnaire that included sociodemographic and clinical characteristics, the Brief Illness Perception Questionnaire, the Pain Self-Efficacy Questionnaire, and the Health-Related Quality of Life: Endometriosis Health Profile-30 (EHP-30). Data were analyzed using. Data were analyzed using SPSS version 27 and SmartPLS 4.0. Partial Least Squares Structural Equation Modeling (PLS-SEM) with bootstrapping (5000 resamples) was also conducted to test both direct and mediating effects. Statistical significance was set at p < .05. The mean age of participants was 30.0 ± 5.5 years. The majority were predominantly married and attained a bachelor’s education, with a marked symptom burden. Two-thirds of participants were overweight and obese. It was found that 28.7% had Stage III endometriosis, and over 80% reported moderate-to-severe pelvic pain. Both Illness perceptions and pain self-efficacy were at moderate levels, while HRQoL impairment was substantial, especially in pain and emotional domains as well. More negative illness perceptions were significantly associated with worse HRQoL (r = 0.458, p < .001) and lower pain self-efficacy (r = − 0.474, p < .001), whereas higher pain self-efficacy was associated with better HRQoL (r = − 0.542, p < .001). In regression analysis, illness perceptions and pain self-efficacy together explained 34.6% of the variance in HRQoL, with pain self-efficacy demonstrating the stronger independent association. This study demonstrated that illness perceptions and pain self-efficacy are related factors that influence HRQoL in endometriosis patients. Negative illness perceptions were found to be associated with HRQoL, and increased levels of pain self-efficacy were found to be related to HRQoL. Pain self-efficacy also partially mediated the relationship between illness perceptions and HRQoL.