BMC Women's Health最新文献

Background: Cervical cancer (CC) causes significant morbidity and mortality in low-and middle-income settings, ranking second commonest female cancer in Ghana, affecting 26.4/100,000 with mortality rate 22.9/100,000 women. Previous studies focused on adults, females and involved smaller sample sizes. This study assessed CC knowledge among secondary school students in Ghana to generate evidence for implementing school-based educational interventions.

Methods: It was a multi-site, cross-sectional study across 14 secondary schools in Greater Accra (GAR) and Central regions(C/R) of Ghana. Self-administered pre-tested questionnaires focused on students' knowledge on causes, risk factors, symptoms, and prevention of CC. Four main domains were covered: general knowledge; cervical cancer features; risk factors; and screening and prevention. Domain scores were categorised into adequate knowledge (>50%) and inadequate knowledge (< 50%). Chi-square was used to test association between knowledge in various domains with participants' gender, school type, and region. P-value below 0.05 was considered statistically significant.

Results: A total of 9,767 students from 14 schools, 25.6% (n=2,280) males and 74.4% (n=6,630) females with mean age 16.9+1.2years participated. Overall, 58.4% of students had adequate general knowledge about CC; 61.1% demonstrated adequate knowledge of risk factors; 21.5% adequate knowledge of features, and 51.8% also had adequate knowledge of screening and prevention. Across all domains tested, 60.6%% of students had inadequate knowledge. More female students(60.9%) had adequate general knowledge than males(50.1%) (p< 0.001).

Conclusion: Significant knowledge gaps exist on risk factors, features, screening and prevention of cervical cancer among senior high school students in Ghana, necessitating targeted educational interventions based on identified gaps.

Objective: This study aims to explore the genetic connection between inflammatory cytokines (IC) and endometriosis (EMs) to provide insights for the treatment of EMs.

Methods: Data from two genome-wide association studies (GWAS) on IC and EMs were analyzed for single nucleotide polymorphisms (SNPs). Both forward and reverse Mendelian randomization (MR) analyses were conducted using inverse variance weighting. In the forward MR analysis, IC-related SNPs were used as instrumental variables with EMs as the outcome. Conversely, in the reverse MR analysis, SNPs associated with EMs were used as instrumental variables with IC as the outcome. Analyses were conducted using the TwoSampleMR package in R.

Results: The forward MR analysis revealed no significant genetic correlation between 51 ICs and EMs (P > 0.05). The reverse MR analysis, however, revealed a significant genetic correlation between EMs and one type of IC (P < 0.05), with no significant correlations for the others (P > 0.05). Notably, specific inflammatory factors varied among different EMs sites (P < 0.05).

Conclusion: Although ICs do not have a genetic influence on EMs, variations in inflammatory factors are observed in EMs patients, especially across different EMs sites. These findings suggest unique inflammatory responses at specific EMs sites.

Background: Cervical cancer (CC) is a significant global health concern, particularly in low- and middle-income countries, where screening participation remains low. This study aimed to compare the effectiveness of two educational interventions, a mobile application-based program (mHealth) and face-to-face training (F2F), in improving knowledge, attitudes, self-efficacy, practices, and Adherence Intention to Pap smear testing among women in Saveh, Iran.

Methods: This study was a parallel-group randomized controlled trial (RCT) conducted between 2023 and 2024. The participants were randomly assigned to three groups: (A) control, (B) F2F training, and (C) mHealth-based education (via the PapTest smartphone app). Data were collected at four time points: baseline (pretest), immediately postintervention, four weeks postintervention, and twelve weeks postintervention. The primary outcomes were measured via two validated instruments: the Cervical Cancer Screening Self-Efficacy Scale and the Self-Efficacy Scale for Pap Smear Screening Participation (SES-PSSP). Statistical analyses, including correlation tests, chi-square tests, ANOVAs, and Kruskal‒Wallis tests were performed via SPSS version 24.

Results: The intervention phase results revealed significant differences over time and across groups in terms of knowledge, attitudes, self-efficacy, and practices (P < 0.05). Notably, knowledge levels differed significantly among the three groups at one month and three months postintervention (P < 0.05). Additionally, practice scores at the three-month follow-up were significantly different across the groups. However, the attitudes and self-efficacy scores were significantly different at baseline, necessitating an adjustment for preintervention variability. Post adjustment analyses confirmed significant within-group and between-group differences in these variables over time. In contrast, Adherence Intention to Pap smear retesting did not significantly differ across the groups at different time points (P > 0.05).

Conclusion: Both mHealth-based education and F2F training significantly improved knowledge, attitudes, self-efficacy, and practices related to Pap smear screening. However, the mobile app intervention demonstrated greater and more sustained improvements than did face-to-face training. Given their accessibility, cost-effectiveness, and scalability, mHealth interventions represent a promising strategy for enhancing cervical cancer screening Adherence Intention. Future research should explore longer follow-up periods and hybrid education models to optimize screening participation and Adherence Intention in diverse populations.

Trial registration: Iranian Clinical Trial Register (IRCT20231130060228N1). Registration date: 2024-02-19, 1402/11/30. URL: https://irct.behdasht.gov.ir/trial/74165.

Background: Attention-Deficit/Hyperactivity Disorder (ADHD) and associated comorbidities in women are poorly recognised and often late diagnosed or misdiagnosed. This has significant negative impacts on the health and wellbeing of girls and women across their lifespan.

Aim: This integrative literature review aims to synthesize existing studies on the impacts of ADHD and associated comorbidities, as well as the challenges of delayed diagnosis and misdiagnosis for women and girls, focussing on critical life stages such as adolescence, perinatal, postnatal and (peri)menopause. Additionally, this review aims to identify evidence-based strategies for improving diagnosis, treatment, and support for this vulnerable population.

Methods: An integrative literature review was conducted using Whittemore and Knafl's framework. Searches were performed in Embase, Cumulative Index for Nursing and Allied Health Literature (CINAHL), PubMed, National Library of Medicine (Medline), Scopus and Google Scholar (March - April 2025). Studies were selected based on defined inclusion and exclusion criteria, focussing on women and girls diagnosed with ADHD and their experience regarding diagnosis, comorbidities and treatment outcomes, were peer-reviewed, and published in English. Data was managed in Covidence and appraised using MMAT and AGREE II.

Results: The review identified and included ten studies (five qualitative, four cohort, one mixed-methods) and one guideline, published between January 2023 - April 2025, revealing five key developmental domains: Childhood and adolescence - late diagnosis and early comorbidities, Adulthood - hormonal impacts and comorbidities, Perinatal period - outcomes and challenges, Menopause and later life - hormonal transitions and late diagnosis, Cross-developmental treatment considerations - evidence gaps and women-specific approaches. Girls and women with ADHD frequently experience delayed diagnosis, leading to heightened risk of anxiety, depression and maladaptive coping strategies. Hormonal fluctuations were found to exacerbate ADHD symptoms, particularly during critical developmental phases such as puberty, the perinatal period, menopause and later life. Highlighting the need for tailored assessment, treatment and care approaches.

Conclusion: The findings highlight the urgent need to improve awareness of specific ADHD presentations in women and girls and better training for healthcare providers, aiming for earlier diagnosis and comprehensive individualised, tailored treatment strategies. Future research should focus on understanding the interplay between ADHD and its comorbidities, as well as exploring sex specific treatment options to improve health outcomes for women with ADHD.

Background: High-risk human papillomavirus (HR-HPV) is the leading cause of cervical cancer. Screening is one of the main cornerstones of cervical cancer prevention. Self-sampling for HR-HPV is introduced to improve patient involvement in the screening program. The study aimed to understand the hesitancy and barriers to self-sampling among high-risk women who are at risk of developing cervical cancer.

Methods: This qualitative study employed semi-structured telephone interviews to explore the factors behind the refusal of HR-HPV self-sampling among twelve purposefully selected women (aged 25-49) with abnormal Pap smears recruited from a colposcopy clinic within a major urban university hospital in Riga, Latvia. The interviews, conducted between June and September 2022, were transcribed verbatim and subjected to inductive content analysis.

Results: Four inductive categories were developed and described: (1) 'Clinic visit-related distress' described patients' situational anxiety, fears, and during the visit to a healthcare facility that resulted in the refusal to take the HR-HPV self-sampling; (2) 'Health literacy challenges' highlighted patients' lack of knowledge and understanding of cervical cancer causation and screening role in the early detection of cervical cancer; (3) 'Doctor does and knows the best' explored patients' doubts and fears about the accuracy and comparability of HR-HPV self-sampling with conventional screening methods; (4) 'Circumstances that can promote taking the HR-HPV self-sampling' illuminated the circumstances that can encourage women to take the HR-HPV self-sampling.

Conclusions: A complex interplay of contextual factors contributed to the hesitancy of HR-HPV self-sampling in the group of women at high risk for cervical cancer, highlighting that women's decision-making regarding this procedure goes beyond its purely clinical aspects.