Women's health (London, England)最新文献

Background: Endometriosis affects approximately 190 million people globally and 2 million in Canada. Experiences of endometriosis can profoundly impact all aspects of life, including physical, mental, and financial well-being. The Coronavirus Disease 2019 (COVID-19) pandemic impacted endometriosis care, mental health outcomes, and increased overt racism towards Asian people internationally.

Objectives: In this study, we aimed to describe the impacts of the COVID-19 pandemic on the mental health of Asian women living with endometriosis.

Design: Qualitative, photovoice.

Methods: We used photovoice, an arts-based methodology, and thematic analyses of 22 interviews with East, South, and Southeast Asian cisgender women living in Canada regarding their experiences with endometriosis during the COVID-19 pandemic.

Results: Participant photographs and narratives conveyed how the COVID-19 pandemic caused disruptions in their lives, which influenced the ways they navigated, managed, and coped with endometriosis symptoms and, ultimately, their mental health. Some disruptions were exacerbated during the COVID-19 pandemic and impacted mental health, including worsening of and inability to manage symptoms as usual, deepening isolation and disconnection from self and society, and turbulent and transformational experiences in interpersonal relationships. Other disruptions were unrelated to the COVID-19 pandemic, including endometriosis invisibility and invalidation, the burden of necessary overplanning, and the complexities of grappling with uncertain fertility. Participants commonly described experiencing feelings of guilt, uncertainty, lack of control, fear, hopelessness, grief, anxiety, and depression.

Conclusion: The COVID-19 pandemic exacerbated disruptions affecting the mental health of participants, disruptions unrelated to COVID-19 remained in participants' lives. Considering the latter was particularly impactful on the mental health of participants as these disruptions existed prior to - and would continue beyond - the COVID-19 pandemic.

Background: Obstetric fistula, a preventable consequence of prolonged obstructed labor, inflicts profound physical, psychological, and social suffering, leaving many women described as "living dead." In Ethiopia, where the burden remains high, little is known about women lived experiences and coping strategies beyond clinical outcomes. This review was conducted to synthesize qualitative evidence, illuminate these challenges, and inform holistic interventions.

Objectives: To synthesize available evidence on the lived experiences and coping mechanisms of women with obstetric fistula in Ethiopia.

Design: This study employed a qualitative meta-synthesis approach.

Data sources and methods: This review was conducted in accordance with the Joanna Briggs Institute systematic review and meta-synthesis methodological guidance and reported following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) 2020 guidelines. ATLAS.ti software, Version 25, Lumivero was used for analysis. A comprehensive literature search was performed across multiple databases up to May 25, 2025, including both published and unpublished studies examining the lived experiences of women with obstetric fistula. All eligible studies were critically appraised using the Critical Appraisal Skills Program to ensure methodological rigor. Data were systematically extracted and analyzed using thematic synthesis, and the results are presented through tables, narrative summaries, and illustrative diagrams, providing a coherent and evidence-based synthesis of women's experiences and coping mechanisms.

Results: Eight studies met the inclusion criteria, encompassing the diverse experiences of women with obstetric fistula in Ethiopia. Four major themes were developed: physical challenges such as pain, foot drop, odor, and urinary incontinence; psychological challenges including hopelessness, grief, and suicidal ideation; socioeconomic challenges like stigma, isolation, divorce, loneliness, social disintegration, and economic difficulties; and coping mechanisms such as self-isolation and wearing multiple layers of clothing.

Conclusion: Women with obstetric fistula face intersecting physical, psychological, and socioeconomic burdens that erode dignity and social participation. Coping strategies such as self-isolation and layering clothes, while adaptive, often reinforce stigma and exclusion. These findings highlight the need for comprehensive interventions that go beyond surgical repair to include psychosocial support, stigma reduction, and economic reintegration programs.

Registration: Registered with PROSPERO 2025 CRD420251064015.

Background: Due to minimal effects, new directions for behavioral (non-pharmacologic/non-surgical) obesity interventions are required. Previous research suggests that physical activity and exercise (PA/exercise) might have considerable merit for weight reduction via impacts on mood and other psychosocial correlates of controlled eating. Although as few as 3 bouts/week of low-moderate intensity PA/exercise are associated with improved mood-with no dose-response effect beyond that frequency-it is unknown if mood improvements may be leveraged when participants already complete ⩾3 bouts/week by treatment start.

Objectives: The present research addressed gaps in the available PA/exercise-psychosocial change-weight management research.

Design: This study combined group contrasts with mediation analyses.

Methods: Women participating in a community-based cognitive-behavioral obesity treatment emphasizing the increase of PA/exercise and exercise-related self-regulation and self-efficacy (N = 99) were divided for separate analyses into groupings of <3 bouts/week, and ⩾3 bouts/week, of light (e.g., easy walking) and moderate (e.g., fast walking) PA/exercise regularly completed prior to treatment start. The participants were assessed on psychosocial and PA/exercise changes from baseline to month 3.

Results: Reductions in total mood disturbance (TMD), depression, and anxiety scores were overall significant, with no significant difference by exercise-frequency grouping. PA/exercise increases were significantly greater in the <3 bouts/week groupings. Change in self-regulatory skills usage mediated relations between groupings and changes in TMD, depression, and anxiety. In subsequent serial mediation models, significant paths from grouping → self-regulation change → self-efficacy change → TMD and depression changes were found.

Conclusion: Whether or not ⩾3 bouts/week of PA/exercise are completed at intervention start, TMD, depression, and anxiety may be reduced through treatment foci on increasing PA/exercise, self-regulation, and self-efficacy. Findings might be useful for informing scalable obesity treatments.

Background: Young refugee women face elevated sexual and reproductive health risks, but their family planning (FP) needs remain understudied.

Objectives: This study aimed to assess FP awareness, contraceptive use and associated factors among young married Rohingya women aged 15-24 years in Cox's Bazar refugee camps and to compare knowledge and use among women who report no desire for additional children.

Design: A prospective cross-sectional survey was conducted between March and April 2023.

Methods: A multistage random sample was used to select 541 married women across 8 refugee camps. Data were collected via interviewer-administered structured questionnaires. Descriptive statistics and multivariate logistic regression were used to identify sociodemographic, informational, and gender-power factors associated with current contraceptive use.

Results: Among 541 participants, 84.7% reported general awareness of FP, but only 27.0% could name a contraceptive brand. Current contraceptive use was 44.9%, and 37.6% of women who wished to avoid pregnancy were not using any method. Factors positively associated with contraceptive use included older age, husband's education, exposure to FP information (adjusted odds ratio (AOR): 1.74; 95% confidence interval (95% CI): 1.06-2.87), fieldworker visits (AOR: 2.00; 95% CI: 1.31-3.04) and awareness of FP centres (AOR: 5.18; 95% CI: 2.30-11.67). Husband-controlled FP decisions were negatively associated with use (AOR: 0.46; 95% CI: 0.30-0.73).

Conclusion: Interventions are needed to enhance women's empowerment, increase contraception use among young women and support local and international organisations in Bangladesh working with refugees by providing more targeted fieldworker visits for education and the delivery of FP services.

Background: Obstetrics and gynecology emergency rooms (OB-GYN ERs) are crucial for treating acute women's health issues. However, utilization of ER services for non-urgent complaints is a challenging issue in the healthcare system and could reflect gaps in the primary healthcare (PHC) setting.

Objectives: To evaluate the epidemiology of OB-GYN ER visits and identify the patterns and predictors of hospital admissions in a referral university hospital in the Eastern Province of Saudi Arabia.

Design: A retrospective, record-based, epidemiological study.

Methods: All OB-GYN ER visits from January to December 2022 were included. Data on patient demographics, triage levels, timing of visits, chief complaints, and admission status were collected. Logistic regression models were used to assess factors associated with hospital admission.

Results: Among 8781 ER visits, the median patient age was 30 years (Interquartile range: 26-36), and 85.30% were Saudi nationals. The majority of visits were triage level IV (71.84%), with only 12.46% resulting in admission. Obstetric complaints (47.44%) were the most common, followed by gastrointestinal and gynecological symptoms. Older age, higher acuity triage levels, the winter season, and visits during night or morning shifts were significantly associated with increased odds of admission. Most presenting complaints had a lower odd of admission when compared to the obstetrics complaints.

Conclusion: The study demonstrates a substantial number of non-urgent OB-GYN ER visits, underscoring gaps in continuity of care. Strengthening PHC services and optimizing referral pathways for women's health may help reduce unnecessary ER utilization and ensure more appropriate use of emergency resources.

Background: Endometrial hyperplasia, a precursor to endometrial cancer, is increasing due to rising obesity and lifestyle risks. Scarce data exist on the molecular characterization of endometrial hyperplasia for prognostic and preventive applications,Objectives:This study investigates the expression of core pluripotency stem cell markers in endometrial hyperplasia, given their emerging role in cancer stem cell regulation in various cancers, including endometrial cancer,Design:This is a case-control study utilizing archival endometrial tissue blocks. In this study, we assessed the immunohistochemical expression of NANOG, OCT4, and SOX2 in hyperplastic endometrium compared to benign non-hyperplastic endometrium obtained from women with abnormal uterine bleeding,Results:The investigation included 165 patients (83 cases with endometrial hyperplasia and 82 controls). The prevalence of endometrial hyperplasia in our cohort was 20.8% (of 500 patients). NANOG showed moderate to high expression in 60.2% of endometrial hyperplasia cases, significantly higher than in controls (19.5%), p < 0.0005. OCT4 showed moderate/high expression in 12% of endometrial hyperplasia cases compared to 3.7% of controls (p = 0.045). In comparison, SOX2 was expressed in 18% of endometrial hyperplasia with no significant difference from controls (19.7%), p = 0.823. Logistic regression showed that age and NANOG expression were significant predictors of endometrial hyperplasia risk, with women exhibiting moderate/high NANOG expression having an 11-fold increased risk of endometrial hyperplasia (95% confidence interval of odds ratio: 3.484-35.864, p < 0.001). Using receiver operating characteristic curves, women's age predicted SOX2 expression in endometrial hyperplasia cases (area under the curve (AUC) = 0.867, cutoff = 49 years, Youden's index = 0.722, sensitivity = 100%, specificity = 72.2%, p < 0.001), and NANOG in controls (AUC = 0.734, cutoff = 42 years, Youden's index = 0.37, sensitivity = 68.8%, specificity = 68.2%, p = 0.004).

Conclusion: NANOG shows promise for a potential predictive role in patients with endometrial hyperplasia, with moderate/high expression indicating a higher risk. SOX2's role was unclear but age-related. Further studies are needed to validate these findings and explore hormonal links.

Background: There has been a surge in female incarceration in the United States in the last decade, and research indicates that women who are incarcerated are among the most likely to experience poor health outcomes. Physical activity is known to improve health and research that has explored women's physical activity in incarcerated settings has been mostly conducted in prisons, with little research in jail populations.

Objectives: This project explores jail staff perceptions of differences in access to physical activity between women and men incarcerated in a US jail to identify potential administrative barriers to providing equitable access to physical activity for those incarcerated.

Design: A qualitative descriptive approach utilizing interviews was used.

Methods: Semi-structured interviews focusing on perceptions of how incarcerated individuals at the coed jail participate in physical activity were conducted with 10 correctional staff at the jail. Interview data were analyzed using a thematic analysis approach in order to extract emergent and prominent themes.

Results: Jail staff unanimously agreed on the value and importance of physical activity during incarceration, but expressed challenges related to providing access to physical activity. Those challenges were organized into three salient themes that have a large impact on access to physical activity while incarcerated in jail: Staffing and Jail Layout, Employment Opportunities for People Incarcerated, and Choices and Motivations of Incarcerated People, all of which were heavily influenced by gender.

Conclusion: Importantly, the themes identified above are contextualized within a gendered organizations and managerial framework for corrections that increases administrative burdens and gender inequality and decreases attention on the health and well-being of those incarcerated as well as those that work within correctional settings.

Black women healthcare workers serve as key drivers of health equity, providing quality care to a population that faces a gamut of concerns regarding (1) patient-provider interactions as well as (2) access to care. As such, it is vital to make sure healthcare is an inclusive field where Black women workers are not overly burdened, or uniquely susceptible to burnout. Here, we present the Heroines of Healthcare Model, which is a conceptual framework developed to better understand the well-being and lived experiences of Black women in healthcare professions. Drawing upon interdisciplinary literature, we combine sociological theory, Historical Womanism with social psychological framework, Superwoman Schema to contextualize Black women's labor, and the overall burden of care work. The Heroines of Healthcare Model not only centers the voices of Black women, but also provides a tool for educators, practitioners, and researchers to develop more inclusive policies, curricula, and wellness strategies. By shifting the narrative from deficit to empowerment, the model affirms the value of Black women's contributions and experiences within healthcare, ultimately promoting equity and systemic transformation.

Background: Sexual violence (SV) is a profound human rights violation and public health issue worldwide, with significant physical, psychological, and financial impacts. It disproportionately affects women and has both immediate and long-term consequences. In higher learning institutions (HLIs), SV remains prevalent, particularly in low- and middle-income countries, where addressing it is challenging due to the lack of context-specific, evidence-based interventions. Generating such interventions first requires robust evidence on the prevalence and associated factors of SV within local settings.

Objectives: This study assessed the prevalence of SV and its contributing factors in Tanzania's HLIs, with the aim of providing insights that can inform the design of context-specific interventions to reduce SV in these settings.

Design: This study employed a quantitative, cross-sectional, analytical design.

Methods: The study was conducted among female nursing students at Muhimbili University of Health and Allied Sciences, a public institution, and Herbert Kairuki Memorial University, a private institution, in Dar es Salaam. Data were collected through a self-administered questionnaire and analyzed using the IBM SPSS version 25. The chi-square test was used to assess associations between sociodemographic factors and SV, followed by multiple logistic regression to identify factors independently associated with SV.

Results: Of the 296 participants, 21 (7.1%) reported experiencing SV since enrollment at the university, with fellow students primarily identified as perpetrators. Reporting of SV and legal actions was very low, with only 9.5% reporting incidents and 4.8% taking legal action. Studying at a public university (adjusted odds ratio: 4.939; 95% confidence interval: 1.611, 15.141; p = 0.005) was a statistically significant factor associated with the experience of SV.

Conclusion: This study revealed notable SV prevalence among female students in the two HLIs, especially the public institution. Underreporting and lack of legal action persist, with students often perpetrators. Urgent institutional interventions are needed to raise awareness, promote reporting, and target perpetrators.

Background: Dysmenorrhoea, a common gynaecological issue in women, is characterised by lower abdominal cramps during menstruation impacting quality of life (QoL).

Objectives: This study evaluates the effectiveness, utilisation and safety of Buscopan^® Plus (hyoscine butylbromide (HBB) Plus: 10 mg HBB + 500 mg paracetamol) for self-treating menstrual pain.

Design: This non-interventional, prospective cohort real-world study included women with menstrual pain registered with Carenity, an online patient platform by Else Care SAS.

Methods: Eligible German patients with the mean (standard deviation) age of 34.0 (8.0) years were enrolled between 15 September 2020 and 15 June 2022 and grouped into primary analysis or safety cohorts. A maximum of one to two tablets (thrice daily) were allowed, limited to 3 g paracetamol per day. Primary outcomes were pain intensity difference by mean change and percentage variation in numeric rating scale (NRS) score, percentage of NRS responders and time to pain relief; safety was a secondary outcome. All parameters were measured at 15 min, 30 min, 1 h, or 4 h following the first HBB Plus intake.

Results: Of 1733 eligible women, 94% provided written consent and completed the baseline questionnaire, 56% met all inclusion criteria, 10% completed all intake assessments (primary analysis cohort) and 33% had ⩾1 dose of HBB Plus (safety cohort). Percent decrease in NRS score from baseline was 11.1%, 29.5%, 42.4%, 53.4% and 65.8% at 15 min, 30 min, 45 min, 1 h and 4 h (p < 0.001 at all-time points), respectively. Overall, 90.8% patients were categorised as responders up to 4 h post HBB Plus intake. Median time to first perceptible pain relief and meaningful pain relief was 30.0 and 37.5 min, respectively. In the safety analysis cohort, five non-serious treatment-emergent adverse events were reported.

Conclusion: HBB Plus effectively reduced menstrual pain within 4 h of treatment and was well-tolerated, providing a viable option for self-management of pain and improving QoL.