Frontiers in global women's health最新文献

Background: Primary dysmenorrhea (PD) is a common gynecological condition affecting many young women, especially university students. It can have significant effects on daily activities and quality of life. This study aims to describe the prevalence and some factors related to PD among female nursing students at Hanoi Medical University and evaluate its impact on students quality of life. The goal is to provide data for developing treatment and prevention strategies for PD in the community, particularly among female university students.

Methods: A cross-sectional descriptive study was conducted on all female nursing students at Hanoi Medical University from January 15th to 31st, 2024. A simple random sampling method was used to select 341 participants. The data were collected using a paper survey and analyzed using SPSS software. The chi-square test was used to compare proportions, and difference rates along with 95% confidence intervals (CIs) were applied to evaluate associations between variables.

Results: The majority of the students were aged 20 years or older, accounting for 72.8%. Most students (73.9%) reported menarche between the ages of 13 and 18. Out of 341 students, the prevalence of PD was 78.6%. Among them, 68.7% reported moderate to severe pain. PD was significantly associated with a family history of menstrual pain (p < 0.001), irregular menstrual cycles (p = 0.02), and frequent caffeine consumption (p = 0.03). Quality of life, assessed using the Q-LES-Q-SF questionnaire, was significantly lower in all domains among students with PD compared with those without menstrual pain (p < 0.05).

Conclusion: PDis highly prevalent among female nursing students and negatively affects their quality of life. Several modifiable and non-modifiable factors are associated were found to be significantly associated with PD. The findings underscore the need for targeted interventions and further analytical studies to improve reproductive health and well-being among female students.

Background: Inspired by feminist theory and Durkheim's social perspective, this study used intersectionality to delve into the determinants of hysterectomy.

Methods: Using data from the Demographic and Health Survey (DHS) of India, we examined the determinants of hysterectomy, focusing on three key themes: society, women's empowerment, and biological factors.

Results: The overall hysterectomy rate in India increased from 31.5 per 1,000 women (age 15-49 years) during 2015-16 to 32.6 per 1,000 women during 2019-21. The results of bivariate and multivariate analyses echo the findings of the interaction analysis, indicating that, among women of the general caste, illiteracy and higher parity correlate with an increased likelihood of undergoing a hysterectomy. Illiterate women from the Other Backward Class also exhibited higher hysterectomy rates, regardless of parity. The second interaction result states that wealth influences hysterectomy, and illiteracy remains a significant risk factor across wealth statuses. The results of the third intersection indicate that higher education is a protective factor against hysterectomy, regardless of residence or parity.

Conclusion: From the intersection of variables, the study observed that illiteracy, residing in rural areas, and high parity increase the likelihood of undergoing hysterectomy among women of reproductive age. There is a need to establish a mechanism for disseminating reproductive health knowledge to women in rural areas.

Background: At least one in four women in the UK has experienced trauma, such as sexual abuse or violence, with profound implications for mental and physical health, particularly during the perinatal period. Despite the potential benefits of addressing trauma in maternity care, many women are reluctant to disclose their experiences due to stigma, fear of judgment, or lack of trust in healthcare systems. This paper presents the development and evaluation of the EMPATHY framework, a novel, evidence-based approach to routine trauma discussions in maternity care, designed to address these challenges and promote emotionally-centred care.

Methods: The EMPATHY framework was developed through a critical participatory action research approach, integrating findings from a systematic review, qualitative interviews, and stakeholder input, including experts by experience, healthcare professionals, and voluntary sector practitioners. The framework was refined through iterative workshops and a public consultation (n = 52), ensuring its relevance and applicability. The development and evaluation of the EMPATHY framework were guided by the Appraisal of Guidelines for Research and Evaluation II (AGREE II) tool, ensuring methodological rigor, transparency, and adherence to established standards in guideline development.

Results: The framework is structured around six core principles: system-wide change, promote trauma awareness, trust and relationships, training and support, local tailoring, and continuous improvement. A key innovation is the recommendation that all women, regardless of disclosure, should have access to information and support. Feedback from the public consultation highlighted the framework's value and its potential to transform perinatal experiences. Challenges such as resource constraints and implementation barriers were acknowledged, but respondents emphasised the importance of the framework in improving care for women who have experienced trauma.

Discussion/conclusion: The EMPATHY framework addresses a critical gap in existing guidance by offering a structured yet flexible approach to routine trauma discussions. Its implementation has the potential to empower women, strengthen therapeutic relationships, and reduce re-traumatisation. The framework represents a significant step forward in trauma-informed perinatal care.

Background: Digital technologies like the electronic partograph have revolutionised the documentation of progress of labour and birth. The purpose of the electronic partograph is to improve documentation of the progress of the intrapartum period by addressing challenges in partograph use. The tool provides real-time decision support, enhances data entry, and increases access and coordination of information for informed decision-making. Further research is required to map innovations in partograph technologies embedded in data documentation and labour progress monitoring.

Objective: The aim of this scoping review is to map innovations in partograph technologies based on studies published between 2000 and 2025.

Methods: This scoping review followed the five-step framework established by Arksey and O'Malley as well as the population, concepts, and contexts model. A comprehensive search was conducted across seven databases using refined keywords. Data were extracted, charted, synthesised, and summarised.

Result: A total of 13 original articles-studying 8,655 women in labour-were included in this review. The studies evaluated an electronic or digital paperless partograph, assessing its effectiveness and user-friendliness compared with the WHO/modified WHO partograph. This scoping review highlights that digital partographs, especially mobile applications and digital paperless versions, are practical tools for improving labour monitoring globally.

Conclusion: This scoping review found that digital paperless and novel partograph designs show promise for improving labour monitoring, particularly in resource-limited settings. The adoption of these tools can streamline documentation, enhance communication among healthcare providers, and facilitate timely interventions. This review recommends integrating ultrasound-based digital tools into labour monitoring for improved diagnostic accuracy and patient comfort.

Systematic review registration: https://osf.io/m96tw/.

Introduction: Many Ethiopian mothers and their infants do not have access to maternity and child health care during the first week after birth, increasing their risk of becoming ill or dying. Midwives doing maternity and child health care home visits could improve the overall maternity and child health care experience. There is inadequate empirical evidence to show the desire of midwives to implement home-based maternity and child health care in low-income countries like Ethiopia.

Methods: Between February 27 and October 27, 2023, 423 midwives participated in an institutional-based mixed methods, cross-sectional study. For the quantitative study, data were collected using a standardized self-administered questionnaire, whereas for the qualitative study, we conducted in-depth interviews with 12 midwives'. Bivariate and multivariable logistic regression analyses were performed. The adjusted odds ratio with confidence intervals at P-value 0.05 was used to identify a statistically significant relationship between the independent and outcome variables. Thematic analysis was used to interpret qualitative data.

Result: The percentage of midwives' who would be willing to offer child health care and home-based maternity care was 74.3%, with a 95% confidence interval between 74% and 77.4%. A strong correlation was found between midwives' high level of willingness to Implement home-based maternity and child health care and their history of obstetrics-related family loss (aOR: 2.2 with CI (1.04-4.8), P = 0.036. organizational factor (aOR: 0.087 CI (0.034-0.22), P = 0.000 individual beliefs factor (aOR: 0.19 CI (0.07-0.48), P = 0.000 and attitudes (aOR: .22 CI (0.08-0.61), P = 0.004. Based on the qualitative findings, the main obstacles to home-based maternity and child health care were found to be infrastructures, finances, and implement burden.

Conclusion and recommendation: This study found that many midwives were willing to offer child health care and home-based maternity services. Establishing and implementing a home-based maternity and child healthcare service requires sufficient manpower, facility equipment, and access infrastructure.

Objective: Lower serum vitamin D levels are inversely correlated with the risk of uterine fibroids (UFs). The existing vitamin D deficiency cutoffs are defined based on the risk of bone loss instead of asymptomatic fibroids. This study aimed to clarify the relationship between vitamin D deficiency and first-time diagnosed asymptomatic UFs, and identify the optimal threshold for assessing the risk of newly-developed fibroids.

Methods: In this case-control study, 171 asymptomatic UFs patients and 125 normal controls aged 34-45 were enrolled. A total of 64 pairs matched by age, BMI, gravity and parity were created. Logistic regression models were used to examine the correlation between vitamin D and the risk of asymptomatic UFs, and the receiver operating characteristic curve was employed to evaluate the diagnostic performance of vitamin D deficiency thresholds for the risk of asymptomatic fibroids.

Results: Both in the unmatched and matched groups, serum vitamin D levels of asymptomatic patients were lower than those of normal control individuals [(12.79 ± 5.55 vs. 16.19 ± 4.64, p < 0.001) and (11.95 ± 5.27 vs. 17.29 ± 4.99, p < 0.001)], and multivariate logistic regression revealed that vitamin D deficiency was related to an increased risk of asymptomatic UFs [(OR = 0.81; 95% Cl = 0.76-0.87) and (OR = 0.79; 95% Cl = 0.72-0.87)]. Compared to the widely-used vitamin D deficiency thresholds (12.00 ng/mL, 20.00 ng/mL and 30.00 ng/mL), the new cutoff of 14.34 ng/mL achieved the highest sensitivity and specificity to asymptomatic UFs (sensitivity 70.3%, specificity 76.6%, accuracy: 73.4%).

Conclusions: The newly-developed vitamin D deficiency threshold pf 14.34 ng/mL generates a balanced screening efficacy in women at a higher risk of UFs, and provides a possible approach for the secondary prevention strategy of UFs.

Introduction: Emotion regulation (ER) abilities predict positive outcomes among children. While parenting behaviors that promote young children's ER development have been widely studied, less is known about how a parent's history of early trauma may interfere with their use of effective strategies, despite well-documented next-generation impacts of early adversity. The present study evaluates the statistical mediating role of parent ER and parent emotion-related socialization behaviors (ERSBs) in the relation between parent adverse childhood experiences (ACEs) and child ER.

Methods: Data come from a cross-sectional study of 214 caregivers of children ages 2 through 5 (inclusive) participating in a larger online study examining parenting factors that are associated with children's self-regulation development. Measures used include Traditional and Expanded ACEs Scales, the Difficulties in Emotion Regulation Scale Short Form, the Coping with Toddlers' Negative Emotions Scale, and the Emotion Regulation Checklist. Data analysis involved correlation and mediation analyses.

Results: Parent difficulties in ER statistically mediated the association between parent ACEs and child ER such that a higher expanded ACEs score was associated with more parent difficulties in ER, and these difficulties were related to lower child ER. Although parent ER and emotion-accepting ERSBs independently contribute to child ER, data did not support a statistical mediational role for ERSBs or multiple statistical mediation.

Discussion: Study findings implicate parent ER as a potential target for parenting interventions aiming to promote child ER among parents with a history of adversity, suggesting that support for parent ER may be one avenue for the reduction of intergenerational transmission of trauma.

Introduction: Since Dobbs v. Jackson Women's Health Organization (2022) overturned Roe v. Wade (1973), thus returning abortion policy decisions to state governments, abortion access across the United States became fragmented, with some states enacting near-total bans and other states strengthening protection. As a parallel, the Republic of Ireland's (ROI) 2018 repeal of the Eighth Amendment and the United Kingdom's (UK) longstanding framework of care offer informative historical examples. This qualitative study explores the perspectives and experiences of abortion-trained physicians in California (CA), Texas (TX), ROI, and the UK, focusing on how legislation shapes physicians' ability to deliver comprehensive abortion care.

Methods: In accordance with Consolidated Criteria for Reporting Qualitative Research (COREQ), nineteen abortion-trained physicians practicing in Family Medicine, Obstetrics & Gynecology, and General Practice (CA n = 6; TX n = 4; UK n = 4; ROI n = 5) participated in 1-hour semi-structured interviews from August 2022 to November 2023 relating to their abortion care training and practice. Interviews were audio-recorded, transcribed, anonymized, and coded using Braun and Clarke's six-step approach to thematic analysis and conducted until thematic saturation was reached.

Results: Analysis revealed several interconnected themes. Across all geographical practices, physicians highlighted the importance of centering care on patients' needs, but variations in legislation largely shaped clinical care. Training experience varied widely with many shaping their own education in the context of available resources. Changing policies functioned as a clinical variable, often shifting with cultural and political attitudes. Geographic, financial, facility-related, and healthcare infrastructure barriers compounded legislative obstacles, highlighting that legality does not guarantee accessibility. Participants additionally emphasized cross-specialty advocacy, reported experiences with stigma, and dispelled common misconceptions on abortion.

Discussion: These findings highlight that policy functions as a major determinant of health and that centering on patient experiences, standardizing education, addressing healthcare infrastructure barriers, strengthening peer support systems, continued physician advocacy, and systemic reforms are necessary to reduce preventable delays, patient distress, and disparities in care. This study highlights the importance of incorporating physicians' perspectives into legislative discussions to ensure accurate representation of patient needs and challenges in accessing abortion care.

Background: Self-care practices during pregnancy significantly influence individuals, families, and communities by fostering health, preventing illness, sustaining wellbeing, and managing health challenges, irrespective of whether there is assistance from healthcare professionals. Recognizing the importance of self-care interventions facilitates the formulation of novel and equitable strategies to enhance access to sexual and reproductive health services, which may also lead to a reduction in healthcare costs by minimizing the need for travel to medical facilities. However, studies on self-care practices during pregnancy are limited in Ethiopia. Therefore, this study aims to assess self-care practices and associated factors among pregnant women who attended public health facilities in the town of Jimma, Oromia, Southwest Ethiopia, in 2023.

Methods: A facility-based cross-sectional study was conducted from 1 to 30 May 2023, on 317 study participants who were selected by simple random sampling techniques and interviewed using structured questionnaires. The data were entered into EpiData version 3.1 and exported to SPSS version 26 for analysis. Descriptive statistics were computed to summarize the data and describe the study participants. Bivariate and multivariate logistic regression analyses were conducted to identify the factors associated with the outcome variable; a 95% confidence interval and a P-value of < 0.05 were taken as the cutoff points to determine whether there was a statistically significant association. Descriptive statistics were presented using figures, tables, and text.

Results: The findings of the current study revealed that nearly half (49.52%) of the pregnant mothers demonstrated good self-care practices. In addition, the following factors were significantly associated with the self-care practices of pregnant mothers: history of abortion (adjusted odd ratio (AOR): 0.44, 95% CI = 0.2003-0.952, P = 0.037), knowledge (AOR: 5.205, 95% CI = 2.679-10.115, P = 0.001), attitude (AOR: 6.034, 95% CI = 3.217-11.317, P = 0.002), and social support (AOR: 1.255, 95% CI = 1.668-2.36, P = 0.048).

Conclusion and recommendation: The findings suggested that only approximately half of the women followed good self-care practices during pregnancy. It is recommended that pregnant mothers should possess the relevant knowledge about the recommended practices to be followed and activities to be avoided during pregnancy.

Debates continue regarding the impacts of COVID-19 on women and girls. Lockdowns increased home-based responsibilities, causing work overloads and trauma. This study investigated the impact of COVID-19 lockdowns on women's household responsibilities and caregiving roles in Limpopo Province, assessing how these effects differed between urban and rural settings. Guided by the 2030 Agenda for Sustainable Development and key SDGs, including SDG 5 (Gender), SDG 4 (Quality Education), and SDG 6 (Water and Sanitation), the research utilized a quantitative survey-based approach, including household and teacher surveys. A total of 4,571 completed household surveys and 226 teacher surveys were conducted between October 2022 and March 2023. The study explored various aspects of gendered experiences during the pandemic, including water access, sanitation, education disruptions, and the increased caregiving burdens placed on women. Descriptive and inferential statistical analyses, including ANOVA tests, were conducted to examine the relationships between household dynamics, water access, and gendered responsibilities. The data revealed significant gender disparities, with women disproportionately impacted by inadequate water, unreliable sanitation facilities, and the added burdens of unpaid caregiving. The research highlighted the increased vulnerability of the girl child, particularly regarding school dropouts and unwanted pregnancies. The paper recommends gendered perspectives in pandemic responses and age-sensitive policies for resilience. It also urges decision-makers to recognize the long-term impacts of COVID-19 on achieving SDG 5 and related goals, such as SDG 3.