Women & Health最新文献

Maternal mortality is a critically significant issue in developing countries, where the lifetime risk for a woman in pregnancy or childbirth is approximately one in six. This elevated risk is often linked to delays in accessing and utilizing maternal health care services. Therefore, the study aims to provide a comprehensive understanding of the delaying factors influencing the maternal health care disparities in developing countries using Thaddeus and Maine's Three Delays Model. Researchers searched Science Direct, Pub Med, Pub Med Central, Embase, Medline, Simantic Scholar and Scopus to extract 69 case study articles published between 2015 and 2023 for this scoping review. The search reveals that among the three primary delay factors (Delay 1- patient, Delay 2- en-route or geographical, and Delay 3- service factors), patient-related factors contribute most to adverse outcomes across Asia, which is often deeply rooted in socio-economic and cultural discrepancy. All three delays significantly hinder maternal health care access in Africa with Delay 2 remaining a persistent challenge. Along with en-route causalities and security risks, many African countries face an acute shortage of emergency obstetric care infrastructure. While, increasing awareness and addressing cultural barriers are essential for achieving better health outcomes across Asia, expanding free maternal health care policies, reducing indirect costs and improving community engagement found to be more significant for African regions. In Latin American countries, Delay 3 is the primary challenge, driven by persistent disparities in health care quality, understaffing, and inconsistent service delivery. The study therefore concludes that bringing structural changes is utmost necessary by framing policies from grass root level understanding to reduce the prevailing maternal health care disparities in developing part of the world.

Pelvic health is an understudied area for female military personnel. This study aimed to explore the pelvic health concerns, prevalence rates, and co-existence of a wide range of pelvic health issues in Australian servicewomen. An online questionnaire was offered to adult females (sex-assigned at birth) who had completed a minimum of 6-month active-duty service in the Australian Defence Force (ADF). Data analyses were focused on calculating prevalence for the included female pelvic health issues and identifying trends within the data (frequencies, 95% CI). Of the 987 survey responses, 496 were excluded, leaving 491 responses (49.7%) to inform this study. Over two-thirds of servicewomen reported pelvic health concerns (n = 350, 71%, 95% CI 67-75%), including sexual dysfunction (41%), gynecological surgery (34%), menstrual cycle manipulation (32%), frequent pelvic pain (20%), endometriosis (18%), irregular menstrual cycles (17%), pelvic organ prolapse (12%), pelvic injury (10%), and frequent episodes of fecal incontinence (2%). Coexistence of pelvic health issues were also reported by 24%. Pelvic health concerns, beyond lower urinary tract symptoms, are common and can co-exist in Australian servicewomen. Consideration of sex-responsive health services within military organizations may help to mitigate potential risks, enhancing wellbeing, operational readiness, and mission outcomes.

This study examined potential disparities in Consumer Assessment of Healthcare Providers and Systems (CAHPS) scores of patient care experiences among racial/ethnic minority survivors and breast cancer-specific mortality. Female breast cancer survivors who completed a CAHPS survey between 2000 and 2019 after being diagnosed with first primary invasive breast cancer were selected from the Surveillance, Epidemiology, and End Results (SEER)-CAHPS data linkage. Adjusted Fine-Gray subdistribution hazards models were used to determine associations of CAHPS scores of patient care experiences with breast cancer-specific mortality, overall and stratified by race/ethnicity. Most survivors were NHW women (80.4 percent). Adjusted associations between CAHPS scores and breast cancer mortality were not significant. However, Hispanic survivors reporting higher Physician Rating scores were less likely to experience breast cancer death (HR = 0.985, 95 percent CI = 0.970-1.000, p = .046). The only interaction found to be significant was observed among other/multi-racial groups and Getting Care Quickly (p = .044). Patient care experience scores were not associated with breast cancer-specific mortality among older breast cancer survivors; some associations were found to be significant among certain racial/ethnic groups. Future research should capture care experiences from historically underrepresented populations.

Pregnancy and childbirth introduce significant physical and psychological changes, often resulting in discomforts such as back pain, pelvic pain, and post-delivery recovery challenges. Physical therapy is known to be an effective intervention, yet there is limited understanding of how women perceive and utilize it during pregnancy and the postpartum period. This study aimed to explore women's experiences and perspectives of physical therapy during pregnancy and after childbirth. A cross-sectional survey was conducted from May 2021 to May 2022, involving 298 women who were receiving or had received pregnancy and postpartum care at a medical center in southern Taiwan. Eligibility participants were aged 20 or older, understood Chinese/Mandarin, and agreed to participate. Data were collected through an online questionnaire covering demographic information, health history, symptom prevalence, physical therapy utilization, and perceptions. Descriptive statistics (means, frequencies and percentages) were used to analyze the data. Of the 298 participants, 53 (17.8 percent) utilized physical therapy during pregnancy and/or after childbirth. Ninety percent believed that pregnant and postpartum women need physical therapy, with breast massage (80.9 percent) being the most needed self-pay service. The primary barrier to utilizing was "lack of time," while the primary facilitator was "affordable self-pay costs." This study highlights the significant need for physical therapy among pregnant and postpartum women, identifying key barriers and facilitators to service utilization. These findings can guide the integration of physical therapy into maternal care pathways, improving overall health outcomes for women.

Tandem breastfeeding is defined as the simultaneous breastfeeding of two children of different ages, either during pregnancy or postpartum. Identifying the emotions and difficulties experienced by mothers during the tandem breastfeeding process is crucial in terms of raising awareness. Accordingly, the objective of this study is to investigate the experiences and challenges associated with tandem breastfeeding. This qualitative study was conducted using a phenomenological research design. Data were collected through online face-to-face interviews conducted via Google Meet in Turkiye between January and March of 2024. Snowball sampling was employed to recruit participants. Fourteen mothers who were concurrently breastfeeding two children participated in the study. The researchers conducted in-depth, individual, open-ended interviews to collect data. The participants were asked to complete a personal information form and a semi-structured in-depth interview. Participants were encouraged to share their experiences with tandem breastfeeding and the challenges they faced. Descriptive data regarding the socio-demographic and obstetric characteristics of the mothers were presented as numbers and percentages. Qualitative data were examined using content analysis. A comprehensive analysis of interview data from tandem breastfeeding women identified eight key themes: happiness, enjoyment, guilt, fear, breast problems, fatigue/boredom, sibling jealousy, and social pressure. Among the tandem breastfeeding mothers, 64.2 percent reported positive emotions, while 35.8 percent reported negative emotions. Furthermore, 28.6 percent of the mothers mentioned difficulties related to "breast problems," 21.4 percent to "sibling jealousy," 28.6 percent to "fatigue and boredom," and 21.4 percent to "environmental pressure. It is important to note that tandem breastfeeding mothers reported positive emotions, yet concurrently indicated the presence of various challenges. During this process, tandem breastfeeding mothers require information and support. In this regard, midwives and nurses play a crucial role in supporting tandem breastfeeding mothers, thereby promoting positive emotions, addressing negative emotions and difficulties, and encouraging breastfeeding.

Palmitoylethanolamide (PEA) is a well-tolerated compound effective in reducing pain. This randomized, double-blind, placebo-controlled crossover study investigated PEA for menstrual pain relief. Conducted in Australia from May to December 2023, the study included adults over 18. Participants consumed 300 mg of PEA or a placebo at menstrual pain onset. Pain scores were recorded on the numerical pain rating scale (NRS) every 30 minutes for up to 4 hours. If pain persisted, a second dose was permitted after 2-hours. The primary outcome measure was the reduction in acute menstrual pain scores from the NRS. Secondary outcome measures included the Treatment Satisfaction Questionnaire for Medication, rescue medication use and adverse events. Pain scores were analyzed using repeated measures analysis of variance. PEA resulted in a significant reduction in pain scores at 1 (p = .045), 1.5 (p = .009), 2 (p = .015) and 2.5 (p = .039) hours post dosage compared to placebo. No difference was seen for the Treatment Satisfaction Questionnaire for Medication, rescue medication used, or adverse events. This study demonstrates PEA supplementation is a safe and effective option for reducing menstrual pain compared to a placebo, with significant pain reduction observed at multiple time points post-dosage.

Women have inadequate access to menstrual health and hygiene, and there is astigma associated with menstruation. A systematic literature review of menstruation-related beliefs, myths, taboos, and harmful practices was conducted on Scopus, Web of Science, PsycINFO, and PubMed. Fourteen articles were included, of which eleven were in relation to beliefs, myths, and taboos, and nine to harmful practices, during menstruation. The results show that menstruation is associated with dirtiness and impurity beliefs and with restrictive and possibly harmful practices that go against human rights. Specific educational and hygiene content about menstruation is necessary for programs and interventions to address women's health.

This study aimed to develop a prognostic nomogram to predict the risk of delayed onset lactogenesis II (DOL II) in Chinese women who delivered via cesarean section. A total of 143 women who delivered via cesarean section in our hospital between June 2021 and May 2022 were retrospectively reviewed. A nomogram was constructed using the independent predictors extracted from the logistic regression analysis. Validation of the prognostic model was conducted using the concordance index, calibration curves and decision curve analyses (DCAs). Multivariate analyses revealed that the factors associated with DOL II after cesarean section were gestational weight gain (GWG), gestational hypertension, previous breastfeeding experience and previous insufficient lactation. The nomogram was constructed based on the above four factors. The area under the receiver operating characteristic curve was 0.801 in the validation set. The Youden index of the model was 0.49, with a sensitivity of 0.661 and a specificity of 0.829. The DCA indicated that our nomogram provided excellent positive net clinical benefits for predicting the risk of DOL II. This nomogram can provide a scientific basis for medical workers to promptly identify the risk of DOL II in women who have undergone cesarean section, prevent the occurrence of DOL II and improve the breastfeeding rate of mothers and the quality of life of newborns.