Women & Health最新文献

Pain during gynecologic exams is prevalent and the quality of provider communication can shape how patients experience and perceive it. This secondary analysis examined provider responses to patients' verbal expressions of pain during initial obstetric physical exams. Audio-recorded and transcribed data from 200 first prenatal visits, randomly selected from a larger National Institutes of Health-funded communication study, was analyzed for instances of pain expression and corresponding provider responses. Logistic regression was used to assess associations between provider and patient characteristics and response types. Fifty providers conducted exams with a diverse patient cohort (mean age 25.4 years; 45.6 percent Black, 38.6 percent White, 15.8 percent Multiracial). Patients vocalized pain in over one-quarter of exams, with providers responding with supportive and non-supportive communication. Providers acknowledged or apologized for pain in 63.2 percent of these encounters and offered positive reinforcement in 33.3 percent. In contrast, pain was referred to as something else in 22.8 percent of exams and ignored in 19.3 percent. Providers were more likely to offer no verbal response when a third-party person was present (OR 5.3, 95 percent CI 1.3-22.4). Findings indicate that pain is frequently expressed and variably addressed even during routine obstetric exams. Educational interventions for gynecologic examination training should emphasize empathetic, trauma-informed communication.

The risk of depression increases significantly in women after menopause. Therefore, it is particularly important to identify and intervene early in postmenopausal depression. The aim of this study was to assess the relationship between cardiometabolic index (CMI) and depression in postmenopausal women. A cross-sectional study was conducted by collecting information from the 2005-2018 National Health and Nutrition Examination Survey (NHANES). Multiple linear regression models were used to investigate the association between CMI and depression among postmenopausal women. Threshold effects analyses and fitted smoothed curves were used to describe nonlinear associations. In addition, interaction tests and subgroup analyses were performed.A total of 956 individuals participated in this study and their mean age was 64.67 ± 9.17 years. CMI was positively associated with postmenopausal depression in a fully corrected model [OR = 1.35 (1.05, 1.77), p = .0202]. Our study found that postmenopausal women with higher CMI were at greater risk of depression. Subgroup analyses found a stronger positive correlation between CMI and depression in postmenopausal women who had experienced a stroke and a higher number of pregnancies (P for interaction < 0.05).We found a non-linear association between postmenopausal depression and CMI (P for log likelihood ratio < 0.05). In addition, our study found that CMI was a better predictor of postmenopausal depression than WWI.Increased CMI is associated with an increased risk of postmenopausal depression.CMI can be used as a new anthropometric measure for predicting postmenopausal depression with greater predictive power than the WWI.

This study aimed to develop and evaluate the psychometric properties of the Attitude Toward Menopause (ATM) Checklist within the Iranian cultural context. Data were collected in 2017 from a total of 700 postmenopausal women residing in Semnan and Khorasan Razavi provinces. Content validity was assessed by a panel of eight experts using the Lawshe method and Content Validity Index (CVI), resulting in the elimination of 11 items that did not meet the required thresholds. Internal consistency analysis yielded a Cronbach's alpha of 0.69, indicating acceptable reliability. Exploratory factor analysis (EFA), conducted on a randomly selected subsample of 350 participants (mean age = 55.45, SD = 5.58), supported a five-factor structure explaining 48 percent of the total variance. Confirmatory factor analysis (CFA) on the remaining 350 participants validated the revised 18-item model, with fit indices demonstrating an acceptable model fit (χ²/df = 2.21, CFI = 0.90, GFI = 0.91, RMSEA = 0.059). These findings suggest that the culturally adapted ATM Checklist is a valid and reliable tool for assessing attitudes toward menopause among Iranian women. Further studies are recommended to confirm its applicability across diverse subpopulations.

Domestic violence (DV) is a global public health and social issue with serious physical and psychological consequences. The incidence of DV rose significantly during the COVID-19 lockdowns. Healthcare professionals (HCPs), especially in emergency departments, are often the first point of contact for victims and play a crucial role in identification and intervention. This study aimed to assess the knowledge and attitudes of HCPs in emergency departments toward DV against Jordanian women during the COVID-19 lockdown. A descriptive cross-sectional study was conducted among a convenience sample of 453 HCPs. The majority of HCPs demonstrated good knowledge of DV (79.7 percent) and a generally positive attitude toward assisting victims (77 percent). Most HCPs (90.1 percent) considered DV a significant healthcare issue. Knowledge levels differed significantly across forms of violence, with higher awareness of psychological (F = 3.37, p < .05), physical (F = 2.53, p < .05), and sexual abuse (F = 6.10, p < .001), but not deprivation or neglect (F = 1.83, p > .05). While HCPs in Jordanian emergency departments generally show good knowledge and attitudes toward DV, gaps remain in recognizing nonphysical forms of abuse. Tailored training programs and structured protocols are needed to enhance identification, support, and referral practices in both routine and crisis contexts, such as pandemics.

Nigeria has the highest population in sub-Saharan Africa and low contraceptive use, leading to high maternal and child mortality rates. The study's purpose is to examine how significantly others influence women's attitudes and decisions regarding family planning (FP). A cross-sectional study involving 2,433 ever-married women of reproductive age across Nigeria was carried out using a three-stage sampling technique. Descriptive and inferential analyses using a binary logistic regression model were used to model the impact of significant others. Support from significant others varied, with 54.6 percent receiving support from husbands and lower rates from mothers, mothers-in-law, and the community. Factors like Islam, rural living, lack of education, unemployment, and early marriage negatively impacted women's experiences, while Christianity, urban living, education, delayed marriage, and male children had positive effects. Women experiencing positive impacts were three times more likely to use FP (OR = 3.041; CI = 2.507-3.690). The study highlights the importance of advocating for gender equality in education, women's empowerment, and job access to improve family planning decisions among women. Strengthening family planning uptake in Nigeria requires engaging significant others, especially husbands and community leaders, while empowering vulnerable women through educational and culturally sensitive health interventions.

This study examines the combined effects of HypnoBirthing education and oxytocin (back) massage on labor experiences and early postpartum outcomes in primiparous women. In this randomized controlled trial, 50 pregnant women were allocated to an intervention (n = 25) or control (n = 25) group. The intervention included 12 hours of HypnoBirthing training over four weeks and oxytocin back massage during the final three weeks. Outcomes were assessed with validated instruments - Wijma Delivery Expectancy/Experience Questionnaire Form A/B, Birth Satisfaction Scale - Short Form, Breastfeeding Self-Efficacy Scale - Short Form, and Mother - Infant Attachment Scale - before intervention and one week postpartum. Compared with controls, the intervention group reported lower fear of childbirth (73.0 ± 5.7 vs 102.0 ± 10.5; p < .001) and higher birth satisfaction (27.1 ± 3.6 vs 13.5 ± 4.6; p < .001), breastfeeding self-efficacy (50.8 ± 7.6 vs 35.4 ± 5.9; p < .001), and mother - infant attachment (16.3 ± 2.5 vs 11.8 ± 2.1; p < .001). Integrating HypnoBirthing training and oxytocin (back) massage into routine prenatal care may reduce fear of childbirth, improve birth satisfaction, enhance breastfeeding self-efficacy, and promote early mother - infant attachment. The program appears feasible, low-cost, and deliverable by midwives within standard antenatal education. These findings reinforce the value of incorporating such non-pharmacological, supportive techniques into prenatal education and care to promote maternal well-being and early bonding.

Unmet need for family planning (FP) in Somalia is a critical public health challenge, contributing to unintended pregnancies and maternal mortality. This study investigates factors associated with unmet FP need among married women, using data from the 2020 SDHS. We analyzed data from 1,074 married women (15-49 years), categorizing unmet FP need into spacing, limiting, and met need. Multinomial logistic regression was used to examine the associations between sociodemographic factors and these categories, reporting Adjusted Odds Ratios (AORs) with 95% confidence intervals (CI). Older women had significantly lower odds of unmet need for limiting compared to younger women (e.g. AOR 0.04 for 45-49 age group vs. 15-19). Conversely, the desire for more children strongly predicted unmet need for limiting. Women desiring children after two years (AOR 19.75), those undecided (AOR 23.27), and those wanting no more children (AOR 1.76) all showed significantly higher odds of unmet need for limiting compared to those desiring children within two years. The high unmet FP need among married Somali women is primarily linked to desires for delayed or limited childbearing. This underscores the need for culturally sensitive interventions that prioritize women's reproductive intentions and further research to identify specific barriers.

This study compared the pelvic floor dysfunction (PFD) symptoms, knowledge level and quality of life inwomen with systemic sclerosis (SSc) and healthy. The study included 30 SSc and 30 healthy women. The presence and severity of PFD symptoms were evaluated using the Pelvic Floor Distress Inventory-20 (PFDI-20) (Subscales: Pelvic Organ Prolapse Distress Inventory-6 (POPDI-6), Colorectal-Anal Distress Inventory-8 (CRADI-8), and Urinary Distress Inventory-6 (UDI-6)). The impact of PFD on women's lives was evaluated using the Pelvic Floor Impact Questionnaire-7 (PFIQ-7). Participants' knowledge levels were assessed using the Prolapse and Incontinence Knowledge Questionnaire (PIKQ) and the Anal Incontinence Knowledge Questionnaire (AIKQ). The SSc group scored significantly higher than controls across all measures: PFIQ-7, POPDI-6, CRADI-8, UDI-6, and PFDI-20 (p < .005). SSc group also knew less about PFD treatment and management strategies compared to controls (p < .05). In women with SSc, knowledge levels about the pelvic floor were lower and PFD severity was higher than in healthy women. Integrating PFD education into routine rehabilitation for women with scleroderma may help improve quality of life.

Endometriosis has been linked to several systemic complications, including cardiovascular disease (CVD), atrial fibrillation (AF), heart failure (HF), hypertension, stroke, and ischemic stroke. The potential causal relationship between endometriosis and these diseases remains poorly understood. This Mendelian randomization (MR) study employed two-sample analyses to explore the associations between endometriosis and disease outcomes using data from large-scale genome-wide association studies (GWAS). The primary analysis method was the inverse variance weighted (IVW) method, which was supplemented by weighted median, weighted mode, and MR Egger methods. Our primary analysis revealed no significant causal association between endometriosis and cardiovascular or cerebrovascular diseases, including CVD, HF, stroke, ischemic stroke, and hypertension. Despite initial indications of a possible genetic link between endometriosis and AF (OR = 132.357; 95 percent CI: 1.126 -15,551.291; p = .045), this association was not robust. Sensitivity tests, including the "leave-one-out" analysis, showed the results to be unstable, and MR-weighted median analyses confirmed the lack of consistency in these findings. This MR study does not support a causal role of endometriosis in major cardiovascular or cerebrovascular diseases. The unstable association with AF may reflect residual pleiotropy or limited power, underscoring the need for validation in larger, diverse cohorts.