Journal of Psychosomatic Obstetrics & Gynecology最新文献

Purpose: Our main objective is to evaluate the psychometric properties of the Spanish version of the EHP-30 questionnaire. The secondary aim is to evaluate the differences in the scores of the core EHP-30 scales between patients with either surgical treatment or conservative management of endometriosis.

Methods: Cross-sectional study conducted into a tertiary hospital endometriosis reference unit. All patients (n = 223) pre-surgically completed the core EHP-30 questionnaire, the EQ-5D questionnaire (n = 184) and a visual analogue scale (n = 210) for endometriosis-related pain. Demographical and clinical data were recorded.

Results: Psychometric characteristics of the Spanish core EHP-30 questionnaire were investigated. Statistical analyses confirmed the five-structure factor, a high degree of internal consistency and of item-total correlation for all the assessed items. Convergent validity between EQ-5D and EHP-30 items and between VAS and EHP-30 subscale pain was observed. Additionally, patients with surgical management rendered significantly higher scores in the core EHP-30 subscales "pain" and "control and powerlessness".

Conclusions: We present the reliability, validity and acceptability of the Spanish core EHP-30 questionnaire, providing clinicians and researchers with an improved tool to assess the endometriosis-related quality of life. Additionally, we show that patients subsidiaries of surgical treatment for endometriosis present with higher pain and powerlessness than those with conservative management.

Objective: The aim was to investigate birth outcome and birth experience in relation to women's emotional health. An additional aim was to explore the relationship between emotional health, continuity with a known midwife, and the birth experience.

Methods: A prospective longitudinal cohort study of 243 women enrolled in a continuity of care project in a rural area in Sweden. Profiles were constructed from instruments measuring depressive symptoms, worries, fear of birth, and sense of coherence. Antenatal and birth records and questionnaires were used to collect data.

Result: Women were categorized into two cluster profiles: "emotionally healthy" vs. "emotionally unhealthy". Women in the "emotionally unhealthy" cluster had a less positive birth experience (p = 0.006). The total score of the Childbirth Experience Questionnaire was highest in women who had had a known midwife assisting at birth. Babies born to women in the "emotionally unhealthy" cluster were more likely to have a severe neonatal diagnosis.

Conclusion: There were few differences in birth outcome between the clusters, while there were explicit differences in the childbirth experience. Having a known midwife is important to warrant women a more positive childbirth experience. Screening with validated instruments during antenatal care could be a first step to further investigate women's emotional well-being and provide targeted psychosocial support.

Aim: 106 donor conceived people (DCP) responded to an anonymous survey study that examined the impact of the method of genetic identity disclosure and age at the time of the disclosure on their emotional wellbeing, familial relations, and perceptions of donor conception practices.Methods: Participants were asked to select the way in which they were informed they are DCP and the age group at which this occurred, and then were asked to select strongly agree, agree, neither agree or disagree, disagree, or strongly disagree in response to 26 statements that examined their perceptions of the topics listed above. Responses were grouped based on the age of genetic identity disclosure and the method of genetic identity disclosure, then numerically compared by assigning each type of response a number. Statistical analysis using repeatedmeasures ANOVA was performed to identify differences among these factors.Results: This analysis revealed that most participants 18 ≥ years and most participants who discovered their genetic identity through means other than through their parent(s) had worse emotional wellbeing and familial relations. However, most participants among all categories had a negative perception of donor conception practices.Conclusion: Continued work is needed to understand and support the growing DCP population.

Objective: To seek validity and reliability evidence of the Brazilian version of the City Birth Trauma Scale (BiTS-Br) and establish diagnostic accuracy.

Method: A total of 343 mothers (up to one year after childbirth, 30.8 years old on average) completed the BiTs-Br and other instruments screening for posttraumatic stress disorder (PTSD), depression, and anxiety for convergent validity analysis. Structural validity was verified using exploratory techniques (principal components analysis), while discriminant validity was checked using the known-groups method and ROC curve. The Structured Clinical Interview for DSM-5 was applied via telephone interviews. Test-retest reliability was obtained in a 15-30-d interval.

Results: A two-factor structure was found (birth-related and general symptoms), with excellent test-retest reliability (0.73) and internal consistency (0.91). Moderate/strong associations (>0.62) were found with correlated symptoms and posttraumatic stress. The scale had a diagnostic accuracy of 86.7% and a cutoff point >28 was the most appropriate, with a sensitivity of 72% and specificity of 83%.

Conclusions: BiTS-Br presented excellent psychometric indexes, similar to the original version and other cross-culturally adapted versions. Thus, it can be widely used in scientific research and clinical settings to support the identification and treatment of PTSD.

Objective: To examine the psychological impact of gestational surrogacy on surrogates' families.

Background: ASRM practice committee guidelines recommend that psychological counseling prior to surrogacy include consideration of a surrogate's own family, but there has been little research to help guide mental health professionals (MHPs) providing implications counseling.

Methods: Fifty-nine family members from 16 surrogate families were recruited and data were collected on family relationships, child psychological well-being, and family experiences of surrogacy. Family members filled out a series of questionnaires based on their age and role in the family system.

Results: Participants included 16 surrogates (28 surrogate pregnancies) with an average time since first surrogate pregnancy = 2.93 years (range = 0-8 years). Overall, families of surrogates are functioning well across a number of psychological domains. There were some differences between surrogates and spouses regarding their perceptions of their children's experience. A small number of children reported negative emotions about surrogacy and more research is needed to identify which children may be at risk. Children reported surrogacy having a positive impact on their lives and endorsed both pride and excitement about their mother being a surrogate.

Conclusions: There has been limited data to inform MHPs tasked with implications counseling prior to surrogacy in offering guidance to surrogates' family members to help prepare them for the experience. This data can be used by MHPs providing implications counseling to help facilitate discussions about the potential impact of surrogacy tohelp ensure positive psychological outcomes for surrogates and their family members.

Introduction: Vulvar lichen planus (LP) and vulvar lichen sclerosus (LS) are chronic inflammatory diseases that affect women's sexual health. In this study, our aim was to investigate sexual function, anxiety level and genital self-image in vulvar LP and vulvar LS patients.

Methods: This study was conducted on a total of 178 women who presented to the gynecology clinic between February 2019 and January 2020. The patients were divided into the following groups: group 1, vulvar LP (n = 21); group 2, vulvar LS (n = 59); group 3, fungal vulvitis controls (n = 48); and group 4, healthy controls (n = 50). The validated Female Sexual Function Index (FSFI), Beck Anxiety Index (BAI), and Female Genital Self-Image Scale (FGSIS) questionnaires were assessed in all women.

Results: There were no significant differences among the groups with respect to age, parity, menopausal status, body mass index (BMI), vaginal intercourse past 1 month, marital status or educational status (p > .05). There were statistically significant differences between the vulvar LP and vulvar LS groups compared to control groups in terms of FSFI total scores and subscores (p < .001). When FGSIS and BAI scores were analyzed, significant statistical differences were found among the study groups (p < .001). A positive correlation was found between the FSFI and FGSIS scores in patients with vulvar LP and LS. Additionally, a negative correlation was found between the FSFI and BAI scores in patients with vulvar LP and LS.

Conclusions: Our study showed that sexual function, genital self-image and anxiety level were associated in vulvar LP and vulvar LS patients. Vulvar LP and vulvar LS patients with worse genital self-image have more sexual problems and anxious conditions.

Background: The prevalence of perinatal mood and anxiety disorders has significantly increased with the COVID-19 pandemic. In parallel, the pandemic has caused a major shift in delivery of care to telemedicine.Purpose: This article aimed to discuss the different advantages and disadvantages of telemedicine for perinatal mental health. Telemedicine has significant benefits for perinatal mental health patients, including increased accessibility to specialized care, direct observation of child-parent interactions in their home environment, and facilitation of collaborative work between obstetrical providers and psychiatrists. Alternatively, telemedicine may impede recovery and contribute to an increase in social isolation. The use of telemedicine by obstetrical care providers may also contribute to a reduction in screening and identification of these disorders.Conclusion: A hybrid model of in-person and telemedicine delivery of care may serve as a durable compromise solution for these women and their families.

Introduction: Despite significant advances, only 35% infertile couples conceive after ART. If IVF is unsuccessful, couples will need to decide whether to proceed again with assisted conception. The aim of this study was to explore Iranian infertile couples' experiences after failed ART to continue treatment.

Methods: In this qualitative study participants were selected using purposeful sampling method. Data were collected using 29 semi-structured face-to-face in-depth interviews at a regional Infertility Center from April 2016 to June 2017. All interviews were recorded, transcribed verbatim, and analyzed with conventional content analysis method using MAXQDA software.

Results: Our findings suggest that couples' decisions to continue treatment after unsuccessful ART is shaped by their social, emotional and financial circumstances. We have constructed two themes to describe their experiences: support to continue and trying for a second chance.

Conclusion: Our findings suggest that good marital and family support networks can support infertile couples during this period of decision making. Considering the depression and anxiety caused by failed ARTs, which itself could affect the success rate of any further ARTs, the clinical team should effectively assess psychological readiness of couples who decide to continue with another ART after unsuccessful treatment.

Purpose: To evaluate how sexual pain influences changes in sexual frequency from the pregnancy to postpartum transition, and to examine how couple's sexual communication interacts with sexual pain during pregnancy.

Methods: We explored data following 159 mixed-sex couples across the transition from pregnancy to 6 months postpartum. Couples completed the Relationship Quality Interview and the Marital Satisfaction Inventory-Revised, which assessed their sexual communication, pain and other sexual problems during pregnancy, and frequency of intercourse at pregnancy and postpartum.

Results: Overall, couples reported a decline in sexual activity from pregnancy to postpartum. Women's sexual pain during pregnancy influenced changes in sexual frequency only among couples who reported poorer communication about sex. Among couples reporting sexual pain and good communication, pain did not impact changes in sexual frequency (i.e. they experienced significant declines in sexual activity into the postpartum period, as expected). In contrast, among couples with poor communication, sexual frequency did not significantly decline.

Conclusion: Our findings suggest that sexual communication alters the effects of sexual pain on postpartum sexual activity. Future research should examine if sexual communication training during pregnancy improves postpartum sexual wellbeing.

Purpose: To analyze the perception of gynecologic examination from the patients' point of view.

Materials and methods: This anonymous electronic cross-sectional survey aimed to evaluate the subjective experiences of women during gynecologic examinations (levels of pain, embarrassment and trauma), the manner the examination was conducted, and women's suggestions for improving their experience.

Results: Overall, 6,508 women answered the survey. The examination was considered an embarrassing event by 47%, painful by 35% and traumatic by 19%. Importantly, only 43% of the respondents stated they would notify the gynecologist in case of physical discomfort or pain during the examination. The quality of physician-to-patient communication was rated as the most important aspect of gynecologic examination, and showed a significant association with the general quality of the experience (levels of pain, embarrassment, and trauma). Matters relating to women's privacy during gynecologic examination were also considered important. An option for a companion was rated as important by 64% of the respondents. Significant differences with large effect-sizes were found between the respondents' preferences and their reports of the observed situation.

Conclusion: The findings highlight the need for establishing guidelines for gynecologic examinations, according to a patient-centered care approach. This study constitutes a first discourse on the subject of gynecologic examinations in Israel in order to provide an overview and initial insights, serving as a starting point for further specific and more in-depth research.