Womens Health Issues最新文献

Objective: This pilot study aimed to evaluate the feasibility of a randomized controlled trial comparing high-intensity focused electromagnetic therapy (HIFEM) combined with pelvic floor muscle training (PFMT) versus PFMT alone for improving urine leakage and quality of life in primiparous and multiparous women with stress urinary incontinence (SUI).

Methods: A single-blinded, pilot randomized controlled trial was conducted with primipara and multipara women aged 30 or older who were experiencing symptoms of SUI. Participants were divided into two groups: the experimental group received both HIFEM and PFMT, while the control group received sham HIFEM and PFMT. Treatments were administered weekly for 6 weeks. Feasibility was evaluated in terms of recruitment, retention, adherence, acceptability, safety, blinding integrity, and the practicality of data collection. Urine leakage/bladder health evaluations included the 1-hour pad test, the International Consultation on Incontinence Questionnaire-Urinary Incontinence Short Form (ICIQ-UI SF), and sonography to measure the vertical movement of the bladder neck, conducted at baseline and after the intervention. One-way repeated measures analysis of covariance was used to compare outcomes between the two groups.

Results: Forty participants were randomly assigned to two groups (n = 20 each). This pilot confirmed the study's feasibility and operational robustness. There were no significant interaction effects between time and group for any measures. However, within-group analysis showed significant improvement in the 1-hour pad test in the experimental group (p = .049) and notable improvements in ICIQ-UI SF scores and sonographic measurements of bladder neck movement in both groups.

Conclusion: These findings support progression to a definitive trial: both interventions improved quality of life and bladder control, and the combination of HIFEM and PFMT significantly reduced urine leakage in the experimental group. Larger, longer-term studies are needed to confirm these results and assess durability. This study was retrospectively registered at ClinicalTrials.gov on 9 October 2024 (Registration ID: NCT06638489).

Objectives: Individuals who undergo abortion are up to three times more likely to have experienced prior traumatic events compared with the general reproductive age population, including sexual assault, interpersonal violence, or adverse childhood events. We sought to elicit and understand perceived facilitators and barriers to providing trauma-responsive abortion care among abortion providers.

Methods: We recruited providers from Chicago-area abortion clinics to participate in a 45-minute, semi-structured one-on-one phone or Zoom interview. We used thematic content analysis to analyze data, developing and refining our code directory with iterative readings of the text. We used ATLAS.ti to apply codes, calculate Cohen's kappa scores to ensure inter-rater reliability, and identify major themes in the data.

Results: We interviewed 20 abortion providers: 13 physicians and seven nurse midwives/advanced practice nurses. Half of the respondents expressed feeling confident in their ability to provide trauma-responsive care. Participants identified several facilitators to providing trauma-responsive abortion care at the individual level, including receipt of formal or informal training in trauma-responsive care and years of clinical experience, and at the structural level, accessible in-clinic behavioral health support and sedation. Barriers to providing trauma-responsive abortion care included perceived inadequate training, lack of clinical guidelines to standardize staff practices, and absence of screening protocols to identify individuals with a history of trauma.

Conclusion: Several provider and clinic-level factors influence providers' abilities to provide trauma-responsive abortion care. Greater provider training and standardization of trauma-responsive clinic practices and resources are warranted to enhance abortion care for all patients, including those with a history of trauma(s).

Background: Women veterans are the fastest-growing population of new users within the Department of Veterans Affairs (VA) health care delivery system. Building on the priorities established in the 2011 research agenda, and the research conducted in the intervening years, this paper describes the expert panel priority-setting process and reports on the national research priorities for women's health and health care research in VA.

Methods: We applied content analysis to documents from a conference brainstorming session and then facilitated an expert panel using a modified Delphi process to generate a ranked list of research priorities. Participants ranked each priority on a 5-point Likert scale (1 = not at all impactful; 5 = extremely impactful) and we calculated average descriptive statistics across panelists for each item.

Results: We identified 14 research priorities spanning mental health (4 items), access/rural health (3 items), primary care/prevention (2 items), reproductive health (2 items), other research topics (2 items), and complex chronic conditions, aging, and long-term care (1 item). The pertinence of a life course approach emerged across several research priorities.

Conclusion: Researchers, VA program leaders, other federal agency leaders, and women veterans collectively established updated VA women's health research priorities. The VA Office of Research & Development used the priorities to inform a women's health-focused notice of special interest setting funding priorities for women veterans' research, and the Women's Health Research Network will use them in strategic planning.