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Factors affecting provision of high-quality maternal and newborn healthcare in Zanzibar – A qualitative study 影响桑给巴尔提供高质量孕产妇和新生儿保健的因素——一项定性研究
IF 1.4 3区 医学 Q3 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH Pub Date : 2025-06-07 DOI: 10.1016/j.srhc.2025.101122
Hibaq Warsame , Malin Bogren , Margaret Sylvester Tayari , Sanura Salim , Helen Elden , Herborg Holter

Objectives

In Tanzania and Zanzibar, the maternal mortality ratio remains high, hence, this study explored factors affecting the provision of high-quality maternal and newborn healthcare in Zanzibar.

Methods

A qualitative research design was used, with data collected through five focus group discussions (FGDs) with healthcare providers. The discussions, held in Swahili, included midwives, nurses, and medical doctors (n = 27) working at five childbirth clinics in Zanzibar. A semi-structured FGD guide was used. All discussions were audio-recorded, transcribed, and translated into English. Content analysis was performed.

Results

Three generic categories describe the factors affecting the provision of high-quality maternal and newborn healthcare: i) a shortage of essential resources, including medical equipment, medication, and an emergency transport system; ii) an inadequate working environment, characterized by understaffing, low salaries, limited involvement of and protection for healthcare providers, and a lack of clinical guidelines; and iii) healthcare perception and cultural dynamics encompassing mistrust of healthcare providers, as well as cultural beliefs and practices.

Conclusions

The study highlights critical barriers to the provision of high-quality maternal and newborn care in Zanzibar, including resource shortages, inadequate working environments, and cultural perceptions of healthcare. These findings suggest that addressing systemic challenges, such as improving resource allocation and enhancing healthcare infrastructure, is essential for advancing maternal and newborn health outcomes. Additionally, efforts to align healthcare practices with local cultural dynamics are crucial to improving service utilization. These findings underscore the need for targeted interventions to strengthen healthcare delivery and reduce maternal and newborn mortality in Zanzibar and similar settings.
在坦桑尼亚和桑给巴尔,孕产妇死亡率仍然很高,因此,本研究探讨了影响桑给巴尔提供高质量孕产妇和新生儿保健的因素。方法采用定性研究设计,通过与医疗保健提供者的五个焦点小组讨论(fgd)收集数据。参加讨论的人员包括在桑给巴尔五个分娩诊所工作的助产士、护士和医生(27人),他们用斯瓦希里语进行了讨论。采用半结构化的FGD导流器。所有的讨论都被录音、转录并翻译成英语。进行内容分析。结果影响提供高质量孕产妇和新生儿保健的因素分为三类:1)基本资源短缺,包括医疗设备、药物和应急运输系统;(二)工作环境不足,其特点是人员不足、工资低、保健提供者的参与和保护有限,以及缺乏临床指南;以及iii)医疗保健感知和文化动态,包括对医疗保健提供者的不信任,以及文化信仰和实践。该研究强调了在桑给巴尔提供高质量孕产妇和新生儿护理的关键障碍,包括资源短缺、工作环境不足和对医疗保健的文化观念。这些发现表明,解决系统性挑战,如改善资源分配和加强卫生保健基础设施,对于促进孕产妇和新生儿健康结果至关重要。此外,努力使医疗保健实践与当地文化动态保持一致对于提高服务利用率至关重要。这些调查结果强调需要有针对性的干预措施,以加强医疗保健服务,降低桑给巴尔和类似地区的孕产妇和新生儿死亡率。
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引用次数: 0
Expectant and new mothers’ experiences from digital midwifery care and information during pregnancy and postpartum 孕妇和新妈妈在孕期和产后的数字助产护理和信息体验
IF 1.4 3区 医学 Q3 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH Pub Date : 2025-06-06 DOI: 10.1016/j.srhc.2025.101121
Bäckström Caroline, Nilvér Helena, Byhmer Linda, Stridh Tiina, Palmér Lina

Objective

Globally, the use of digital solutions in midwifery care, parental information, and antenatal classes is increasing. However, research on how these digital solutions function for mothers has not kept pace. Therefore, the aim of this study was to describe expectant and new mothers’ experiences from digital midwifery care and information during pregnancy and postpartum.

Methods

This is a Swedish study with a qualitative method and an inductive approach. Twelve expectant and new mothers were individually interviewed, and data was analysed using thematic analysis.

Results

The results are presented in one overall theme: An ongoing Negotiation between digital and physical midwifery care is required to promote engagement and address needs, and three themes: A complement that creates flexibility but request balance; Enable participation and inclusion of partners, and The needs of being seen and heard are met to various extends.

Conclusion

While the flexibility offered through digital midwifery care and parental information is beneficial and facilitates convenience for mothers, digital midwifery care is not entirely interchangeable with physical midwifery care, including antenatal classes. An ongoing negotiation between digital and physical midwifery care is essential to achieve balanced midwifery care that addresses the unique, individual needs of mothers throughout different stages during pregnancy and postpartum.
在全球范围内,助产护理、父母信息和产前课程中数字解决方案的使用正在增加。然而,关于这些数字解决方案如何对母亲起作用的研究却没有跟上步伐。因此,本研究的目的是描述孕妇和新妈妈在怀孕和产后的数字助产护理和信息的体验。方法采用定性和归纳相结合的研究方法。对12位准妈妈和新妈妈进行了单独访谈,并使用主题分析对数据进行了分析。结果结果呈现在一个总体主题中:需要在数字和物理助产护理之间进行持续的谈判,以促进参与和满足需求;三个主题:创造灵活性但要求平衡的补充;促进合作伙伴的参与和包容,并在不同程度上满足被看到和听到的需求。结论虽然数字助产护理和家长信息提供的灵活性是有益的,并为母亲提供了便利,但数字助产护理与物理助产护理(包括产前课程)并不完全可互换。数字助产护理和物理助产护理之间的持续谈判对于实现平衡的助产护理至关重要,以满足母亲在怀孕和产后不同阶段的独特个性化需求。
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引用次数: 0
Women’s experiences of the transition phase of physiological labour during freebirth: A qualitative study 妇女在自然分娩期间生理分娩过渡阶段的经验:一项定性研究
IF 1.4 3区 医学 Q3 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH Pub Date : 2025-06-01 DOI: 10.1016/j.srhc.2025.101115
Eleanor Young , Karen-Ann Clarke , Rachel Reed , Carolyn Hastie

Purpose

There is a poverty of knowledge relating to the transition phase of labour and undisturbed childbirth physiology. This study explored women’s experiences of the transition phase of physiological labour during freebirth.

Background

Transition within physiological labour is described as a phase occurring as a woman ends the first stage of labour. The woman may display a range of signs and symptoms, including shaking, thirst, nausea, difficulty in communication, irritation, loss of control and inability to cope.

Aim

The study aimed to explore women’s experiences of the transition phase of physiological labour during an intended, unassisted labour and birth, known as freebirth.

Methods

A qualitative study design, using narrative inquiry was undertaken. Individual in-depth interviews were conducted with women who had experienced physiological births in Australia without the presence of registered health practitioners, doulas or childbirth attendants (n = 10). Reflexive thematic analysis was undertaken to identify themes and patterns.

Findings

Women experienced a physiological ‘peak intensity’ of labour that was individualised and nuanced. Three over-arching themes, inner world, outer world and other world, were conceptualised from data analysis. The inner world focussed on the somatic experience of labour. The outer world centred on the women’s perceptions of others and feelings of safety. The other world explored experiences of liminal space and oneness.

Conclusions

Findings support earlier studies regarding how women experience physiological processes and affirm that women experience the peak intensity of labour in individualised ways which are not reflected or supported in the common midwifery discourse. This study provides evidence about women’s experiences of physiological labour and insight into their dynamic inner, outer and other worlds. Further research is recommended into the freebirth experience in Australia from the perspective of childbirth physiology, and how the context of the birth setting, and midwifery practice may influence physiology and experience. It is also recommended that emergent knowledge on the altered states of consciousness and the sexual nature of birth be explored.
目的关于分娩过渡阶段和不受干扰的分娩生理学的知识贫乏。本研究探讨妇女在自然分娩时生理分娩过渡阶段的经验。生理分娩过渡期是指妇女结束第一产程后的一个阶段。妇女可能表现出一系列体征和症状,包括颤抖、口渴、恶心、沟通困难、烦躁、失控和无法应对。目的:本研究旨在探讨女性在无辅助分娩(即自由分娩)过程中生理分娩过渡阶段的经历。方法采用定性研究设计,采用叙述性调查。对在没有注册保健医生、助产师或助产士在场的情况下在澳大利亚经历过生理分娩的妇女进行了个别深入访谈(n = 10)。进行了反身性专题分析,以确定主题和模式。研究发现,女性会经历一种个性化的、微妙的生理“峰值强度”劳动。三个主要的主题,内心世界,外部世界和其他世界,是通过数据分析概念化的。内心世界关注的是劳动的肉体体验。外部世界以女性对他人的看法和安全感为中心。另一个世界探索了有限空间和合一的体验。研究结果支持了早期关于妇女如何经历生理过程的研究,并确认妇女以个性化的方式经历劳动的高峰强度,这在常见的助产话语中没有得到反映或支持。这项研究提供了关于女性生理劳动经验的证据,并深入了解了她们动态的内在、外在和其他世界。建议从分娩生理学的角度进一步研究澳大利亚的自由分娩经验,以及分娩环境和助产实践的背景如何影响生理和经验。它还建议对意识状态改变和出生性别本质的新兴知识进行探索。
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引用次数: 0
Emergency medical technicianś experiences of assignments with women in labour 急救医疗技术人员与分娩妇女一起工作的经验
IF 1.4 3区 医学 Q3 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH Pub Date : 2025-05-31 DOI: 10.1016/j.srhc.2025.101118
Kathrine Hågensen , Maria Bakland , Ingela Lundgren

Objective

To describe Emergency Medical Technicianś(EMTś) experiences of assignments involving women in labour.

Methods

A qualitative study with Systematic Text Condensation (STC) for data analysis, as described by Malterud. Ten semi-structured interviews with EMTs in Norway, exploring EMTs experiences during assignments involving women in labour. Participants were recruited via social media and email inquiries to ambulance stations, ensuring a diverse range of travel times to hospitals. Interviews were conducted face-to-face, lasting between 22 and 45 min, and focused on EMTs’ experiences during these assignments.

Results

The findings present three main categories: an unpredictable situation, lack of competence and training, and the desire to provide good maternity care while a sense of falling short. EMTs described assignments with women in labor as unpredictable and stressful due to the potential for rapid changes and complications. They expressed a lack of competence and training in obstetric care, relying on random knowledge and experiences shared by colleagues. Despite these challenges, EMTs demonstrated a desire to provide good maternity care, emphasizing the importance of communication, presence, and adapting to the woman’s needs.

Conclusions

EMTs experience assignments with women in labour as a demanding event, compounded by a perceived lack of competence and training. There is a desire among EMTs to provide quality maternity care, but they often feel they fall short. Enhancing EMT training in obstetric care and providing regular practice opportunities could improve their confidence, and the quality of care provided to women in labour.
目的描述紧急医疗技术人员(emtka)在涉及分娩妇女的任务中的经验。方法采用Malterud描述的定性研究方法,采用系统文本缩合法(system Text Condensation, STC)进行数据分析。对挪威的EMTs进行了10次半结构化访谈,探讨了EMTs在涉及分娩妇女的任务中的经验。参与者是通过社交媒体和向急救站发送电子邮件的方式招募的,以确保他们在不同的时间内到达医院。访谈是面对面进行的,持续时间在22到45分钟之间,重点是急救医生在这些任务中的经验。结果调查结果显示了三个主要类别:不可预测的情况,缺乏能力和培训,并希望提供良好的产妇护理,但有不足的感觉。急诊医生称,由于可能发生快速变化和并发症,产妇的任务是不可预测和有压力的。他们表示缺乏产科护理的能力和培训,依赖于同事分享的随机知识和经验。尽管面临这些挑战,急诊医师仍表现出提供良好产科护理的愿望,强调沟通、在场和适应妇女需求的重要性。结论:semt认为与劳动中的妇女一起工作是一项艰巨的任务,而且他们认为缺乏能力和培训。急救医生渴望提供高质量的产科护理,但他们常常觉得自己做得不够。加强产科护理方面的急诊医疗培训,并提供定期实习机会,可以提高她们的信心,并提高向分娩妇女提供护理的质量。
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引用次数: 0
Correlates of very early sexual intercourse among adolescents in a Southeastern European country 一个东南欧国家青少年过早性交的相关因素
IF 1.4 3区 医学 Q3 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH Pub Date : 2025-05-29 DOI: 10.1016/j.srhc.2025.101116
Myzafer Kaçaj , Gentiana Qirjako , Iris Mone , Enver Roshi , Genc Burazeri

Background

Early sexual intercourse can lead to increased risks of unintended pregnancies, and negative impacts on adolescents’ health. Our aim was to assess the prevalence and correlates of very early sexual intercourse (≤14 years) among adolescents in a Southeastern European country undergoing rapid transformations.

Methods

We carried out a cross-sectional study in Albania in 2022, which included a nationally representative sample of 1877 schoolchildren aged 15 years (about 55 % girls; overall response: ≈96 %). Data collection included age of commencement of sexual intercourse (if applicable) and important determinants of early sex comprising behavioural factors, health characteristics, child maltreatment indices and sociodemographic factors. Logistic regression assessed the association of very early sexual intercourse with covariates.
Findings: Among 321 schoolchildren with lifetime sexual intercourse who also reported on age of commencement (≈17 % of the total), the prevalence of very early (≤14 years) sexual intercourse was ≈53 %. It was more prevalent in boys (P = 0.01), in children from more affluent families (P = 0.06), among lifetime smokers (P = 0.02), in children who never/rarely felt low (P = 0.06), and in children who reported lifetime physical abuse (P = 0.06), or lifetime sexual abuse (P = 0.10). In multivariable-adjusted logistic regression models, independent significant positive correlates of very early sexual intercourse included family affluence (OR = 1.8, 95 %CI = 1.0–3.1) and lifetime physical abuse (OR = 2.1, 95 %CI = 1.2–3.6).

Conclusion

Our study evidenced a substantial prevalence of very early sexual intercourse, especially among male adolescents, which is a cause of concern. Interventions should address child maltreatment and promote healthy family environments, alongside comprehensive sexual education tailored to the developmental needs of adolescents.
背景:频繁的性交会增加意外怀孕的风险,并对青少年健康产生负面影响。我们的目的是评估一个正在经历快速转型的东南欧国家青少年中过早性行为(≤14岁)的患病率及其相关因素。方法我们于2022年在阿尔巴尼亚进行了一项横断面研究,其中包括具有全国代表性的1877名15岁学童(约55%为女孩;总有效率:≈96%)。收集的数据包括开始性交的年龄(如适用)和早性行为的重要决定因素,包括行为因素、健康特征、儿童虐待指数和社会人口因素。Logistic回归评估了很早性交与协变量的关系。结果:321名有终生性行为且报告开始性行为年龄的学童(约占总数的17%)中,极早(≤14岁)性行为的发生率约为53%。在男孩(P = 0.01)、富裕家庭的儿童(P = 0.06)、终生吸烟者(P = 0.02)、从不或很少感到自卑的儿童(P = 0.06)、终生遭受身体虐待(P = 0.06)或终生遭受性虐待(P = 0.10)的儿童中患病率更高。在多变量调整logistic回归模型中,极早性行为的独立显著正相关因素包括家庭富裕程度(OR = 1.8, 95% CI = 1.0-3.1)和终生身体虐待(OR = 2.1, 95% CI = 1.2-3.6)。结论:我们的研究证明了过早性交的普遍存在,尤其是在男性青少年中,这是一个值得关注的问题。干预措施应解决虐待儿童问题,促进健康的家庭环境,同时针对青少年的发展需要进行全面的性教育。
{"title":"Correlates of very early sexual intercourse among adolescents in a Southeastern European country","authors":"Myzafer Kaçaj ,&nbsp;Gentiana Qirjako ,&nbsp;Iris Mone ,&nbsp;Enver Roshi ,&nbsp;Genc Burazeri","doi":"10.1016/j.srhc.2025.101116","DOIUrl":"10.1016/j.srhc.2025.101116","url":null,"abstract":"<div><h3>Background</h3><div>Early sexual intercourse can lead to increased risks of unintended pregnancies, and negative impacts on adolescents’ health. Our aim was to assess the prevalence and correlates of very early sexual intercourse (≤14 years) among adolescents in a Southeastern European country undergoing rapid transformations.</div></div><div><h3>Methods</h3><div>We carried out a cross-sectional study in Albania in 2022, which included a nationally representative sample of 1877 schoolchildren aged 15 years (about 55 % girls; overall response: ≈96 %). Data collection included age of commencement of sexual intercourse (if applicable) and important determinants of early sex comprising behavioural factors, health characteristics, child maltreatment indices and sociodemographic factors. Logistic regression assessed the association of very early sexual intercourse with covariates.</div><div><strong>Findings:</strong> Among 321 schoolchildren with lifetime sexual intercourse who also reported on age of commencement (≈17 % of the total), the prevalence of very early (≤14 years) sexual intercourse was ≈53 %. It was more prevalent in boys (P = 0.01), in children from more affluent families (P = 0.06), among lifetime smokers (P = 0.02), in children who never/rarely felt low (P = 0.06), and in children who reported lifetime physical abuse (P = 0.06), or lifetime sexual abuse (P = 0.10). In multivariable-adjusted logistic regression models, independent significant positive correlates of very early sexual intercourse included family affluence (OR = 1.8, 95 %CI = 1.0–3.1) and lifetime physical abuse (OR = 2.1, 95 %CI = 1.2–3.6).</div></div><div><h3>Conclusion</h3><div>Our study evidenced a substantial prevalence of very early sexual intercourse, especially among male adolescents, which is a cause of concern. Interventions should address child maltreatment and promote healthy family environments, alongside comprehensive sexual education tailored to the developmental needs of adolescents.</div></div>","PeriodicalId":54199,"journal":{"name":"Sexual & Reproductive Healthcare","volume":"45 ","pages":"Article 101116"},"PeriodicalIF":1.4,"publicationDate":"2025-05-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144169610","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
pre-SUCCECS: Lessons learned from implementing resuscitation and stabilisation with an intact cord during caesarean sections – Focus group discussions with implementation teams pre-SUCCECS:在剖腹产过程中使用完整脐带实施复苏和稳定的经验教训-与实施小组的焦点小组讨论
IF 1.4 3区 医学 Q3 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH Pub Date : 2025-05-26 DOI: 10.1016/j.srhc.2025.101114
Katarina Ekelöf , Elisabeth Sæther , Ola Andersson , Jenny Svedenkrans , Karolina Linden

Objective

The primary aim of this study was to explore the lessons learned from implementing a procedure of resuscitation and stabilization with an intact umbilical cord for preterm and term infants requiring resuscitation or stabilization during emergency caesarean sections.

Methods

Data were collected by two focus group discussions and one individual interview. Participants were members of implementation teams responsible for implementing of resuscitation and stabilization with an intact cord during caesarean sections. The implementation teams were from two hospitals from different metropolitan areas in Sweden. We used a deductive approach with data collection and analysis guided by the Consolidated Framework for Implementation Research 2.0 and an inductive approach to derive lessons learned.

Results

All implementation domains except the outer setting were represented in the results. Suggested solutions to common concerns such as maintaining sterility, temperature control of the neonate and availability of the equipment were described by the implementation teams. Additionally, the participants highlighted the importance of a multidisciplinary implementation team with all professions represented as well the need for decision-making authority in the team, for successful implementation.

Conclusions

The lessons learned from implementing neonatal resuscitation and stabilisation with an intact umbilical cord during caesarean section can inform efficient strategies for implementing this complex intervention into clinical routines across difverse birth settings.

Synopsis

Lessons learned from implementing resuscitation and stabilization with an intact cord during emergency caesarean sections are included. Possible solutions to concerns about sterility, neonatal temperature control, and equipment availability are presented.
目的本研究的主要目的是探讨在紧急剖宫产手术中对需要复苏或稳定的早产儿和足月儿实施完整脐带复苏和稳定程序的经验教训。方法采用2次焦点小组讨论和1次个人访谈法收集资料。参与者是实施小组的成员,负责在剖宫产期间使用完整脐带实施复苏和稳定。执行小组来自瑞典不同大都市地区的两家医院。在实施研究统一框架2.0的指导下,我们使用了数据收集和分析的演绎法和归纳方法来得出经验教训。结果除外部设置外,所有实施域均在结果中表示。执行小组描述了对诸如保持无菌、新生儿温度控制和设备可用性等共同关切的建议解决办法。此外,与会者强调了由所有专业代表组成的多学科实施团队的重要性,以及团队中有决策权的必要性,以便成功实施。结论:在剖宫产过程中使用完整脐带实施新生儿复苏和稳定的经验教训可以为在不同分娩环境中实施这一复杂干预的临床常规提供有效的策略。在紧急剖宫产术中使用完整脐带实施复苏和稳定的经验教训也包括在内。提出了可能的解决方案,以关注无菌,新生儿体温控制和设备的可用性。
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引用次数: 0
Response to Whop and Butler 回应胡普和巴特勒
IF 1.4 3区 医学 Q3 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH Pub Date : 2025-05-24 DOI: 10.1016/j.srhc.2025.101112
Melissa Bartick , Hannah Dahlen , Jenny Gamble , Shawn Walker , Roger Mathisen , Karleen Gribble
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引用次数: 0
Prevalence and predictors of depression in Jordanian women post-hysterectomy: A multi-centre cross-sectional study 约旦妇女子宫切除术后抑郁症的患病率和预测因素:一项多中心横断面研究
IF 1.4 3区 医学 Q3 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH Pub Date : 2025-05-22 DOI: 10.1016/j.srhc.2025.101113
Nadeen Abu Ghali , Rasmieh Al-Amer , Yacoub Abuzied , Ahmad Aqel , Ruba W. Al-Rwashdih , Mohammad Y.N. Saleh , Mohammed Albashtawy , Eman Zmaily Dahmash

Purpose

This study aimed to assess the prevalence of depression among Jordanian women who underwent hysterectomy and determine the associations with their demographic characteristics and their social support levels.

Methods

The study included women over 18 years who underwent hysterectomy and received care at government hospitals in Amman, the capital of Jordan. The study instruments were a demographic questionnaire, a Depression, and Stress Scale (DASS), and a social support scale. The DASS categorises depression levels as ’No depression’, ‘Mild’, ’Moderate’, ’Severe’, to ’Extremely severe’.

Results

The study included 220 participating women; 68.2 % of them (n = 150) were married, with a mean age of 48.17 (SD = 11.78) years. Approximately half of the women reported experiencing some form of depressive symptoms. The study found significant negative relationships between depression and age, (r = −0.403; p < 0.001), number of children (r = −0.342; p < 0.001), and sexuality pattern change. Additionally, there were significant positive correlations between depression and duration of marriage, body mass index, employment status, marital status, fertility wishes, education level, and family income. The whole regression model concerning depression was significant, with an R2 of 0.256. Depression among Jordanian women who underwent hysterectomy was significantly predicted by their age (β = −0.315, p < 0.001); sexuality change (β = −0.207, p = 0.001); and number of children (β = −0.202, p = 0.002).

Conclusions

Depression was highly prevalent among Jordanian women who underwent hysterectomy and was significantly predicted by age, sexuality change, and number of children.
目的本研究旨在评估接受子宫切除术的约旦妇女中抑郁症的患病率,并确定其人口统计学特征和社会支持水平之间的关系。方法本研究包括在约旦首都安曼的政府医院接受子宫切除术治疗的18岁以上妇女。研究工具为人口统计问卷、抑郁与压力量表(DASS)和社会支持量表。DASS将抑郁程度分为“无抑郁”、“轻度”、“中度”、“重度”和“极度严重”。结果该研究包括220名参与研究的女性;其中68.2% (n = 150)已婚,平均年龄48.17岁(SD = 11.78)。大约一半的女性报告称经历了某种形式的抑郁症状。研究发现,抑郁与年龄之间存在显著的负相关关系(r = - 0.403;p & lt;0.001),儿童数(r =−0.342;p & lt;0.001),性模式改变。此外,抑郁与婚龄、体重指数、就业状况、婚姻状况、生育意愿、受教育程度、家庭收入有显著正相关。与抑郁相关的整个回归模型显著,R2为0.256。接受子宫切除术的约旦妇女的抑郁与年龄有显著关系(β = - 0.315, p <;0.001);性别变化(β = - 0.207, p = 0.001);儿童数(β = - 0.202, p = 0.002)。结论:抑郁症在约旦接受子宫切除术的妇女中非常普遍,并且与年龄、性别变化和子女数量有显著关系。
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引用次数: 0
Navigating child adoption decision among women with infertility in Southern Ghana 引导加纳南部不孕妇女的儿童收养决定
IF 1.4 3区 医学 Q3 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH Pub Date : 2025-05-19 DOI: 10.1016/j.srhc.2025.101111
Belinda Nana Ama Quartey , Joseph Quartey , Josephine M. Kyei , Deborah Armah , Florence Naab
The traditional Ghanaian society is pro-natal, with childbearing as the ultimate purpose of marriage. However, infertility may impede this purpose, leading to the need for child adoption among couples. This study explored child adoption decisions among women with infertility in Southern Ghana. A qualitative descriptive exploratory design was used. Purposive and snowball sampling techniques were used to recruit eligible participants. Overall, 14 women with infertility were interviewed. Analyses of the data were conducted using content analysis after audio-recorded interviews were transcribed verbatim. The findings suggested that to navigate the decision to adopt a child in Southern Ghana, there are key factors and environmental factors influencing the decision of these women. The study revealed that child adoption is associated with stigma, and some cultural beliefs, which were described as impediments to their decision-making process. The findings suggest that discrimination, stigma, and cultural beliefs, are the obstacles to child adoption in Southern Ghana. As a result, there is a need for community engagement, particularly with traditional and religious leaders, on child adoption issues in Ghana.
传统的加纳社会是亲产的,以生育为婚姻的最终目的。然而,不孕症可能阻碍这一目的,导致夫妇之间需要收养孩子。本研究探讨了加纳南部不孕妇女收养儿童的决定。采用定性描述性探索性设计。采用目的性和滚雪球抽样技术招募符合条件的参与者。总共采访了14名不孕妇女。在逐字记录访谈录音后,采用内容分析方法对数据进行分析。研究结果表明,在加纳南部,决定收养孩子的关键因素和环境因素会影响这些妇女的决定。研究表明,收养儿童与耻辱和一些文化信仰有关,这些被描述为他们决策过程的障碍。调查结果表明,歧视、耻辱和文化信仰是加纳南部儿童收养的障碍。因此,在加纳的儿童收养问题上,需要社区参与,特别是与传统和宗教领袖的参与。
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引用次数: 0
Introducing tranexamic acid into the protocol for management of post-partum haemorrhage: An observational study using repeated cross-sectional analysis 将氨甲环酸引入产后出血治疗方案:一项使用重复横断面分析的观察性研究
IF 1.4 3区 医学 Q3 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH Pub Date : 2025-05-17 DOI: 10.1016/j.srhc.2025.101110
Megan Weller , Alison Griffin , Sarah Janssens

Objective

Primary post-partum haemorrhage (PPH) is an important cause of maternal morbidity and mortality. Following the WOMAN trial, tranexamic acid (TXA) was endorsed as an important component of PPH management, because it was shown to reduce the risk of maternal death due to bleeding. This study aimed to assess changes in maternal outcomes in relation to PPH following vaginal birth pre and post the introduction of TXA into the PPH management policy at a tertiary level Australian Maternity Hospital.

Materials and methods

A repeated cross-sectional analysis was performed, assessing outcomes for the two years before, and two years after the introduction of TXA into the PPH management protocol. The primary outcome was estimated blood loss at PPH. Additional outcomes assessed were red cell transfusion post-delivery, iron infusion post-delivery and operative management of PPH. Maternal characteristics were described and compared. Multinomial logistic regression was used to estimate the unadjusted and adjusted relative risk of having blood loss 1000–1499 mL or ≥1500 mLs (with reference 500–999 mLs) pre and post TXA.

Results

This policy change did not confer a difference in maternal outcomes. Surprisingly, there was an increased risk of PPH ≥ 1500 mLs in both adjusted and unadjusted models. Given the observational nature of our study, it is likely this finding is due to an unknown confounder.

Conclusions

The incidence of severe PPH increased despite alteration to our management protocol to include 1 g of TXA. Ongoing research is required to determine factors contributing to PPH, and the optimal medical management.
目的原发性产后出血(PPH)是孕产妇发病和死亡的重要原因之一。在WOMAN试验之后,氨甲环酸(TXA)被认可为PPH管理的重要组成部分,因为它被证明可以降低产妇因出血而死亡的风险。本研究旨在评估澳大利亚一家三级妇产医院在PPH管理政策中引入TXA前后阴道分娩后与PPH相关的产妇结局的变化。材料和方法进行了重复的横断面分析,评估了将TXA引入PPH管理方案之前和之后两年的结果。主要终点是PPH时的估计失血量。评估的其他结果包括产后红细胞输注、产后铁输注和PPH的手术管理。描述和比较母亲的特征。采用多项logistic回归估计未调整和调整TXA前后出血1000-1499 mL或≥1500 mL(参考500-999 mL)的相对风险。结果这一政策改变并未对产妇结局产生影响。令人惊讶的是,在调整和未调整的模型中,PPH≥1500 ml的风险都增加了。鉴于我们研究的观察性质,这一发现很可能是由于未知的混杂因素造成的。结论:尽管我们修改了治疗方案,纳入了1 g的TXA,但严重PPH的发生率仍有所增加。需要持续的研究来确定导致PPH的因素,以及最佳的医疗管理。
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Sexual & Reproductive Healthcare
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