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The elephant in the room: a study on the dialogue about sexuality during Assisted Reproductive Technology visits. 房间里的大象:关于辅助生殖技术就诊期间性问题对话的研究。
IF 2.1 3区 医学 Q2 OBSTETRICS & GYNECOLOGY Pub Date : 2024-12-01 Epub Date: 2024-07-04 DOI: 10.1080/0167482X.2024.2372565
Michele Montecalvo, Elena Vegni, Raffaella Balestrieri, Daniela Leone, Lidia Borghi

Despite ongoing medical advancements in infertility treatment, the significant impact of sexuality on this journey often goes unaddressed. The present research aims to examine sexual conversations during ART visits, including who initiate the conversation and their content.This quali-quantitative study delves into analyzed video-recorded ART visits to explore how "sex" conversations are broached during healthcare interactions. Our findings reveal a strikingly low proportion of utterances related to sexuality, accounting for only 1.3% of the total 14,372 utterances analyzed. Sex utterances were mainly introduced by physicians (72%), while regarding those introduced by the couple, 64% were reported by men. From the qualitative analysis on the utterances emerged three distinct levels of communication about sex: explicit, almost explicit, and implicit. While physicians and males exhibit an almost balanced distribution across the 3 levels, female patients primarily respond to explicit and almost explicit communication initiated by physicians. The low percentage of sexual utterances underscores the rarity of these conversations during ART interactions, despite the clinical field where sexual health should deserve a crucial attention. Opening the door to conversations about sexuality could help to create a safe and supportive space for patients to talk about sex, with a potential impact on well-being and quality of care during the ART process.

尽管不孕不育治疗的医疗技术不断进步,但性生活对这一过程的重要影响却往往没有得到关注。本研究旨在探讨抗逆转录病毒疗法就诊过程中的性对话,包括由谁发起的对话及其内容。这项定性定量研究深入分析了抗逆转录病毒疗法就诊过程中的视频录像,以探讨在医疗互动过程中如何进行 "性 "对话。我们的研究结果表明,与性有关的话语比例极低,在分析的 14372 条话语中仅占 1.3%。性话题主要由医生引入(72%),而由夫妻引入的性话题中,64%由男性报告。通过对这些话语的定性分析,我们发现关于性的交流有三个不同的层次:明确、几乎明确和含蓄。医生和男性在这三个层次上的分布几乎是平衡的,而女性患者则主要对医生发起的明确和几乎明确的交流做出反应。尽管在临床领域,性健康应该得到高度关注,但在 ART 互动中,性话题所占的比例很低,这突出表明了此类对话的稀缺性。打开性对话的大门,有助于为患者创造一个安全和支持性的空间来谈论性,从而对抗逆疗法过程中的幸福感和护理质量产生潜在影响。
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引用次数: 0
Correction. 更正。
IF 3.1 3区 医学 Q2 OBSTETRICS & GYNECOLOGY Pub Date : 2024-12-01 Epub Date: 2024-05-09 DOI: 10.1080/0167482X.2024.2335858
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引用次数: 0
Navigating recovery while postpartum: examining the relationship between maternal functioning and substance use disorders. 产后康复导航:研究产妇功能与药物使用障碍之间的关系。
IF 2.1 3区 医学 Q2 OBSTETRICS & GYNECOLOGY Pub Date : 2024-12-01 Epub Date: 2024-11-07 DOI: 10.1080/0167482X.2024.2424417
Leah A Holcomb, Rachel Mayo, Bonnie Treado, Jennifer Barkin, Kathleen Cartmell, Lori Dickes, Lior Rennert

Our current understanding of postpartum people's functioning while managing substance use disorder (SUD) recovery is limited. This study explored whether having a SUD impacts maternal functioning and examined the reliability of the Barkin Index of Maternal Functioning (BIMF) in postpartum people with SUDs. We conducted a prospective, cross-sectional survey (n = 141) by administering the BIMF and a demographic questionnaire with a sample of postpartum people with SUD (n = 48) and a comparative sample of postpartum people without SUD (n = 93). The internal reliability (Cronbach's alpha = .86) was consistent with previous studies. SUD diagnosis was significantly associated with lower functioning, with individuals in the SUD group having an 8-point lower BIMF score compared to persons without SUDs, although both groups reported moderately high BIMF scores (>80). While not statistically significant, participants with SUDs had reduced functioning scores over time. Considering the increasing rate of overdose deaths in postpartum persons, further examination of functioning in postpartum persons with SUDs is warranted. Integration of the BIMF into SUD screening and treatment can provide a holistic view of postpartum experiences in this high-risk population and serve as a unique tool to understand the needs of new mothers navigating SUD recovery.

目前,我们对产后妇女在药物使用障碍(SUD)康复过程中的功能的了解还很有限。本研究探讨了患有药物滥用障碍是否会影响产妇的功能,并检查了患有药物滥用障碍的产后妇女的 Barkin 产妇功能指数 (BIMF) 的可靠性。我们进行了一项前瞻性横断面调查(n = 141),对患有精神分裂症的产后妇女样本(n = 48)和未患有精神分裂症的产后妇女样本(n = 93)进行了 BIMF 和人口学问卷调查。其内部信度(Cronbach's alpha = .86)与之前的研究结果一致。有严重精神障碍诊断与较低的功能明显相关,有严重精神障碍组与无严重精神障碍组相比,BIMF 分数低 8 分,尽管两组的 BIMF 分数都处于中等偏上水平(大于 80 分)。虽然没有统计学意义,但随着时间的推移,患有药物滥用症的参与者的功能得分有所降低。考虑到产后人员用药过量致死的比例不断上升,有必要对患有药物依赖性疾病的产后人员的功能进行进一步检查。将 BIMF 纳入药物滥用筛查和治疗中,可以全面了解这一高风险人群的产后经历,并作为一种独特的工具来了解新妈妈在药物滥用康复过程中的需求。
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引用次数: 0
Testing the efficacy of a narrative short film in educating the public about providing emotional support to individuals with fertility problems. 测试叙事短片在教育公众为有生育问题的人提供情感支持方面的效果。
IF 2.1 3区 医学 Q2 OBSTETRICS & GYNECOLOGY Pub Date : 2024-12-01 Epub Date: 2024-07-15 DOI: 10.1080/0167482X.2024.2378330
Maija J Kiviharju, Sarah K Gulash, Ashley A Balsom, Jennifer L Gordon

Background: To educate the public on how best to support people with fertility problems, a narrative short film "Ten Things Not to Say to Someone Struggling with Infertility" was created, depicting the impact that helpful versus unhelpful dialogue has on someone with fertility problems.

Methods: Before and after watching the video, 419 participants from the public were presented with a hypothetical vignette describing a woman experiencing fertility problems and asked about the likelihood that they would endorse a series of helpful and unhelpful statements when communicating with the protagonist. Pre and post endorsement of helpful versus unhelpful statements were compared, as were self-perceived knowledge about the mental health aspects of fertility problems, confidence in providing emotional support to someone with fertility problems, and empathy for the protagonist.

Results: Participants endorsed fewer unhelpful statements after the video relative to before (M(SD) = 2.2(2.3) vs. 1.3(2.3), p < .001) and fewer participants endorsed at least one unhelpful statement (72% to 47%, p < .001). Self-perceived knowledge of fertility problems, confidence in providing support, and empathy increased at post-test (ps < .001; Cohen's d = .56-.83) indicating medium-large effects.

Conclusions: A narrative short film appears to be an effective dissemination strategy for sensitizing the public to the emotional struggles of individuals experiencing fertility problems.

背景:为了教育公众如何为有生育问题的人提供最好的支持,我们制作了一部叙事短片《不要对有不孕困扰的人说的十句话》,描述了有益与无益的对话对有生育问题的人的影响:在观看视频前后,我们向 419 名公众参与者展示了一个描述一位有生育问题的妇女的假想小故事,并询问他们在与主人公交流时,是否会赞同一系列有益和无益的言论。我们比较了参与者赞同有用和无用陈述的前后情况,以及他们对生育问题的心理健康方面的自我认知、为有生育问题的人提供情感支持的信心和对主人公的同情:结果:与观看视频前相比,观看视频后参与者认可的无益言论更少(M(SD)= 2.2(2.3) vs. 1.3(2.3),p .001),认可至少一种无益言论的参与者更少(72% 对 47%,p < .001)。自我感觉对生育问题的了解、提供支持的信心和同理心在测试后都有所提高(PS < .001;Cohen's d = .56-.83),显示出中等程度的效果:叙事短片似乎是一种有效的传播策略,可以让公众了解遭遇生育问题的人的情感挣扎。
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引用次数: 0
Predictors for cannabis cessation during pregnancy: a 10-year cohort study. 孕期戒除大麻的预测因素:一项为期 10 年的队列研究。
IF 3.1 3区 医学 Q2 OBSTETRICS & GYNECOLOGY Pub Date : 2024-12-01 Epub Date: 2024-02-24 DOI: 10.1080/0167482X.2024.2319290
Maia Brik, Miguel Sandonis, Carmen Cabeza Oliver, Joaquín Temprado, Alina Hernández Fleury, Elena Sánchez Echevarria, Elena Carreras

The aim of this study is to determine factors associated with cannabis discontinuation, to assess the impact of mental health and addiction interventions on cannabis discontinuation during pregnancy and to investigate the neonatal impact of cannabis discontinuation. This is a 10-year cohort study in a tertiary hospital in Barcelona, Spain, including women with self-reported cannabis use during pregnancy. Main outcome was cannabis discontinuation based on biological sample testing. Secondary outcomes were neonatal intensive care unit (NICU) admission, preterm birth, birth weight and bottle-feeding. When cannabis use was detected during pregnancy, 32 out of 81 (38.3%) discontinued cannabis during pregnancy vs. four out of 61 (6.6%) when detected at birth (p < .001). Multivariate binary logistic regression showed that null parity (OR: 6.95, p = .011), detection of cannabis use during pregnancy (OR: 5.35, p = .018) and early detection and referral to mental health care for counseling on cannabis cessation and interventions on the first trimester (OR: 25.46, p < .001) increased cannabis discontinuation. Risk for preterm birth <37 weeks (11.4% vs. 30.8%) and NICU admission (25.7% vs. 54.2%) were lower when discontinuation. Early detection of cannabis use during pregnancy, cessation counseling with mental health interventions, and null parity are predictors for cannabis discontinuation during pregnancy.

本研究旨在确定与停止吸食大麻有关的因素,评估精神健康和成瘾干预对孕期停止吸食大麻的影响,并调查停止吸食大麻对新生儿的影响。这是一项在西班牙巴塞罗那一家三甲医院进行的为期 10 年的队列研究,研究对象包括自我报告在怀孕期间吸食大麻的妇女。主要结果是根据生物样本检测结果确定是否停止使用大麻。次要结果是入住新生儿重症监护室(NICU)、早产、出生体重和奶瓶喂养。在怀孕期间检测到使用大麻时,81 名孕妇中有 32 人(38.3%)在怀孕期间停止使用大麻,而在出生时检测到使用大麻时,61 名孕妇中有 4 人(6.6%)在出生时停止使用大麻(P = .011);在怀孕期间检测到使用大麻(OR:5.35,P = .018);在怀孕头三个月及早检测到并转介到心理保健机构接受戒大麻咨询和干预(OR:25.46,P = .018)。
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引用次数: 0
Decision-making in case of an unintended pregnancy: an overview of what is known about this complex process. 意外怀孕时的决策:对这一复杂过程的了解综述。
IF 3.1 3区 医学 Q2 OBSTETRICS & GYNECOLOGY Pub Date : 2024-12-01 Epub Date: 2024-03-12 DOI: 10.1080/0167482X.2024.2321461
Eline W Dalmijn, Merel A Visse, Inge van Nistelrooij

Introduction: Unintended pregnancies are a worldwide health issue, faced each year by one in 16 people, and experienced in various ways. In this study we focus on unintended pregnancies that are, at some point, experienced as unwanted because they present the pregnant person with a decision to continue or terminate the pregnancy. The aim of this study is to learn more about the decision-making process, as there is a lack of insights into how people with an unintended pregnancy reach a decision. This is caused by 1) assumptions of rationality in reproductive autonomy and decision-making, 2) the focus on pregnancy outcomes, e.g. decision-certainty and reasons and, 3) the focus on abortion in existing research, excluding 40% of people with an unintended pregnancy who continue the pregnancy. Method: We conducted a narrative literature review to examine what is known about the decision-making process and aim to provide a deeper understanding of how persons with unintended pregnancy come to a decision.Results: Our analysis demonstrates that the decision-making process regarding unintended pregnancy consists of navigating entangled layers, rather than weighing separable elements or factors. The layers that are navigated are both internal and external to the person, in which a 'sense of knowing' is essential in the decision-making process. Conclusion: The layers involved and complexity of the decision-making regarding unintended pregnancy show that a rational decision-making frame is inadequate and a more holistic frame is needed to capture this dynamic and personal experience.

导言:意外怀孕是一个世界性的健康问题,每年每 16 人中就有 1 人面临意外怀孕,而且意外怀孕的方式多种多样。在本研究中,我们将重点放在意外怀孕上,这些怀孕在某种程度上被认为是不想要的,因为怀孕者需要做出继续妊娠或终止妊娠的决定。本研究的目的是进一步了解决策过程,因为我们对意外怀孕者如何做出决定缺乏深入了解。造成这种情况的原因有:1)生殖自主和决策的理性假设;2)关注妊娠结果,如决策的确定性和原因;3)现有研究只关注人工流产,将继续妊娠的 40% 意外怀孕者排除在外。研究方法我们对文献进行了叙事性回顾,研究了有关决策过程的已知信息,旨在更深入地了解意外怀孕者是如何做出决定的:我们的分析表明,有关意外怀孕的决策过程是在纠缠不清的层次中进行的,而不是权衡可分离的要素或因素。在决策过程中,"认知感 "是必不可少的。结论意外怀孕决策所涉及的层次和复杂性表明,理性的决策框架是不够的,需要一个更全面的框架来捕捉这种动态的个人经历。
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引用次数: 0
The role and outcomes of music therapy during pregnancy: a systematic review of randomized controlled trials. 孕期音乐治疗的作用和结果:随机对照试验的系统回顾。
IF 3.1 3区 医学 Q2 OBSTETRICS & GYNECOLOGY Pub Date : 2024-12-01 Epub Date: 2023-12-26 DOI: 10.1080/0167482X.2023.2291635
Chao Ji, Jing Zhao, Qiaole Nie, Shuo Wang

Introduction: The abundant functions of music and its effects on human's mental and physical health have been verified since ancient times, but rarely received attention as an alternative obstetric intervention.

Objective: This study aims to investigate the benefits of music therapy on prenatal and delivery experiences of pregnant women.

Method: A systematic search for articles was conducted in electronic databases including CINAHL, Web of Science, PubMed/Medline, and CNKI. A total of 240 articles were identified, and 17 studies were selected for this review. The extracted data included author, year, location, sample size, intervention phase, type of music, music therapy strategy, measuring instruments, and results. The data were organized chronologically based on the publication year of each study.

Result: The articles indicated that music therapy has advantages in reducing pain during childbirth, lowering anxiety and stress levels in mothers, improving sleep quality, and increasing fetal movements, basal fetal heart rate, and accelerations.

Conclusion: Based on the findings, it can be concluded that music therapy is an effective approach to enhance the experience of pregnant women during pregnancy and delivery. Therefore, its implementation in obstetrical clinical practice is highly recommended.

简介:音乐的丰富功能及其对人类身心健康的影响自古以来就已得到证实,但作为一种可供选择的产科干预措施却很少受到关注:本研究旨在探讨音乐疗法对孕妇产前和分娩体验的益处:方法:在 CINAHL、Web of Science、PubMed/Medline 和 CNKI 等电子数据库中对文章进行了系统检索。共检索到 240 篇文章,其中 17 项研究被选入本综述。提取的数据包括作者、年份、地点、样本量、干预阶段、音乐类型、音乐治疗策略、测量工具和结果。数据根据每项研究的发表年份按时间顺序排列:结果:文章表明,音乐疗法在减轻分娩疼痛、降低母亲焦虑和压力水平、改善睡眠质量、增加胎动、基础胎心率和加速度方面具有优势:根据研究结果,可以得出结论:音乐疗法是改善孕妇妊娠和分娩体验的有效方法。因此,强烈建议在产科临床实践中实施音乐疗法。
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引用次数: 0
Clinical characteristics of female long COVID patients with menstrual symptoms: a retrospective study from a Japanese outpatient clinic. 有月经症状的女性长COVID患者的临床特征:一项来自日本门诊的回顾性研究。
IF 3.1 3区 医学 Q2 OBSTETRICS & GYNECOLOGY Pub Date : 2024-12-01 Epub Date: 2024-01-25 DOI: 10.1080/0167482X.2024.2305899
Yasue Sakurada, Yui Matsuda, Kanon Motohashi, Toru Hasegawa, Yuki Otsuka, Yasuhiro Nakano, Kazuki Tokumasu, Koichiro Yamamoto, Naruhiko Sunada, Hiroyuki Honda, Hideharu Hagiya, Keigo Ueda, Fumio Otsuka

Purpose: To elucidate the impact of long COVID on menstruation and mental health, medical records of patients with long COVID were evaluated.

Methods: Symptoms of long COVID, QOL, mental health, and related endocrine data were compared between two groups with and without menstrual disturbances.

Results: Of 349 female patients who visited our clinic between February 2021 and March 2023, 223 patients with long COVID (aged 18-50 years) were included. Forty-four (19.7%) of the patients had menstrual symptoms associated with long COVID. The patients with menstrual symptoms were older than those without menstrual symptoms (42.5 vs. 38 years). The percentage of patients with menstrual symptoms was higher during the Omicron phase (24%) than during the Preceding (13%) and Delta (12%) phases. Cycle irregularity was the most frequent (in 63.6% of the patients), followed by severe pain (25%), heavy bleeding (20.5%), perimenopausal symptoms (18.2%), and premenstrual syndrome (15.9%). Fatigue and depression were the most frequent complications. Scores for fatigue and for QOL were significantly worse in long COVID patients with menstrual symptoms. Results of endocrine examinations showed significantly increased cortisol levels in patients with menstrual complaints.

Conclusion: Long COVID has an impact on menstrual conditions and on QOL related to menstrual conditions.

目的:为了阐明长期月经失调对月经和心理健康的影响,我们对长期月经失调患者的病历进行了评估:方法:比较有月经紊乱和无月经紊乱两组患者的长期COVID症状、QOL、心理健康和相关内分泌数据:结果:在 2021 年 2 月至 2023 年 3 月期间就诊的 349 名女性患者中,有 223 名患者患有长 COVID(18-50 岁)。其中 44 名患者(19.7%)有与长 COVID 相关的月经症状。有月经症状的患者年龄比无月经症状的患者大(42.5 岁对 38 岁)。有月经症状的患者在 Omicron 期(24%)的比例高于 Preceding 期(13%)和 Delta 期(12%)。最常见的症状是月经周期不规律(占 63.6%),其次是剧烈疼痛(25%)、大量出血(20.5%)、围绝经期症状(18.2%)和经前综合征(15.9%)。疲劳和抑郁是最常见的并发症。有月经症状的长期 COVID 患者的疲劳和 QOL 评分明显较差。内分泌检查结果显示,月经不调患者的皮质醇水平明显升高:结论:长期 COVID 会影响月经状况以及与月经状况相关的 QOL。
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引用次数: 0
Validation of the Birth Beliefs Scale for maternity care professionals in The Netherlands. 为荷兰孕产妇护理专业人员验证分娩信念量表。
IF 2.1 3区 医学 Q2 OBSTETRICS & GYNECOLOGY Pub Date : 2024-12-01 Epub Date: 2024-08-21 DOI: 10.1080/0167482X.2024.2392160
Dirkje C Zondag, Tamar M van Haaren-Ten Haken, Pien M Offerhaus, Eveline Mestdagh, Hubertina C J Scheepers, Marianne J Nieuwenhuijze

Objectives: To validate the Birth Beliefs Scale (BBS) for maternity care professionals by testing: (1) content validity; (2) internal reliability; (3) known-group discriminant validity; and examine potential relationships between regions and birth beliefs.

Methods: First, content validity was tested. Before distribution of the questionnaire among maternity care professionals of six maternity care networks (MCNs), adjustments in the statements were made whenever content validity was too low. Data were collected from November 2022 to March 2023. Statistical analysis was performed using Cronbach's alpha, ANOVA and regression analysis.

Results: Based on the content validity-test, item 6 of the questionnaire was adjusted before distribution. In total, 199 maternity care professionals completed the questionnaire. A good internal reliability of the BBS was found. There was a significant difference between the different disciplines for the BBS-Med subscale (p < .001), and the BBS-Nat subscale (p < .001). For the BBS-Nat subscale, the factors work experience and MCN were significant in the regression analysis, with interaction on the association between BBS-Nat and discipline.

Conclusions: The BBS is a valid instrument to measure birth beliefs among maternity care professionals. The BBS can help to create awareness within professionals of their beliefs and may help to explain practice variation in childbirth.

目的通过测试:(1) 内容效度;(2) 内部信度;(3) 已知群体判别效度;以及研究地区与分娩信念之间的潜在关系,验证产科护理专业人员的分娩信念量表(BBS):首先,对内容效度进行测试。在向 6 个孕产妇护理网络(MCNs)的孕产妇护理专业人员发放问卷之前,对内容效度过低的语句进行了调整。数据收集时间为 2022 年 11 月至 2023 年 3 月。采用Cronbach's alpha、方差分析和回归分析进行统计分析:根据内容效度测试结果,问卷第 6 项在发放前进行了调整。共有 199 名产妇护理专业人员填写了问卷。BBS 的内部信度良好。在 BBS-医疗分量表中,不同学科之间存在明显差异(p p 结论:BBS-医疗分量表是一个有效的工具,可用于产妇护理专业人员的健康管理:BBS 是测量孕产妇护理专业人员分娩信念的有效工具。BBS 有助于提高专业人员对其信念的认识,并有助于解释分娩实践中的差异。
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引用次数: 0
Investigating socioeconomic disparities of Kangaroo mother care on preterm infant health outcomes. 调查袋鼠妈妈护理对早产儿健康影响的社会经济差异。
IF 3.1 3区 医学 Q2 OBSTETRICS & GYNECOLOGY Pub Date : 2024-12-01 Epub Date: 2024-01-08 DOI: 10.1080/0167482X.2023.2299982
Muhammad Muneeb Hassan, Muhammad Ameeq, M H Tahir, Sidra Naz, Laraib Fatima, Alpha Kargbo

Several studies have been conducted to examine the complicated relationships between various factors that influence Kangaroo mother care (KMC) for preterm infants. However, the extended socio-economic model has not been seen in any of the previous studies that looked into the factors related to KMC and how it affects the health outcomes of babies born before in our study population. This study examines the various dimensions of KMC implementation and its influence on the health outcomes of premature infants. The current cross-sectional study was carried out in South Punjab, Pakistan, covering both private and public KMC units in obstetrics and gynecology departments. The study included a sample size of 719 patients and was conducted during a period covering 21 September 2022 to 14 October 2023. Multinomial logistic regression analysis is employed to ascertain the factors by using SPSS-26 (SPSS Inc., Chicago, IL). The use of folic acid (OR: 1.44; 95% CI: 0.87-3.11) and factor anemia (OR: 8.82; 95% CI: 1.69-14.59) no significantly correlated with better health outcomes, while environmental toxin exposure had a negative impact (OR: 0.90). The findings underscore the need for comprehensive interventions and policies to bridge socioeconomic gaps, ensuring all preterm infants benefit from KMC.

已有多项研究探讨了影响早产儿袋鼠妈妈护理(Kangaroo Mother Care,KMC)的各种因素之间的复杂关系。然而,在我们的研究人群中,以前的任何一项研究都没有发现扩展的社会经济模型,这些研究探讨了与袋鼠妈妈护理相关的因素,以及袋鼠妈妈护理如何影响早产儿的健康状况。本研究探讨了实施 KMC 的各个层面及其对早产儿健康结果的影响。本横断面研究在巴基斯坦南旁遮普省进行,涵盖了妇产科的私立和公立 KMC 单位。研究的样本量为 719 名患者,研究时间跨度为 2022 年 9 月 21 日至 2023 年 10 月 14 日。研究使用 SPSS-26 (SPSS Inc., Chicago, IL) 进行多项式逻辑回归分析,以确定影响因素。叶酸的使用(OR:1.44;95% CI:0.87-3.11)和贫血因素(OR:8.82;95% CI:1.69-14.59)与更好的健康结果无显著相关性,而环境毒素暴露则有负面影响(OR:0.90)。研究结果强调,有必要采取全面的干预措施和政策来缩小社会经济差距,确保所有早产儿都能从 KMC 中受益。
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引用次数: 0
期刊
Journal of Psychosomatic Obstetrics & Gynecology
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