Women's health (London, England)最新文献

Background: Older Black women experience structural and intersectional disadvantages at the intersection of age, race, and gender. Their disadvantaged social statuses can translate into serious psychological health consequences. One concept that may aid in understanding psychosocial determinants of older Black women's depression risk is the "Strong Black Woman," which suggests that Black women have supernatural strength amidst experiencing adversity and are expected to "be strong" for others by providing self-sacrificial aid without complaint.

Objectives: Drawing inspiration from the "Strong Black Woman" concept, the current study examined whether three psychosocial factors (i.e., mastery, anger suppression, and relational demands (from spouse, children, relatives, and friends)) were associated with depressive symptoms, clinically significant depressive symptoms, and lifetime professionally diagnosed depression among older Black women (i.e., ages 50 years and older).

Design: This was a cross-sectional study. Data were drawn from the 2010 to 2012 waves of the Health and Retirement Study (N = 1,217).

Methods: For past-week depressive symptoms, ordinary least squares regression analyses were conducted, and beta coefficients were reported. For clinically significant depressive symptoms (i.e., reporting three or more depressive symptoms in the past week) and lifetime professionally diagnosed depression, binary logistic regression analyses were performed, and odds ratios were reported.

Results: Higher levels of mastery were associated with lower risk for depressive symptoms and depression. Anger suppression was associated with higher risk for depressive symptoms and depression. Demands from children and one's spouse were associated with higher depressive symptoms while demands from family were associated with risk for lifetime depression diagnosis. Not having a spouse was associated with heightened risk of depressive symptoms and depression. Interestingly, demands from friends were not associated with depressive symptoms nor diagnosed depression.

Conclusion: Study findings revealed important nuances in the determinants of depression among older Black women which, in turn, has implications for research and mental health care provision in this population.

Background: Kidney transplantation is a superior treatment for end-stage renal disease (ESRD), compared with hemodialysis, offering better quality of life and birth outcomes in women with ESRD and lower fertility rates.

Objectives: To investigate the pregnancy, maternal, fetal, and graft outcomes following kidney transplantation in women with ESRD and evaluate the improvements in quality of life and associated risks.

Design: A systematic review and meta-analysis performed according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses and the Meta-analysis of Observational Studies in Epidemiology guidelines.

Data sources and methods: A thorough search of multiple databases, including PubMed, Embase, Scopus, ATC abstracts, and Cochrane Central Register of Controlled Trials, was conducted to identify studies that analyzed pregnancy outcomes in kidney transplant patients. The search was conducted from the inception of each database to January 2023.

Results: The study reviewed 109 studies that evaluated 7708 pregnancies in 5107 women who had undergone renal transplantation. Of these, 78.48% resulted in live births, 9.68% had induced abortion, and 68.67% had a cesarean section. Miscarriage occurred in 12.54%, preeclampsia in 20.87%, pregnancy-induced hypertension in 24.30%, gestational diabetes in 5.08%, and preterm delivery in 45.30% of cases. Of the 853 recipients, 123 had graft loss after pregnancy and 8.06% suffered acute rejection.

Conclusion: Pregnancy after kidney transplantation is associated with risks for mother and fetus; however, live births are still possible. In addition, there are reduced overall risks of stillbirths, miscarriages, neonatal deaths, and gestational diabetes.

Registration: PROSPERO (CRD42024541659).

There is a lack of standardized measurement tools globally to assess knowledge, attitudes, and perceptions of expecting women toward prenatal screening. The purpose of this systematic review was to identify reasons women pursue or decline prenatal screening and compare the strengths and limitations of available measurement tools used to assess pregnant women's perceptions, knowledge, and attitudes toward prenatal screening. This review followed the five-step York methodology by Arksey and O'Malley and incorporated recommendations from the Preferred Reporting Items for Systematic Reviews and Meta-Analysis checklist for the extraction, analysis, and presentation of results. The five steps consisted of: (1) identification of the research questions; (2) searching for relevant studies; (3) selection of studies relevant to the research questions; (4) data charting; and (5) collation, summarization, and reporting of results. Four online databases (PubMed, Embase, Web of Science, and Cochrane Library) were selected after the librarian's development of a detailed search strategy. The Rayyan platform was used between June 2023 and August 2023 to epitomize the articles produced from our search. A total of 68 eligible studies were included in the analysis. The top five major reasons for declining prenatal screening uptake included (1) being unsure of the risk of prenatal screening and harm to the baby or miscarriage (n = 15), (2) not considering action such as termination of pregnancy for prenatal screening to be considered as necessary (n = 14), (3) high cost (n = 12), (4) lack of knowledge about testing procedures and being anxious about the test (n = 10), and (5) being worried about probability of false negative or false positive results (n = 6). Only 32 studies utilized scientifically validated instruments. Difficulties in capturing representative, adequately sized samples inclusive of diverse ethnicities and demographics were pervasive. Findings highlight the need for rigorous validation of research measurement methodologies to ensure the accuracy and applicability of resulting data regarding the assessment of prenatal screening perceptions, knowledge, and attitudes across diverse female populations.Registration: N/A.

Background: Persistent pelvic pain is pain sensed in or around the pelvis and is often associated with negative cognitive, behavioral, sexual, and emotional consequences. The lack of interprofessional persistent pelvic pain management programs that address the complex interplay of biopsychosocial factors result in lengthy wait times and negative health outcomes. Limited access to evidence informed self-management educational resources contributes to poor coping strategies. Evidence shows that self-management education and strategies support patients while they wait for care. However, very few studies explore the patient's lived experience of participating in an online educational program designed for persistent pelvic pain.

Objectives: This study aims to understand the experience of women with persistent pelvic pain participating in an online, self-management education program ("Pelvic Pain Empowered Management" program) while awaiting care at an interprofessional pelvic pain clinic.

Design: A descriptive qualitative approach was used to explore the experiences of women participating in an online educational program designed for cis women with persistent pelvic pain.

Methods: We conducted semi-structured interviews with 11 women, transcribed the data verbatim using NVivo software (NVivo 12, QSR International Pty Ltd.), and analyzed inductively using previously established methods.

Results: We identified four main themes relevant to women's experiences of the program: (1) the program shaped expectations around upcoming pelvic pain appointments, (2) the program content is relevant and resonates with people with lived experience of persistent pelvic pain, (3) the program enhanced understanding of persistent pelvic pain, and (4) the program empowered people with skills and strategies to better manage their persistent pelvic pain.

Conclusion: Our findings highlight how self-directed online patient education can be leveraged while persistent pelvic pain patients wait for care to support them in setting expectations around care and in engaging in pain self-management.

Background: Health-related mobile applications (apps) have the potential to improve health knowledge and promote healthy behaviours during pregnancy. Pregnancy apps are popular and extensively used by consumers.

Objective: This study investigates the usage patterns, decision-making criteria and concerns regarding the quality and credibility of health-related information within pregnancy mobile applications. The aim of this study is to understand consumer perspectives to potentially contribute to guidelines for apps containing health-related information.

Design: A cross-sectional study, utilising an online questionnaire for data collection.

Methods: The study surveyed pregnant women in Australia who were recruited via online platforms, including social media and paid Facebook ads. Participants completed a 29-item questionnaire assessing their use of pregnancy apps, sources of health information and perceptions of app quality and safety, with data collected and analysed using the Qualtrics platform and SPSS Statistics.

Results: The survey was survey completed by 427 current-or-recently pregnant individuals, aged 18 or over and located in Australia. Overall, 62.3% were currently pregnant and 37.7% were recently pregnant, within 6 months. Medical practitioners were the primary source of pregnancy-related health information, and pregnancy apps were the third most common source. Pregnancy apps were considered to be a trustworthy source of information by 63.8% of respondents and the majority used apps during pregnancy (94.2%). Of those who used pregnancy apps (n = 325), information being safe and trustworthy was their top priority when selecting an app. However, 35.5% (n = 115) had encountered information in an app they felt was unsafe or conflicted with previous knowledge or advice. Only 4.6% (n = 15) were aware that health-related apps are not screened for accurate information/undergo quality assurance checks before being made available to download. If provided with a guide to evaluate app quality, 74.6% (n = 241) would utilise the tool.

Conclusions: These findings highlight a need to promote the critical assessment of health information within pregnancy apps and to develop resources to support consumers in doing so.

Breast cancer accounts for one in three new cancer cases in women each year. Despite having a higher survival rate than other cancers, it is associated with various side effects, including anorgasmia, vaginismus, hair loss, and decreased libido. This review aims to explore trends in the incidence of sexual dysfunction in breast cancer survivors, the etiology of sexual dysfunction, and the role of factors such as family history, age, duration of marriage, and depression in predisposing patients. We summarize the limitations of the treatment modalities already used to cater to sexual dysfunction in breast cancer survivors and patients. The authors conducted searches on databases such as PubMed and Google Scholar using relevant search terms: sexual dysfunction, breast cancer, breast cancer survivors, chemotherapy, dyspareunia, vaginismus, and anorgasmia from 1997-2023. The inclusion criteria encompassed all types of articles with abstracts or titles indicating research on sexual dysfunction in breast cancer survivors in Asia. A total of 64 articles were included out of which 10 were systematic reviews and meta-analyses. The literature search yielded results showing high incidence rates of breast cancer in Asia (45.4%), with 31.6%-91.2% of breast cancer survivors likely to experience sexual dysfunction. Regional differences were noted, as female sexual dysfunction occurred in 74.1% of Asian breast cancer women. Further randomized controlled trials should be conducted to assess the effectiveness of treatment modalities. Personalized approaches should be tailored to address beliefs, such as the potential impact of sexual activity on disease recovery. Utilizing a family history of breast cancer as a preemptive tool can help reduce the risk of developing female sexual dysfunction in survivors, and factors such as age and depression should be considered when formulating solutions.

Menstrual health represents an interdisciplinary concern that necessitates a broad, integrated understanding beyond its biological foundations, encompassing social, psychological, and cultural dimensions. This study examines whether the corpus of scientific literature from 1970 to 2023 aligns with this holistic perspective by exploring the evolving paradigms within menstrual health. Grounded in Kuhn's theoretical framework, the research delves into thematic shifts, author collaborations, and international partnerships that have emerged over the decades. Utilizing advanced text-mining methodologies, we analyzed a dataset of 34,854 documents obtained from Institute for Scientific Information Web of Science and PubMed in September 2023. These documents were processed through deduplication and data cleaning to ensure accuracy. The study employs a combination of univariate analyses, correspondence factor analyses, hierarchical cluster analyses, and network analyses to uncover insights into thematic evolution and collaborative dynamics within menstrual health research. Thematic analysis reveals three distinct periods in menstrual health research, depicting evolving paradigms. In the first period (1970-1996), the focus was on reproductive health, infertility treatments, hormonal regulation, and epidemiology. The second period (1997-2017) witnesses a transition, emphasizing menstrual health and social inequalities, gynecological studies, and contraception. The third period (2018-2023) maintains a focus on contraception and reproductive health but introduces a pronounced psychological dimension, emphasizing menstrual disorders, gynecological surgery, and socioeconomic concerns. Collaboration analysis indicates increased connectivity, consolidation of researcher communities, and a shift toward interdisciplinary approaches. While international collaborations demonstrate global commitment, geographical concentration prompts questions about paradigm universality. The study shows the existence and evolution of the menstrual health paradigm. Findings suggest a trajectory toward paradigmatic inscription, marked by heightened collaboration and global commitment. Acknowledging the pivotal role of biological aspects, the study underscores the need for a balanced, holistic understanding of menstrual health. Continued efforts are essential to tailor interventions, foster inclusivity, and honor diverse cultural and psychological realities related to menstruation.

Background: Adolescent girls face numerous challenges which hinder their ability to manage menstruation in a healthy and dignified manner.

Objectives: To examine the menstrual hygiene practices of adolescent girls schooling in rural Anambra communities.

Study design: Cross-sectional descriptive study.

Method: Participants were selected using multistage stratified random sampling technique and interviewed using self-administered semi-structured questionnaire. Data were analysed using Statistical Package for Social Sciences version 22.0.

Results: Mean age of all, pre-menarche and post-menarche girls were 14.7 ± 1.84, 12.8 ± 1.09 and 15.1 ± 1.73 years, respectively. About 46% of the pre-menarche girls had not received any information on menstruation. Common sources of initial menstruation information were mother (87.3%), school (52.2%) and peers (20.0%). Among the 1091 (85.0% (1091/1283)) post-menarche girls, last menstrual period, last menstrual period duration and cycle length could not be recalled by 53.9%, 34.4% and 39.3%, respectively. Majority (98.3%) who could recall last menstrual period had a cycle length of ⩽30 days and the mean duration of menses was 4.4 ± 0.84 days. Disposable sanitary pad was mostly (60%) cited as recommended product, but cloth/rags (40.6%) or tissue paper (32. 3%) were predominantly used. Majority (88.6%) took their bath ⩾twice/day, 50.9% changed sanitary product ⩽twice/day while 72.5% exhibited poor hand washing. Sanitary products were mostly discarded by burning (45.4%). Fifty-one percent could not change in school predominantly due to lack of functional toilets/changing rooms (84.2%) while 72.5% of those who changed did so in bushes or unused spaces. Challenges faced during menstruation include restriction from holy places (38.9%), waist pain (74.9%), blood stains (36.1%) and lack of money to buy pad (27.0%). Factors significantly associated with using commercial pads were age (p = 0.047), class (p = 0.006), mother's educational status (p < 0.001), social class (p < 0.001), ability to recall last menstrual period date (p = 0.029) or duration (p = 0.001).

Conclusion: Menstrual hygiene management was unsatisfactory among studied adolescents. Continuous education of adolescent girls on menstrual hygiene management and advocacy for adequate menstrual hygiene management support are imperative.

Background: An exclusive breastfeeding period is a time when the infant's feeding depends on only breast milk. Inadequate maternal nutrition during this period could lead to insufficient infant feeding, which can further lead to childhood undernutrition and developmental restrictions. Evidently, the burden of maternal undernutrition was higher in resource-limited countries, including Ethiopia.

Objectives: This study aimed to assess the proportion of undernutrition among exclusive breastfeeding mothers and its associated factors in Southwest Ethiopia.

Design: The study used a community-based cross-sectional design.

Methods: The study was conducted among 442 nursing mothers from 10 to 30 June 2022. The participants were selected using multistage sampling techniques. An interviewer-administered structured questionnaire was used to collect information. Statistical software EpiData version 3.1 and SPSS version 20 were used for data entry and analysis, respectively. The factors associated with undernutrition were identified using a binary logistic regression analysis. In the bivariable analysis, a p-value of less than 0.25 was used to include the variable in the multivariable analysis, whereas p-value less than 0.05 was an odds ratio used to declare an independent association at a 95% confidence interval.

Results: The proportion of undernutrition among the participants was found to be 24.8% in the study area. Poor intake of extra meals (adjusted odds ratio = 2.104; 95% confidence interval: 1.208, 3.664), poor dietary diversity habits (adjusted odds ratio = 3.605; 95% confidence interval: 2.112, 6.153), a lack of nutrition information (adjusted odds ratio = 1.853; 95% confidence interval: 1.070, 3.212), and household food insecurity (adjusted odds ratio = 4.424; 95% confidence interval: 2.639, 7.417) were identified as factors enhancing undernutrition among exclusive breastfeeding mothers in the area.

Conclusion: A quarter of exclusive breastfeeding mothers were undernourished in the area. Poor dietary diversity habits, poor intake of extra meals, a lack of nutrition information, and household food insecurity were found to be the factors determining undernutrition. Hence, it is important to reinforce nutrition intervention programs, including maternal nutrition education and counseling.