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Trial registered on ANZCTR
Registration number
ACTRN12625000455460
Ethics application status
Approved
Date submitted
11/04/2025
Date registered
14/05/2025
Date last updated
14/05/2025
Date data sharing statement initially provided
14/05/2025
Type of registration
Prospectively registered
Titles & IDs
Public title
Feasibility and Acceptability of a Digital Holistic Prehabilitation and Rehabilitation Program for Endometriosis Surgery Patients
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Scientific title
Feasibility and Acceptability of a Digital Holistic Prehabilitation and Rehabilitation Program for Endometriosis Surgery Patients
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Secondary ID [1]
314105
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nil known
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Universal Trial Number (UTN)
U1111-1321-3413
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Trial acronym
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Linked study record
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Health condition
Health condition(s) or problem(s) studied:
endometriosis
336890
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Condition category
Condition code
Surgery
333362
333362
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0
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Other surgery
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Reproductive Health and Childbirth
333657
333657
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0
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Other reproductive health and childbirth disorders
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Intervention/exposure
Study type
Interventional
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Description of intervention(s) / exposure
Participants will voluntarily enrol into a a holistic digital prehabilitation and rehabilitation program tailored to people undergoing surgery for suspected endometriosis, called the Matilda program (www.matilda.health). The resources are housed within the Matilda App and have all been created for the Matilda program.
The Matilda program includes
1. Prehabilitation (4 weeks pre-surgery):
a. Self-guided yoga and Pilates sessions (30 minutes, 2x/week).
b. Mindfulness and relaxation techniques (self-guided meditations). This includes ~5-20 mins of mindfulness/relaxation techniques provided per week, with the frequency self determined by the participant
c. Educational modules delivered via short video lectures (with subtitles) and accompanying text documents that provide information on
i. Pelvic floor anatomy and how to best use the pelvic floor for the participant's needs
ii. Optimal diet
iii. Understanding the pain system,
iv. Stress management,
v. Physical activity/movement,
vi. Pre-anaesthetic appointment navigation,
vii. Logistics regarding hospital stay for surgery,
viii. What support systems are available and how to best navigate them
ix. Gas pain – what it is and how to manage it,
x. Psychological Health management: Navigating a diagnosis (or no diagnosis)
d. Lifestyle tracking (movement, nutrition, mental wellbeing, sleep), completed. These will be tracked within the Matilda App (ie the same App that the educational content and mindfulness/relaxation techniques are housed on).
e. Lived experience pre-recorded interviews from people who have previously had surgery for their endometriosis. These interview videos will be housed within the Matilda App
f. Weekly clinician-led video conference group calls, delivered as weekly online calls with up to 50 participants.
g. Peer support via a community forum with forum messages moderated by a member of the research team and by a community lead and filters have been set up to flag/ban certain words (i.e. profanities or racist comments This is available only to those within the program, and is a separate community forum platform (Slack)
h. Weekly check-ins via email and SMS to encourage engagement.
2. Rehabilitation (4 weeks post-surgery):
a. Progressive Yoga and Pilates. These sessions are lighter and easier than the prehabilitation classes in order to accommodate the post-surgery period. The participants are encouraged within the Matilda App to determine their own level of participation according to what works for their body, starting with less and then building slowly.
b. Mindfulness and relaxation techniques. As per the prehabilitation sessions there are 5 to 20 minutes duration and the frequency determined by participant preference.
c. Educational modules delivered via short video lectures (with subtitles) and accompanying text documents that provide information on
i. What is endometriosis,
ii. Return to movement,
iii. Healing foods,
iv. Wound care,
v. Returning to sex,
vi. Maintaining long term changes,
d. Weekly clinician-led video conference group calls, delivered as weekly online calls with up to 50 participants.
e. Peer support via a community forum with forum messages moderated by a member of the research team and by a community lead and filters have been set up to flag/ban certain words (i.e. profanities or racist comments This is available only to those within the program, and is a separate community forum platform (Slack).
f. Weekly check-ins via email and SMS to encourage engagement.
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Intervention code [1]
330767
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Rehabilitation
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Comparator / control treatment
The comparator will involve participants who do not enrol in the Matilda program. Participants in this arm of the study would be free to conduct their own prehabilitation and or rehabilitation, sourcing health professional help as they would like. Participants who do not enrol in the Matilda program do not have access to the program resources, as the resources sit behind a pay wall.
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Control group
Active
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Outcomes
Primary outcome [1]
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Quality of Life
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Assessment method [1]
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EuroQOL-5D-5L
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Timepoint [1]
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1 Baseline demographic survey for all participants undergoing laparoscopic surgery (Timepoint 1) 2. End of Prehab Survey for all participants undergoing laparoscopic surgery (Timepoint 2: approximately four weeks post timepoint 1, before surgery). 3. End of Program Survey for all participants undergoing laparoscopic surgery (Timepoint 3: 4 weeks post-surgery)
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Primary outcome [2]
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Change in composite score of most troublesome symptoms
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Assessment method [2]
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Numerical rating scale of symptom
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Timepoint [2]
341043
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1 Baseline demographic survey for all participants undergoing laparoscopic surgery (Timepoint 1) 2. End of Prehab Survey for all participants undergoing laparoscopic surgery (Timepoint 2: approximately four weeks post timepoint 1, before surgery). 3. End of Program Survey for all participants undergoing laparoscopic surgery (Timepoint 3: 4 weeks post-surgery)
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Primary outcome [3]
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Average pain over the last week
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Assessment method [3]
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Numerical rating scale
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Timepoint [3]
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1 Baseline demographic survey for all participants undergoing laparoscopic surgery (Timepoint 1) 2. End of Prehab Survey for all participants undergoing laparoscopic surgery (Timepoint 2: approximately four weeks post timepoint 1, before surgery). 3. End of Program Survey for all participants undergoing laparoscopic surgery (Timepoint 3: 4 weeks post-surgery)
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Secondary outcome [1]
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Self rated anxiety over the last week
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Assessment method [1]
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Numerical rating scale
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Timepoint [1]
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1 Baseline demographic survey for all participants undergoing laparoscopic surgery (Timepoint 1) 2. End of Prehab Survey for all participants undergoing laparoscopic surgery (Timepoint 2: approximately four weeks post timepoint 1, before surgery).
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Secondary outcome [2]
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Self-Efficacy for Managing Chronic Diseases
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Assessment method [2]
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Self-Efficacy for Managing Chronic Diseases 6 item scale
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Timepoint [2]
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1 Baseline demographic survey for all participants undergoing laparoscopic surgery (Timepoint 1) 2. End of Prehab Survey for all participants undergoing laparoscopic surgery (Timepoint 2: approximately four weeks post timepoint 1, before surgery). 3. End of Program Survey for all participants undergoing laparoscopic surgery (Timepoint 3: 4 weeks post-surgery)
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Secondary outcome [3]
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Self rated anxiety in regards to surgery
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Assessment method [3]
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Numerical rating scale
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Timepoint [3]
445938
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Baseline demographic survey for all participants undergoing laparoscopic surgery (Timepoint 1) End of Prehab Survey for all participants undergoing laparoscopic surgery (Timepoint 2: approximately four weeks post timepoint 1, before surgery). End of Program Survey for all participants undergoing laparoscopic surgery (Timepoint 3: 4 weeks post-surgery)
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Secondary outcome [4]
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Confidence in managing pre- and post-surgery care
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Assessment method [4]
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A single question asking about confidence in managing pre- and post-surgery care measured via a 5 point likert scale from very confident to not confident at all
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Timepoint [4]
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Baseline demographic survey for all participants undergoing laparoscopic surgery (Timepoint 1) End of Prehab Survey for all participants undergoing laparoscopic surgery (Timepoint 2: approximately four weeks post timepoint 1, before surgery). End of Program Survey for all participants undergoing laparoscopic surgery (Timepoint 3: 4 weeks post-surgery)
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Secondary outcome [5]
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Acceptability will be asked of all the participants who enrol in the Matilda program and will not be asked of the participants who do not enrol in the Matilda program
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Assessment method [5]
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A previously developed questionnaire that examines acceptability of health care interventions by Sekhon etal 2022 will be used to provide a composite score of acceptability
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Timepoint [5]
446164
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End of Prehab Survey for all participants undergoing laparoscopic surgery (Timepoint 2: approximately four weeks post timepoint 1, before surgery). End of Program Survey for all participants undergoing laparoscopic surgery (Timepoint 3: 4 weeks post-surgery)
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Secondary outcome [6]
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Feasibility will be asked of all the participants who enrol in the Matilda program and will not be asked of the participants who do not enrol in the Matilda program
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Assessment method [6]
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Likert scale in response to question
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Timepoint [6]
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End of Prehab Survey for all participants undergoing laparoscopic surgery (Timepoint 2: approximately four weeks post timepoint 1, before surgery). End of Program Survey for all participants undergoing laparoscopic surgery (Timepoint 3: 4 weeks post-surgery)
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Secondary outcome [7]
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Percentage of modules completed within the Matilda App will be gathered in all the participants who enrol in the Matilda program and will not be asked of the participants who do not enrol in the Matilda program
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Assessment method [7]
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Percentage of total complete modules available within the Matilda App
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Timepoint [7]
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Timepoint 2: approximately four weeks post timepoint 1, before surgery). Timepoint 3: 4 weeks post-surgery
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Secondary outcome [8]
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Number of participants who enter the trial per week
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Assessment method [8]
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Count number of participants who consent via Qualtrics survey
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Timepoint [8]
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At weekly intervals from start of trial for 6 months
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Eligibility
Key inclusion criteria
The inclusion criteria are those scheduled for laparoscopic surgery for suspected endometriosis
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Minimum age
18
Years
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Maximum age
No limit
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Sex
Both males and females
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Can healthy volunteers participate?
No
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Key exclusion criteria
People who do not have access to a smartphone, electronic device or computer with internet connectivity. The exclusion criteria include people who are non-English speakers (due to language limitations in the program) and those aged under 18.
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Study design
Purpose of the study
Treatment
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Allocation to intervention
Non-randomised trial
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Procedure for enrolling a subject and allocating the treatment (allocation concealment procedures)
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Methods used to generate the sequence in which subjects will be randomised (sequence generation)
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Masking / blinding
Open (masking not used)
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Who is / are masked / blinded?
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Intervention assignment
Parallel
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Other design features
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Phase
Not Applicable
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Type of endpoint/s
Efficacy
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Statistical methods / analysis
It is anticipated that 30 people who are scheduled for laparoscopic surgery will be required to provide a representative sample. This is the median target sample size of two armed studies examined in a review examining sample size of feasibility studies (Totton etal 2023)
• Quantitative Data: Descriptive statistics will be generated for recruitment rates, adherence,, demographics, limited efficacy testing variables (pain, anxiety, self efficacy, rating of most troublesome symptoms, quality of life,) acceptability and feasibility scales. Data will be examined for normality, with continuous data that is not normally distributed reported using Median (quartile one, quartile three). Continuous data that is normally distributed will be reported using Mean (standard deviation). Differences between the groups (those that did the Matilda program and those that did not) in the limited efficacy testing variables will be examined using Stata (StataCrop, College Station, TX) with a generalised linear mixed model (GLMM) analysis.
• Qualitative Data: Content inductive analysis of open-ended text box responses will be conducted using two independent coders who will use an iterative six-stage process which includes data familiarisation, generation of initial codes, generating themes, reviewing concepts, defining, and naming conceptual themes and report production(Hsieh and Shannon 2005, Braun and Clarke 2006, Nowell, Norris et al. 2017)
• Merging integration: Findings from quantitative and qualitative data will be integrated to compare, complement, and triangulate results, ensuring a comprehensive understanding of the feasibility and acceptability of the intervention, using joint displays as recommended by prior authors(Aschbrenner, Kruse et al. 2022) .
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Recruitment
Recruitment status
Not yet recruiting
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Date of first participant enrolment
Anticipated
16/05/2025
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Actual
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Date of last participant enrolment
Anticipated
3/08/2025
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Actual
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Date of last data collection
Anticipated
3/11/2025
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Actual
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Sample size
Target
30
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Accrual to date
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Final
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Recruitment in Australia
Recruitment state(s)
ACT,NSW,NT,QLD,SA,TAS,WA,VIC
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Recruitment outside Australia
Country [1]
26956
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New Zealand
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State/province [1]
26956
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Country [2]
26957
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United Kingdom
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State/province [2]
26957
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Funding & Sponsors
Funding source category [1]
318611
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Commercial sector/Industry
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Name [1]
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Matilda program
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Address [1]
318611
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Country [1]
318611
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Australia
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Primary sponsor type
University
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Name
Curtin University
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Address
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Country
Australia
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Secondary sponsor category [1]
321109
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None
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Name [1]
321109
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Address [1]
321109
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Country [1]
321109
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Ethics approval
Ethics application status
Approved
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Ethics committee name [1]
317215
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Curtin University Human Research Ethics Committee
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Ethics committee address [1]
317215
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https://www.curtin.edu.au/students/essentials/higher-degree-by-research/ethics-safety/human/
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Ethics committee country [1]
317215
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Australia
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Date submitted for ethics approval [1]
317215
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03/01/2025
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Approval date [1]
317215
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04/03/2025
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Ethics approval number [1]
317215
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HRE2025-0071
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Summary
Brief summary
Endometriosis is a gynaecological syndrome that is associated with substantial pelvic pain and dysmenorrhea and is defined as the presence of endometrial-like tissue outside the uterus. This condition affects between 1 and 39% of women (including people assigned female at birth) during their reproductive years, and is associated with poor quality of life and sleep, anxiety, and depression. Endometriosis can directly cost each person between US$1459 and US$20,239 and indirectly cost as high as US$14,079 Diagnosis is often dependent on surgical findings, with a substantial number of people undergoing laparoscopic surgery to obtain a definitive diagnosis. To our knowledge, no studies exist that specifically compare pain, quality of life, self efficacy, and anxiety outcomes beyond the hospital stay, between people undergoing laporoscopic surgery for endometriosis that have and have not undertaken prehabilitation or rehabilitation programs. Thus, it is not known whether prehabilitation/rehabilitation programs can enhance recovery from endometrial laparoscopic surgery This study aims to assess the feasibility and acceptability of a holistic digital prehabilitation and rehabilitation program tailored to people undergoing surgery for suspected endometriosis, called the Matilda program( www.matilda.health). This aims to provide data for the planning of a larger scale clinical controlled trial. In addition, this study aims to determine whether any improvements to the intervention can be made. The methods include the use of a mixed method convergent feasibility study, delivered to participants undergoing laparoscopic surgery via three online surveys (one at baseline, one immediately prior to surgery and one 4 weeks after surgery). One group will be those that undergo the Matilda program (4 weeks of prehabilitation prior to surgery and 4 weeks of post surgery rehabilitation). The other group will be those that do not undergo the Matilda program. In addition, gynaecologists will also be invited to fill out a survey and provide number of participants that have been provided with recruitment materials. The outcomes that will be examined include pain, anxiety, rating of most troublesome symptoms, quality of life, self efficacy, surgical anxiety. In addition acceptability variables from a prior survey developed by Sekhon et al will also be examined, such as affective attitude, burden, ethicality, perceived effectiveness, intervention coherence, patient self efficacy, opportunity costs and general acceptability. In addition domains from Bowen's framework for acceptability and feasibility will also be examined.
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Trial website
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Trial related presentations / publications
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Public notes
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Contacts
Principal investigator
Name
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Dr Leanda McKenna
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Address
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Curtin University, GPO Box U1987, Perth, Western Australia 6845.
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Country
140370
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Australia
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Phone
140370
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+61 8 92663660
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Fax
140370
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Email
140370
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[email protected]
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Contact person for public queries
Name
140371
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Leanda McKenna
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Address
140371
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Curtin University, GPO Box U1987, Perth, Western Australia 6845.
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Country
140371
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Australia
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Phone
140371
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+61 8 92663660
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Fax
140371
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Email
140371
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[email protected]
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Contact person for scientific queries
Name
140372
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Leanda McKenna
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Address
140372
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Curtin University, GPO Box U1987, Perth, Western Australia 6845.
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Country
140372
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Australia
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Phone
140372
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+61 8 92663660
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Fax
140372
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Email
140372
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[email protected]
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Data sharing statement
Will the study consider sharing individual participant data?
No
No IPD sharing reason/comment:
with a small sample of a specific targetted demographic, it may be possible to identify the individual participants
What supporting documents are/will be available?
No Supporting Document Provided
Results publications and other study-related documents
Documents added manually
No documents have been uploaded by study researchers.
Documents added automatically
No additional documents have been identified.
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