Women & Health最新文献

Our objective is to understand patients' preexisting values, beliefs, and preferences regarding removal or preservation of the cervix, ovaries, and fallopian tubes at the time of hysterectomy for benign indications. We performed semi-structured interviews from August 2021 to March 2022 with patients referred for hysterectomy. Participants were recruited according to pre-specified diversity axes. The interview guide was informed by literature review, expert stakeholders, and pilot testing. pers. comm. occurred prior to scheduled consultation. Responses were analyzed for themes, with thematic saturation reached. Age of participants (n = 13) ranged from 24 to 60 years. Identified themes included knowledge, decision-making, treatment goals, short- and long-term consequences, fertility, identity, and lack of concern. Many participants expressed lacking necessary knowledge of the risks and benefits of removing the cervix and adnexa. Treatment goals included symptom relief and definitive treatment. Long-term consequences included concerns about menopause and future cancer. Many patients expressed some degree of lack of knowledge, desire to remove most or all pelvic structures, or no attachment to their reproductive organs. Many patients expressed decision-making based on the effects of organ removal on long-term consequences and the relief of current symptoms, rather than immediate surgical risk. This information can help to inform patient-centered surgical counseling.

The spread of sexually transmitted infections (STIs) is a significant public health problem. Screening and treating STIs in partners is crucial for interrupting the transmission chain, and it is essential to identify factors that contribute to maintaining it. The objective of this study was to compare the intentions of men and women to adhere to the treatment for STIs diagnosed in their partner as well as the perception of partner adherence. An observational, cross-sectional study was conducted using a self-administered structured questionnaire in Unified Health System (SUS) users who were treated at the Pedro Ernesto University Hospital between August 2023 and January 2024. Overall, 255 questionnaires were analyzed. Among the 42 participants who reported previous STIs, 21 percent maintained risky behavior in their current relationship. Attendance at the consultation in the case of a partner diagnosed with STI was high (90 percent women and 87 percent men); however, unconditional adherence to medication use was 63 percent in women and 55 percent in men, with the duration of medication use and its route of administration highlighted as the possible obstacles. Although no significant differences were observed between men and women, measures to increase adherence to STI treatment are necessary to interrupt STI transmission.

Length of labor is one of the factors contributing to maternal and neonatal childbirth outcomes. Auriculotherapy is a potential therapeutic intervention for reducing labor duration. This systematic review aims to evaluate the efficacy of auriculotherapy in shortening labor time.This systematic review and meta-analysis included randomized controlled trials published from inception until July 2024. Scopus, Cochrane Library, Web of Science, Embase, and PubMed were searched for eligible studies. Article screening was performed using Endnote X8. Data analysis and assessment of the risk of bias were performed by Review Manager 5.3. Analysis of pooled data was performed using fixed and random effect models. Five studies (n = 433 participants) were included in the meta-analysis from an initial pool of 150 articles. The participants' mean age was 25.07 ± 4.52. Auriculotherapy reduced the length of the active and second phases of labor by approximately sixty (MD = -63.54; 95 percent CI: -84.47, -42.62; p < .00001) and seven minutes (MD = -7.67; 95 percent CI: -13.46, -1.89, p = .009), respectively. Auriculotherapy was found to significantly decrease the duration of the active and second phases of labor. However, it is not possible to generalize the results and further high-quality studies involving more individuals from various socioeconomic backgrounds are needed to provide support for these findings.

The present study sought to determine if inequities exist in Hispanic women's pregnancy intentions and birth outcomes by metropolitan status. In the U.S. pregnancy intentions and birth outcomes of young Hispanic women are a significant public health problem as they are often overlooked on health issues such as pregnancy and childbirth. Data were from the 2015 to 2019 National Survey of Family Growth and focused on the first pregnancies of Hispanic women aged 18 to 24 years old who were not pregnant at the time of the interview and answered the nativity question. Multivariable multinomial regression was used to evaluate how metropolitan status affects pregnancy intentions and birth outcomes. Additionally, multivariable multinomial regression was used to evaluate how metropolitan status affects each pregnancy intention-birth outcome combination. There was no significant association solely between metropolitan status and pregnancy intention (i.e. unintended pregnancy). Metropolitan Hispanic women reported more miscarriages than live births. Hispanic women in the suburbs were more likely to miscarry during an intended pregnancy than those in urban. These findings can improve family planning services for rural women by identifying the specific factors that affect pregnancy intentions and developing targeted interventions to reduce unintended pregnancies.

Vasomotor symptoms (VMS) are the hallmark of menopause and negatively affect a large proportion of women over many years. However, studies evaluating the overall impact of VMS are limited. This systematic review (SR) aimed to examine epidemiological, clinical, humanistic, and economic outcomes of VMS among perimenopausal women and among women aged ≥65 years in the US. A systematic search of the MEDLINE and Embase databases was conducted to identify observational studies (2010-2022) reporting on these populations. Data reporting outcomes of interest were extracted and analyzed descriptively. Of 7,613 studies identified, 34 met inclusion criteria, of which 30 reported on perimenopausal women and 4 reported on VMS in women aged ≥ 65 years. VMS and severe/moderate-to-severe VMS were reported by 48.4-70.6 percent and 13.0-63.1 percent, respectively, of perimenopausal women. Mean VMS duration was 2.6 years, and median duration ranged from 7.4 to 10.1 years among women with onset in early perimenopause and from 3.8 to 6.1 years among those with onset in late perimenopause. Among women aged ≥65 years, 20.9-45.1 percent reported VMS; 2.0 percent reported severe symptoms, and 17.6 percent reported moderate symptoms. No studies reported VMS frequency and duration or the economic or humanistic burden among women aged ≥65 years. In conclusion, high VMS frequency and severity were observed among perimenopausal women and women aged ≥65 years in the US in this SR, highlighting the need for (1) better management of VMS to reduce frequency and severity and (2) further research to clarify the impact of VMS on disease burden, quality of life, and economic impact.

The purpose of this study was to develop a workplace breastfeeding support scale for working mothers and examine their psychometric properties. This methodological research was conducted between February and April 2022. This study included 325 mothers who continued breastfeeding while working. The tool development stages included item generation, expert review for content validity testing, and psychometric testing. The data were collected through face-to-face interviews between February and April 2022. In data analysis, for explanatory factor analysis, the direct oblimin technique and scree plot test were performed. Structural equation modeling was performed for confirmatory factor analysis. Two sub-dimensions (manager support, environmental support) and a nine-item workplace breastfeeding support scale showed good validity and reliability. The Cronbach's alpha value of the total scale and sub-dimensions of the scale were greater than 0.70. Confirmatory factor analysis showed that the model fit indices were acceptable (χ2 = 68.658, χ2/df = 2.64, CFI = 0.94, GFI = 0.96, AGFI = 0.92, and RMSEA = 0.07). The total variance explained by the scale was 54.32 percent. This newly developed 9-item and 2-dimensional version is a valid and reliable tool for measuring the working mothers' perception of workplace breastfeeding support. This tool is recommended to be verified in other low, middle, and high-income countries.

The present cross-sectional study aimed to compare climacteric symptoms and arterial stiffness indices between perimenopausal and postmenopausal women. The study sample comprised 70 healthy female participants, including 27 perimenopausal (49.8 ± 3.8 years) and 43 postmenopausal (55.7 ± 4 years) individuals. Validated methods were used to assess physical activity level, quality of life, climacteric symptoms, and anthropometric data. Arterial stiffness parameters were measured using Mobil-O-Graph. Pulse wave velocity (PWV) had a higher mean in the postmenopausal group than in the perimenopause group [8.04 m/s (SD 0.79) vs 7.01 m/s (SD 0.78), p < .001). PWV was strongly correlated with peripheral (r = 0.619) and central (r = 0.632) Systolic Blood Pressure (SBP) in postmenopausal group and an even stronger correlation was observed in perimenopausal group (r = 0.779 pSBP and 0.782 cSBP). BMI was a risk predictor in the perimenopausal group contributing positively to increase Pulse Pressure Amplification (PPA) (0.458, p < .05). In postmenopausal women, heart rate (HR) was a stronger predictor for central SBP, cardiac output, and total vascular resistance, whereas perimenopausal women HR influenced central diastolic blood pressure and PPA. Vascular changes initiating during perimenopause may contribute to the development of cardiovascular pathologies in the postmenopausal period. Further research with larger, representative samples is warranted to corroborate these findings.

The rise of mHealth has transformed maternal healthcare in low- and middle-income countries, enhancing care and women's access to quality services. The "Kapasia Model," launched in 2017 in Bangladesh, aims to connect beneficiaries with healthcare providers, improve antenatal care (ANC) and reduce maternal mortality. This study aimed to explore healthcare providers' perspective on digitalized ANC services within the Kapasia model. Conducted from January to July 2022, it involved 30 in-depth interviews with community-level healthcare providers across 17 facilities in Kapasia Upazila, Gazipur. A thematic analysis was performed to analyze data. The findings revealed that healthcare providers emphasized the Kapasia Model's role in raising awareness and knowledge of pregnancy care and increasing antenatal care attendance. They viewed digitalized service as means of improving connectivity and access to healthcare for pregnant women. However, providers also discussed challenges such as women's limited access to mobile phones and the time-consuming nature of completing information forms. Overall, healthcare providers supported integration of digital tools and endorsed digitalization in their workflow. Addressing these challenges is essential for optimizing ANC delivery and improving quality of services. Insights from this study will inform evidence-based decisions for future scaling-up and replication by policymakers and stakeholders in similar settings.

The increased prevalence of autism spectrum disorder (ASD) has placed a significant emotional and psychological burden on mothers. We explored the association between the severity of ASD symptoms in children and the mental health of their mothers during the COVID-19 pandemic. Our study included 1,924 mothers of children with ASD, enrolled in a web-based cross-sectional survey over 85 consecutive days to gather clinical and sociodemographic data. The severity of ASD symptoms was obtained according to the children's age. Using the Depression, Anxiety, and Stress Scales (DASS-21) scale, we found that 35.8 percent of mothers experienced both anxiety and depression. A high education level and a high family income reduced the chance of concurrent anxiety and depression. Conversely, unemployment, a child using psychiatric medication, and higher severity of ASD symptoms increased the chance. Notably, the severity of the ASD symptom was the sole predictor of maternal co-occurring anxiety and depression across all age groups (<3 years aOR = 2.04, 95%CI 1.07-3.89; 3-5 years aOR = 2.76, 95%CI 1.67-4.56; ≥ 6 years aOR = 1.61, 95%CI 1.04-2.50). Recognizing the challenges associated with ASD leads to greater acceptance and tailored interventions, ultimately improving the overall well-being of both individuals with ASD and their mothers.