BMC Women's Health最新文献

Purpose: Women with breast cancer face a high degree of uncertainty. Trust between health providers and patients has been shown to improve patient quality of life and may enhance clinical outcomes. This study aimed to explore the meaning of trust along the treatment pathway.

Methods: The study followed a convergent mixed-methods design. We collected qualitative data longitudinally from diagnosis to follow-up using unstructured digital diaries and 45 semi-structured interviews with twelve women with breast cancer. To measure symptom burden and trust, we collected quantitative data by means of 57 questionnaires. Data analysis was based on phenomenology according to van Manen and on descriptive statistics. Data synthesis resulted in a conceptual model of trust.

Results: The women experienced trust as a dynamic phenomenon within the biomedical cancer care "machinery". Their trust was strongly influenced by contextual factors, professionals' expertise, and person-centeredness. The relevance of trust differed according to treatment phases.

Conclusions: Due to a high degree of uncertainty, trust was particularly important. Professionals positively influenced the women's trust to a certain extent through a patient-centered approach and by demonstrating expertise within the biomedical cancer care "machinery". The conceptual model of trust should receive attention to bring care closer to the women's lived experience so that their care experience can be improved.

Background: Intimate partner violence (IPV) is a pervasive issue across Sub-Saharan Africa and other developing countries, including Somalia. Understanding the prevalence and drivers of IPV against women is crucial for effective prevention and intervention efforts. However, limited research has focused on identifying these determinants specifically in the Somali context.

Purpose: This study aims to identify the prevalence and key determinants of IPV in Somalia, including age groups, administrative regions, place of residence, educational level, household size, husband/partner's education and work, respondent's work, and total children ever born.

Methods: Data from the Somali Demographic and Health Survey (SDHS) 2020 were analyzed. Univariate analysis, bivariate analysis and multivariable logistic regression models were used to assess the associations between the identified determinants and IPV.

Results: The study found significant associations between several factors and IPV. Age, region of residence, type of residence, educational level, husband/partner's education and work, respondent's work, and total children ever born were identified as significant determinants of IPV in Somalia. Younger age groups, rural residence, lower educational attainment, unemployment of the husband/partner and respondent, and larger household size were associated with an increased risk of IPV.

Conclusion and recommendations: The findings highlight the importance of addressing socio-demographic factors to effectively combat IPV in Somalia. Based on the results, recommendations include implementing comprehensive educational programs promoting gender equality and challenging traditional norms, enhancing economic opportunities for women and men, tailoring interventions to address regional disparities, strengthening the legal framework, and improving support services for IPV survivors. Future research should focus on longitudinal studies, qualitative research, intervention evaluation, multi-sectoral collaboration, and the impact of IPV on children. By addressing these recommendations and conducting further research, stakeholders can work towards preventing and reducing IPV in Somalia and other similar contexts.

Background: The etiology of depression involves many biological and environmental factors, among which the inflammatory process is an important contributor. However, the role of pro-inflammatory cytokines in postmenopausal depression is unclear. Therefore, we aimed to explore the association between the serum concentrations of four pro-inflammatory cytokines (IL-1β, IL-6, IL-18, and TNF-α) and depressive symptoms in postmenopausal women who had been receiving menopause hormone therapy (MHT) for at least 6 months and postmenopausal women who had not received MHT.

Methods: This study included a total of 136 Chinese postmenopausal women aged 40 to 65 years who visited the gynecology outpatient department between June 2020 and December 2022. They were divided into the POST group (n = 94) and the POST + MHT (n = 42) group. Demographic information was collected, and the Hamilton Rating Scale for Depression (HAMD) was used to assess depression. The circulating levels of IL-1β, IL-6, IL-18, and TNF-α were determined using ELISA kits.

Results: According to the HAMD score, 39.36% of the participants in the POST group and 14.29% in the POST + MHT group were considered to have depression. The POST + MHT group had significantly lower serum concentrations of IL-18 and TNF-α than the POST group. Multiple linear regression analysis showed that the serum IL-18 (β = 3.996, 95% CI = 0.508-7.484), and TNF-α levels (β = 4.784, 95% CI = 0.939-8.629) were significant predictors of the HAMD-24 scores in women in the POST group. In addition, age was found to be positively related with the level of depression (β = 0.531, 95% CI = 0.063-0.999).

Conclusions: Postmenopausal women who received MHT had a lower HAMD-24 score as well as lower serum TNF-α and IL-18 levels than women who did not receive MHT. Further, the TNF-α and IL-18 level were positively associated with the HAMD-24 score in women who had not received MHT.

Background: This study aimed to investigate the relationship between family care, anxiety, depression, and sleep quality in perimenopausal women. Furthermore, it also aimed to examine the role of anxiety and depression in mediating family care and sleep quality. The study findings aim to provide theoretical support for alleviating anxiety and depression levels and improving sleep quality in perimenopausal women.

Methods: Perimenopausal women (n = 860) in Gansu Province were surveyed using the self-rating scale of sleep, self-rating anxiety scale, self-rating depression scale, and family adaptation partnership growth affection resolve.

Results: The sleep quality, anxiety, and depression scores of the perimenopausal women in Gansu Province were 25.33 ± 5.00, 40.74 ± 10.89, and 40.77 ± 10.03, respectively, and the family care score was 6.64 ± 2.36. Family care was negatively correlated with sleep quality, anxiety, and depression scores; anxiety was positively correlated with depression and sleep quality scores, and depression was positively correlated with sleep quality scores. Anxiety and depression in perimenopausal women partially mediated family care and sleep quality, with mediating effects accounting for 15.74% and 60.69% of the total effect, respectively.

Conclusion: Anxiety and depression are mediating variables between family care and sleep quality in perimenopausal women. It is recommended that hospital and community staff pay attention to the role of good family care in perimenopausal women, actively implement intervention strategies aimed at reducing anxiety and depression pathways, and improve their sleep quality.

Background: Preconception care is expected to prevent diseases, promote health, and improve pregnancy outcomes. Although a consensus exists on the efficacy of folic acid supplementation and preconception vaccination, evidence regarding comprehensive approaches to preconception care targeting the general population remains lacking. We aimed to identify and examine preconception care programs delivered to reproductive-aged women and men to promote behavioral change.

Methods: We searched the MEDLINE, EMBASE, and CENTRAL databases on November 30, 2023. We included randomized controlled trials (RCTs) and cluster RCTs assessing preconception care programs provided to the general population. We included behavioral change interventions, including screening, counseling, and education, to encourage preconception health. We performed a narrative synthesis of the characteristics and a summary of the intervention effects of the included studies.

Results: We identified 26 trials (from 29 reports). Most of the studies recruited women. The most common study setting was healthcare services, and various types of behavioral change interventions were noted. All types of interventions, including individual education, group education, online education, and information campaigns, exhibited certain effects of improvement regarding behavioral change, knowledge, health outcomes, and other health-related outcomes in preconception health.

Conclusions: In this systematic review, only three studies recruited men. Further research on preconception care in men is needed. The topics typically addressed in preconception care are folic acid supplementation and nutrition. Additionally, further research is needed for a comprehensive approach, including physical, mental, and social health. Future research addressing the broad determinants of preconception health for both women and men could provide more effective preconception care.

Background: Women are disproportionately affected by disasters due to their vulnerability and limited access to resources. The purpose of this study is to investigate the health concerns and experiences of women who relocated to a different city following the February 2023 earthquake in Turkey.

Methods: Data was collected using a constructivist qualitative research design. Between May 1 and July 1 2023, interviews were conducted with female participants who relocated to a different city after the February 2023 earthquake in Turkey. The collected data underwent qualitative content analysis, adhering to the Standards for Qualitative Research Reporting (SRQR). The study utilized Graneheim and Lundman's content analysis method to analyze the interview data. Interviews were transcribed. The transcripts were analyzed in the qualitative research software package ATLAS.ti 9.

Results: In the study, 32 women aged 19-43 years were interviewed. The results revealed four distinct categories and 10 sub-categories derived from the interviewees' narratives. These four categories were physiological needs, safety concerns, need for love and belonging, and self-realization.

Conclusions: It was concluded that individuals who experience disasters face multiple hardships, especially related to these categories. Therefore, it is crucial to focus on the issues and requirements of survivors, particularly women belonging to vulnerable groups. One should not overlook the fundamental needs of women in service delivery.

Background: Cervical cancer is the most prevalent cancer in Mozambique, with endocervical adenocarcinoma accounting for approximately 5.5% of cases. Knowledge regarding the most prevalent HPV genotypes in endocervical adenocarcinoma is limited, within this setting. This study aimed to investigate human papillomavirus (HPV) prevalence and genotypes within a cohort of endocervical adenocarcinoma patients in the context of Mozambique's recently introduced vaccination programme, considering the country's HIV-endemic setting.

Methods: Forty consecutive cases of endocervical adenocarcinoma diagnosed at Maputo Central Hospital between 2017 and 2018, with limited clinical data available, were included. Human immunodeficiency virus (HIV) status was determined through serological data or in situ hybridisation on histopathological slides. HPV detection was performed using a multi-methodological approach, including Anyplex II, in-house polymerase chain reaction (PCR), and chromogenic and fluorescent in situ hybridisation techniques.

Results: All 40 cases exhibited HPV-dependent morphology. Fourteen of the 40 patients were HIV-positive. No significant differences were observed between the two groups regarding age, stage, or histopathological type. hrHPV16, 18, or 45 were detected in all cases. Notably, multiple hrHPV infections were identified exclusively in HIV-negative cases (10/26, p = 0.0075), with hrHPV18/45 co-infection being the most common (n = 8).

Conclusions: These findings suggest that the newly implemented quadrivalent vaccination programme has the potential to prevent morbidity and mortality from endocervical adenocarcinoma, irrespective of HIV infection status, in Mozambique's HIV-endemic environment.

Background: Chronic pelvic pain is a common yet undertreated condition that significantly impacts quality of life for women worldwide. Digital exercise therapy designed to target pelvic pain can improve symptomology while reducing time and cost-related barriers to in-person clinical care.

Methods: This longitudinal, observational study of a digital women's pelvic health program examined pelvic pain, anxiety, and depression at 4 and 12 weeks in female adults experiencing chronic pelvic pain. Intervention participants received a digital pelvic health program including personalized exercise therapy sessions, health education articles, and health coaching. A comparison group of nonparticipants received a series of education articles related to pelvic health. Data were collected at baseline, 4 and 12 weeks. Unadjusted and adjusted linear mixed effects models were conducted to model changes in clinical outcomes over time.

Results: A total of 797 participants (intervention: 495, nonparticipants: 302) were included in the sample. Baseline mean (SD) age was 41.5 (11.7) years and mean pain was 45.7 (18.5) out of 100. Compared to baseline, the intervention group showed significantly more pain improvement at 4 and 12 weeks versus nonparticipants after adjusting for baseline factors. The intervention group's pain scores decreased by 44.5% at 4 weeks and 53.6% at 12 weeks. The intervention group's adjusted pain scores decreased from 42.0 (95% CI: [39.4, 44.7]) at baseline to 23.3 (95% CI: [20.5, 26.2]) at 4 weeks to 19.5 (95% CI: [16.7, 22.4]) at 12 weeks. In contrast, nonparticipants' pain scores decreased by 21.6% at 4 weeks and 32.7% at 12 weeks. Nonparticipants' adjusted pain scores decreased from 42.1 (95% CI: [38.4, 45.9]) at baseline to 33.0 (95% CI: [29.2, 36.8]) at 4 weeks to 28.3 (95% CI: [24.5, 32.2]) at 12 weeks. After adjustments, the probability of the intervention group screening for moderate or severe depression was significantly lower by 11.0% at 12 weeks versus nonparticipants. There were no significant differences in anxiety outcomes between groups at baseline, week 4, or week 12.  CONCLUSIONS: A digital women's pelvic health program may help reduce short-term pelvic pain and depression symptoms.

Trial registration: The WIRB-Copernicus Group Institutional Review Board (registration number IRB20234932) approved this study on November 6, 2023.

Background: Menstrual poverty remains a significant health problem among female learners in Zambia, particularly due to the lack of access to menstrual products, leading to the use of unsafe alternatives and potential health risks such as reproductive tract infections. To address this pressing issue, this study examined the disparities in knowledge, attitudes, and practices concerning menstrual poverty among female learners in both urban and rural government schools within Zambia.

Methods: The study utilized a mixed-method sequential explanatory design, combining quantitative and qualitative approaches. A cross-sectional survey of 447 female learners was conducted in urban and rural areas using a multistage stratified sampling approach. Quantitative data were analysed using descriptive and bivariate techniques in Stata version 14.2. The qualitative arm consisted of focus group discussions and key informant interviews, with thematic analysis applied.

Results: The findings revealed that urban female learners possessed a more comprehensive understanding of menstruation than their rural peers, with a significantly higher proportion accurately defining the process (74% vs. 50%). Notably, both urban and rural learners experienced a spectrum of emotional responses to menarche, with fear and discomfort common among learners in both urban and rural settings, while support-seeking behaviours and cultural beliefs varied geographically. Rural learners commonly turned to herbal remedies for menstrual management (30% vs. 21%, p = 0.007). Furthermore, over 50% of urban and rural leaners reported dissatisfaction with the sanitary facilities, citing concerns such as cleanliness, privacy, and inadequate handwashing amenities.

Conclusion: This study reveals significant disparities in menstrual knowledge, practices, and attitudes between urban and rural female learners. Government funding is imperative to implement comprehensive menstrual health education in all public schools to create a supportive environment for menstruating learners. Collaboration with the Ministry of Health is crucial to ensure access to essential resources, including pain relief and gender-sensitive facilities.

Background: Sexual self-care and quality of sexual life are critical factors in women's health. These factors can also influence women's fertility desire. This study aims to examine sexual self-care, quality of sexual life, and their relationship with fertility desire in women attending comprehensive health centers in Urmia.

Methods: This descriptive-analytical study was conducted on 384 women which were randomly selected using a multistage sampling method. Data were collected using standard validity and reliability questionnaires of sexual self-care, quality of sexual life and fertility desire. Data were analyzed using one-way ANOVA, independent t-test, and multiple regression.

Results: The average age of the participants was 32.92 ± 8.03 years. Women's education level and economic status were significantly associated with fertility desire (P < 0.05). Additionally, sexual self-care (B = 0.490,p < 0.001) and the quality of sexual life (B = 0.232,p < 0.001) were strong predictors of fertility desire. Together, they accounted for 92.8% of the variance in total fertility desire scores.

Conclusion: Sexual self-care and the quality of women's sexual life are directly related to the fertility desire. Therefore, Participating in training workshops on body anatomy, menstrual cycle and sexual self-care techniques, providing private counseling sessions to investigate sexual concerns and problems, and providing suitable solutions will help women's fertility desire.