Sexual & Reproductive Healthcare最新文献

英文中文

Investigating the associations between early labour onset symptoms and self-diagnosed labour onset in a cohort study of primiparas 在一项初产妇队列研究中调查早产症状与自我诊断早产之间的关系

IF 1.4 3区医学 Q3 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH

Sexual & Reproductive Healthcare

Pub Date : 2024-09-10 DOI: 10.1016/j.srhc.2024.101033

Objective

The early recognition of possible labour onset symptoms may be pivotal to identifying the beginning of early labour and are usually recognised by the birthing women themselves. The present study illustrates the interrelationship among five labour-onset symptoms and explores the association of these labour-onset symptoms with the self-diagnosed labour onset of primiparas.

Methods

A prospective cohort study on a sample of 69 primigravida in Giessen, Germany, expecting spontaneous onset of labour at term. The participants filled in a diary from ≥37 + 0 weeks gestation until self-diagnosed labour onset. Descriptive, bivariate and inferential analysis explored association of labour onset symptoms with self-diagnosed labour onset while accounting for maternal and newborn characteristics.

Results

Self-diagnosed labour onset was positively associated with all symptoms and clinical characteristics, apart from irregular pain and maternal weight and age. Moreover, regular pain was negatively correlated with irregular pain; having regular pain increased the odds of self-diagnosed labour onset substantially (OR: 10.18, 95 % CI: 2.39–66.27), followed by gastrointestinal symptoms (OR: 2.07, 95 % CI: 0.40–13.10) and emotional symptoms (OR: 2.05, 95% CI: 0.30–13.98).

Conclusion

Being the initiator of intrapartum care without any birth experience, primiparas are prone to experiencing dissatisfaction in care and may enter professional care too late or too early. The present study showed that regular pain may signify primiparas to self-diagnose labour onset within 24 h and indicate early labour symptoms that may be relevant for a self-diagnosed labour onset.

目的早期识别可能出现的临产症状可能是确定早产开始的关键，这些症状通常由分娩妇女自己识别。本研究阐述了五种临产症状之间的相互关系，并探讨了这些临产症状与初产妇自我诊断的临产症状之间的关联。参与者填写了从妊娠≥37 + 0 周到自我诊断分娩开始的日记。描述性分析、双变量分析和推理分析探讨了临产症状与自我诊断临产的相关性，同时考虑了产妇和新生儿的特征。此外，有规律的疼痛与无规律的疼痛呈负相关；有规律的疼痛会大大增加自我诊断为临产的几率（OR：10.18，95 % CI：2.39-66.27），其次是胃肠道症状（OR：2.07，95 % CI：0.40-13.10）和情绪症状（OR：2.07，95 % CI：0.40-13.10）。结论初产妇作为没有任何分娩经验的产前护理的发起者，很容易对护理感到不满，并可能过晚或过早进入专业护理。本研究表明，有规律的疼痛可能是初产妇在 24 小时内自我诊断分娩开始的信号，并提示可能与自我诊断分娩开始相关的早期分娩症状。

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引用次数: 0

Overuse of intrapartum CTG monitoring in low-risk women in Norway 挪威低风险产妇过度使用产前 CTG 监测

IF 1.4 3区医学 Q3 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH

Sexual & Reproductive Healthcare

Pub Date : 2024-09-05 DOI: 10.1016/j.srhc.2024.101032

引用次数: 0

The conclusion of CTG overuse is not justified 过度使用 CTG 的结论是没有道理的。

IF 1.4 3区医学 Q3 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH

Sexual & Reproductive Healthcare

Pub Date : 2024-09-01 DOI: 10.1016/j.srhc.2024.101031

引用次数: 0

Hysterectomy and medical financial hardship among U.S. women 子宫切除术与美国妇女的医疗经济困难

IF 1.4 3区医学 Q3 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH

Sexual & Reproductive Healthcare

Pub Date : 2024-08-28 DOI: 10.1016/j.srhc.2024.101019

Objective

Hysterectomy is one of the common surgical procedures for women in the United States. Studies show that hysterectomy is associated with elevated risk of developing chronic conditions, which may cause financial toxicity in patients. This study aimed to assess whether women who underwent hysterectomy had a higher risk of experiencing medical financial hardship compared to women who didn’t.

Methods

Using data on 32,823 adult women from the 2019 and 2021 waves of the National Health Interview Survey, we estimated binomial and multinomial logistic regressions to assess the relationship between hysterectomy and financial hardship, defined as problems paying or unable to pay any medical bills. Further, we performed a Karlson-Holm-Breen (KHB) decomposition to examine whether the association could be explained by chronic comorbidity.

Results

While the prevalence of financial hardship was 13.6 % among all women, it was 16.2 % among women who underwent a hysterectomy. The adjusted odds of experiencing medical financial hardship among women with a hysterectomy were 1.36 (95 % CI: 1.22–1.52) times that of their counterparts who did not have a hysterectomy. The KHB decomposition suggested that 34.5 % of the size of the effect was attributable to chronic conditions. Women who had a hysterectomy were also 1.45 (95 % CI: 1.26–1.67) times more likely to have unpaid medical debts.

Conclusions

Our results suggested that women, who underwent a hysterectomy in the US, were vulnerable to medical financial hardship. Policy makers and health professionals should be made aware of this issue to help women coping against this adversity.

目的子宫切除术是美国妇女常见的外科手术之一。研究表明，子宫切除术与罹患慢性疾病的风险升高有关，这可能会给患者带来经济上的负担。本研究旨在评估与未接受子宫切除术的女性相比，接受子宫切除术的女性是否会有更高的医疗经济困难风险。方法利用2019年和2021年两波全国健康访谈调查（National Health Interview Survey）中32,823名成年女性的数据，我们估计了二项式和多项式逻辑回归，以评估子宫切除术与经济困难之间的关系，经济困难的定义是有问题支付或无法支付任何医疗账单。此外，我们还进行了卡尔森-霍尔姆-布林（Karlson-Holm-Breen，KHB）分解，以检验慢性合并症是否可以解释这种关联。结果虽然在所有女性中，经济困难的发生率为 13.6%，但在接受子宫切除术的女性中，这一比例为 16.2%。接受过子宫切除术的妇女经历医疗经济困难的调整后几率是未接受子宫切除术的妇女的 1.36 倍（95 % CI：1.22-1.52）。KHB 分解表明，34.5% 的影响可归因于慢性病。我们的研究结果表明，在美国接受子宫切除术的妇女很容易陷入医疗经济困境。决策者和医疗专业人员应该意识到这一问题，以帮助妇女应对这一困境。

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引用次数: 0

The vital role of birth centers in modern maternity care 分娩中心在现代产妇护理中的重要作用

IF 1.4 3区医学 Q3 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH

Sexual & Reproductive Healthcare

Pub Date : 2024-08-26 DOI: 10.1016/j.srhc.2024.101020

引用次数: 0

Comment on the study by Aanstad et al. “Intrapartum fetal monitoring practices in Norway: A population-based study” 就 Aanstad 等人的研究 "挪威的产前胎儿监护实践：基于人口的研究"

IF 1.4 3区医学 Q3 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH

Sexual & Reproductive Healthcare

Pub Date : 2024-08-23 DOI: 10.1016/j.srhc.2024.101018

引用次数: 0

A low cesarean section rate is not a reason for overusing CTG 剖宫产率低不是过度使用 CTG 的理由

IF 1.4 3区医学 Q3 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH

Sexual & Reproductive Healthcare

Pub Date : 2024-08-23 DOI: 10.1016/j.srhc.2024.101017

引用次数: 0

A qualitative study of the experience of doula support to women in socially disadvantaged positions in Sweden: The voices of women and doulas 对瑞典处于社会弱势地位的妇女获得朵拉支持的经验进行定性研究：妇女和助产士的声音

IF 1.4 3区医学 Q3 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH

Sexual & Reproductive Healthcare

Pub Date : 2024-08-15 DOI: 10.1016/j.srhc.2024.101016

Background

Women in socially disadvantaged positions face increased risk of fear of birth, birth complications, and postpartum depression, highlighting the need for targeted interventions for this group. Doula support is associated with positive emotional and medical outcomes for mother and child. Experience of doula support for women in socially disadvantaged positions in Sweden remains unexplored.

Aim

To describe experiences of doula support within a project for women in socially disadvantaged positions in Sweden.

Methods

In-depth interviews with seven women and focus group discussions with twelve doulas in a Doula support project were conducted. Data was analysed with inductive content analysis.

Results

Women and doulas described experiences of doula support as a significant relationship with challenges, due to unclear boundaries for the support, and the time and trust needed to establish the relationship. The support was perceived as comprehensive, far exceeding traditional doula support, with extensive assistance provided postpartum. The project was regarded as meaningful, and that it led to positive birth experiences.

Conclusions

Women in socially disadvantaged positions may benefit from doula support during the perinatal period. The support fosters feelings of calmness, security and empowerment, and alleviates feelings of isolation, which is crucial for a positive birth experience. Support for these women is complex due to increased social needs, leading to unclear expectations of the doula’s role. Support from colleagues is deemed crucial. Future projects should establish clear frameworks and a supportive structure for doulas.

背景处于社会弱势地位的妇女面临着更高的分娩恐惧、分娩并发症和产后抑郁风险，这突出表明需要对这一群体进行有针对性的干预。朵拉支持与母婴的积极情感和医疗结果相关。目的描述瑞典社会弱势妇女在一个项目中获得朵拉支持的经验。方法在一个朵拉支持项目中对七名妇女进行了深入访谈，并对十二名朵拉进行了焦点小组讨论。结果妇女和朵拉将朵拉支持描述为一种具有挑战性的重要关系，这是因为支持的界限不明确，以及建立这种关系需要时间和信任。朵拉的支持被认为是全面的，远远超过了传统的朵拉支持，并在产后提供了广泛的帮助。结论处于社会弱势地位的妇女在围产期可能会从朵拉支持中受益。朵拉的支持可促进平静感、安全感和力量感，并减轻孤独感，这对积极的分娩体验至关重要。由于社会需求的增加，对这些妇女的支持非常复杂，导致对朵拉角色的期望不明确。来自同事的支持被认为是至关重要的。未来的项目应为朵拉建立明确的框架和支持性结构。

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引用次数: 0

“But I’m not a professional” − How women with high-risk pregnancies voice the experiences of home-based telemonitoring; a qualitative interview study "但我不是专业人员"--高危妊娠妇女如何表达家庭远程监控的体验；定性访谈研究

IF 1.4 3区医学 Q3 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH

Sexual & Reproductive Healthcare

Pub Date : 2024-08-10 DOI: 10.1016/j.srhc.2024.101015

Objectives

Telemonitoring of high-risk pregnancy complications is a new approach that offers remote obstetric caregiving using mobile and wireless technologies. New evidence shows that home-based obstetric telemonitoring is not only feasible but also a safe alternative to inpatient or frequent outpatient care. As little is known how performing obstetric telemonitoring is perceived, this study examined how women with pregnancy complications experienced performing home-based telemonitoring.

Methods

A qualitative, semi-structured interview study was conducted with women with ongoing experience in performing home-based telemonitoring procedures for high-risk pregnancy complications. Purposeful sampling strategy and data saturation were applied followed by verbatim transcription. The data were analyzed using systematic text condensation.

Results

Fifteen informants participated in the study and four major themes emerged. The study revealed that performing telemonitoring was overall positively experienced as an ‘Empowering yet challenging responsibility’ as well as an ‘Extended patient-clinician partnership.’ There were pros and cons as to the influence of telemonitoring in everyday life; ‘Tele-comfort yet ambivalence’ and that it could be accompanied by annoying practical issues; ‘Accompanying remote issues.’

Conclusions

Performing obstetric telemonitoring was experienced as an empowering yet challenging responsibility as well as an extended partnership between the clinician and the pregnant woman. Pros and cons were voiced as to the influence and ambivalence of telemonitoring in everyday life, and that it could be accompanied by annoying practical issues. Patient aspects and experiences of telemonitoring are important clinical knowledge that must be considered when a telemonitoring plan is tailored preferably in a shared decision-making process.

目的远程监测高危妊娠并发症是一种新方法，它利用移动和无线技术提供远程产科护理。新的证据表明，基于家庭的产科远程监护不仅可行，而且是住院或频繁门诊护理的安全替代方案。由于人们对实施产科远程监护的看法知之甚少，本研究探讨了患有妊娠并发症的妇女在实施家庭远程监护过程中的体验。研究方法：本研究采用半结构式定性访谈的方式，采访了在实施高危妊娠并发症家庭远程监护过程中具有丰富经验的妇女。采用了有目的的抽样策略和数据饱和，然后进行逐字记录。结果15 位信息提供者参与了研究，并提出了四大主题。研究显示，进行远程监控总体上是一种积极的体验，被认为是一种 "赋权而又具有挑战性的责任 "以及一种 "病人与医生之间的扩展合作关系"。对于远程监护在日常生活中的影响；"远程舒适感与矛盾感"，以及可能伴随着恼人的实际问题；"伴随着远程问题"，既有优点也有缺点。人们对远程监护在日常生活中的影响和矛盾性提出了利弊意见，并认为远程监护可能伴随着恼人的实际问题。患者对远程监护的看法和体验是重要的临床知识，在制定远程监护计划时必须加以考虑，最好是在共同决策过程中加以考虑。

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引用次数: 0

Optimizing the role of midwives in humanitarian and developmental settings 优化助产士在人道主义和发展环境中的作用

IF 1.4 3区医学 Q3 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH

Sexual & Reproductive Healthcare

Pub Date : 2024-08-08 DOI: 10.1016/j.srhc.2024.101014

引用次数: 0

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