163 Impact paragraph found that only 36.4% would consider a bleeding disorder in women of reproductive age [7]. In 2022, an international qualitative study among practicing obstetricians and gynecologists (N=183, 22 countries) revealed that during the initial consultation, only 13% of responders would still consider a bleeding disorder as a potential reason for HMB. However, more than half of responders reported that bleeding disorders, as a cause of HMB, are underdiagnosed because of low-level awareness among first-contact physicians and gynecologists (28% and 19%, respectively). Responders most commonly used the BAT to assess women with HMB after failed hormonal therapy (48%) [8]. This thesis shows to optimize the diagnostic pathway for women with HMB and underlying bleeding disorders in gynaecology to enhance timely and appropriate diagnosis for the management of potential bleeding symptoms. Target group This thesis and its results are especially relevant to clinicians investigating and treating women with HMB, guidelines developers, fellow researchers, policymakers and of course women suffering from HMB themselves. It is important for clinicians in the field of benign gynaecology to be aware of potential bleeding disorders among women with HMB. To assist timely and appropriate interdisciplinary communication to enhance the management of bleeding disorders into daily gynaecological clinical care, it is essential that guideline developers are aware of this. Following this thesis, clinical guidelines may be updated to provide clinicians guidance on optimal interdisciplinary communication and to raise awareness for each woman with HMB and potential bleeding symptoms. Creating a uniform European patient-centered flow-chart of these crucial communication steps should be considered. Furthermore, a humanistic perspective of health care stimulates patient-centered care. Incorporating patients’ perspectives and narratives through free-text responses in closedended questionnaires like the self-BAT to empower the patient. This approach could potentially be explored to evaluate other closed-ended screening tools or study questionnaires. Also, the narrative medicine method we used, including an art-based approach, stimulate patient-centered care. That could fascinate fellow researchers to continue performing research on the remaining questions regarding the usefulness of arts in healthcare. With additional knowledge about the evidence of patient-centered care, researchers can develop subsequent training for clinicians which could improve awareness of stigmatization in women with bleeding symptoms, facilitating communication links between hematologists-gynecologist’s and reducing delays in diagnosis. Ultimately, systemic changes are needed to address the multiple barriers to HMB care worldwide, and this requires collaborations between researchers, government, and patient groups [9-13]. For example, to reduce period poverty, policymakers in several countries have reduced or eliminated taxes on period products [14]. Also, anemia affects half a billion women of reproductive
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