Impact of Mindfulness Meditation Program on pain and quality of life in women with deep Endometriosis

INTERVENTION: Behavioural Control intervention consists of standard medical treatment, consisting of one or combinations of oral contraceptives, hormone progesterone analogs, gonadotrophin‐releasing hormone, and /or surgical resection of the lesion. Sixteen patients will be part of the control intervention group. Study intervention comprises of standard medical treatment plus Mindfulness‐Based Intervention (MBI). MBI is a program offered in a group of 10 to 15 participants, each class lasts 2 hours, occurring once a week, for a period of 5 weeks in a person. The MBI program is composed of the following elements: Psychoeducation ‐ the educational content of the program is integration between current approaches to education for chronic pain and psychoeducation of mindfulness. Pain education includes clarifying the difference between pain and amount of tissue damage, modulating factors, and possible maladaptive beliefs about pain and disease. In the psychoeducation of mindfulness, the strategy is to reinforce, contextualize, and amplify what is learned through the experience with the practical exercises. We explore how the stress response develops and the influences of the interpretations on it, as well as the interrelationship between thoughts, emotions, physical sensations, and symptoms. The participant is guided to recognize how the thoughts about an initial event can modify their emotions, sensations, symptoms, and well‐being. They learn to become aware of autopilot or a habitual way of reacting to experiences. It is demonstrated how the constant functioning on autopilot brings consequences of elevation of pain, stress, and decrease in the quality of life and can facilitate the perpetuation of deleterious habits. Mindfulness Meditation Practices ‐ the mindfulness strategy, uses sensory stimuli that serve as attention objects or "anchors", passing through the sessions of more intense and noticeable (e.g., motion) stimuli to more subtle (e.g., sensations produced by emotions an Mindfulness CONDITION: Deep Endometriosis ; Endometriosis Endometriosis N00‐N99 PRIMARY OUTCOME: Expected outcome 1: decrease in pain intensity of 20 mm in the visual analogic scale of 100 mm, after five weeks of treatment. SECONDARY OUTCOME: Expected outcome 2: decrease of the number of descriptors (number of words chosen to express pain) and pain index (intensity of words chosen to express pain) from the Mcgill pain questionnaire. ; ; Expected outcome 3: improvement in the quality of life by increase score os Brazilian version of sf36. Expected outcome 4: Psychological stress reduction evidenced by the decrease of the Brazilian version of 10 items perceived stress scale. Expected outcome 5: Mindfulness improvement through Brazilian version of five facets of mindfulness. INCLUSION CRITERIA: Aged between 18 and 45 years; pelvic pain for more than 6 months, of intensity equal to or greater than 45 mm on the visual analog scale; Be under standard medical treatment. Have at least one infiltrative endometriosis nodule 2 cm or larger in size, as evidenced by magnetic resonance imaging or prior deep endometriosis surgery confirmed by histopathology.