BMC Women's Health最新文献

Background: Postoperative pain is a persistent challenge in gynecological surgery, influenced by psychological and clinical factors. Surgical anxiety, a critical preoperative psychological state, is shaped by underlying psychological conditions that can affect pain experiences during recovery. This study aimed to explore the psychological factors contributing to surgical anxiety and their interaction with postoperative pain outcomes, focusing on anxiety, psychological distress, and general gynecological status.

Methods: A cross-sectional study was conducted with 114 women undergoing gynecological surgery at a tertiary care hospital. Data collection included demographic and clinical characteristics, along with psychological assessments using the surgical anxiety questionnaire, Kessler psychological distress scale, and general health questionnaire-12. Postoperative pain was evaluated using the American Pain Society Patient Outcome Questionnaire-Revised and the Postoperative Pain Assessment Tool-Day 1/7. Statistical analyses involved correlation tests, group comparisons, and structural equation modeling (SEM).

Results: Psychological distress and general health were significant predictors of surgical anxiety. Higher levels of surgical anxiety were associated with increased psychosocial impacts on postoperative pain, particularly in activity interference and self-care. SEM analysis revealed moderate indirect effects of surgical anxiety on pain outcomes through psychological distress, while direct effects on pain were minimal.

Conclusions: Preoperative assessments of psychological distress and general health are essential for understanding surgical anxiety and its nuanced impact on postoperative pain. Tailored pain management strategies that address both psychological and clinical factors may enhance recovery and patient satisfaction following gynecological surgery.

Background: This study aimed to evaluate the efficacy and safety of docetaxel plus capecitabine (TX) and docetaxel plus epirubicin (TE) in the treatment of human epidermal growth factor 2 (HER2)-negative breast cancer.

Methods: Relevant studies assessing the efficacy and safety of TX versus TE were systematically searched from PubMed, Cochrane Library, Embase, and Web of Science databases until February 6, 2025. Progression-free survival (PFS), and clinical response, including the overall response rate (ORR), disease control rate (DCR), and grade 3/4 adverse events were compared.

Results: Four articles with moderate methodological quality were included. The pooled results revealed no significant differences in PFS (hazard ratio [HR] (95% confidence interval CI) = 0.86 (0.70, 1.05), P = 0.14), ORR (risk ratio [RR] (95%CI) = 1.02 (0.92, 1.14), P = 0.71), or DCR (RR (95%CI) = 1.02 (0.92, 1.14), P = 0.71) between the TX and TE groups. For grade 3/4 adverse events, only the combined results for neutropenia (RR (95%CI), 0.71 (0.52, 0.95); P = 0.02) and hand-foot syndrome (RR (95%CI) = 14.36 (3.45, 59.84); P = 0.0003) demonstrated significant differences between the two groups. No significant differences were observed in other adverse events, including febrile neutropenia, anemia, thrombocytopenia, nail/hair toxicity, hepatic toxicity, diarrhea, nausea, vomiting, infection, asthenia, and neuropathy.

Conclusion: In patients with HER2-negative breast cancer, TX and TE have comparable survival benefits and efficacy. However, TX exhibits a reduced incidence of neutropenia, but a higher likelihood of hand-foot syndrome than that observed in TE.

Background: Skin diseases are a category of chronic conditions that often impact patients' appearance, potentially leading to psychological issues, including sexual dysfunction. The present study is an attempt to determine the global prevalence of female sexual dysfunction (FSD) in women with skin diseases.

Methods: For this systematic review and meta-analysis, databases including PubMed, Web of Science, Scopus, Science Direct, Embase, and Google Scholar were systematically searched for relevant studies. All published research up to April 2024 imported into EndNote for further analysis. A random-effects model was applied for the analysis, and the I² statistic was used to assess study heterogeneity.

Results: Analysis of 24 studies (45 datasets) indicated that the overall prevalence of FSD in women with skin diseases was estimated at 61.3% (95% CI: 53.9-68.2%). Additionally, subgroup analysis based on skin disease type revealed an FSD prevalence of 69.8% (95% CI: 56.7-80.2%) in women with vitiligo, 59.2% (95% CI: 49.1-68.5%) in those with psoriasis, and 56.5% (95% CI: 47.8-64.8%) in women with hidradenitis suppurativa.

Conclusion: There was a high prevalence of FSD in women with skin diseases. There is a need for policy makers and healthcare providers to prioritize the well-being of these patients.

Background: Pregnancy/puerperium cranial venous sinus thrombosis (CVST) is rare, mainly occurring in perinatal/late pregnancy, and less frequently in early pregnancy. None has been reported after early spontaneous abortion.

Case report: This study reports a case of CVST following early pregnancy spontaneous abortion in a patient with no known risk factors such as hypertension, diabetes, coagulopathy, or antiphospholipid syndrome. Following aggressive endovascular thrombectomy and thrombolytic treatment with 300,000 units of urokinase administered through a catheter, the patient experienced marked improvement in headache symptoms, with nausea and vomiting completely resolving. Four days later, a repeat magnetic resonance venography scan demonstrated successful recanalization of the intracranial venous sinuses, accompanied by a notable decrease in D-dimer levels upon reassessment.

Conclusion: For young patients with early pregnancy bleeding, comprehensive coagulation function and D-dimer tests could be conducted. Even after a spontaneous abortion, if the patient presents with symptoms such as headache, vomiting, or visual impairment, the possibility of pregnancy-associated CVST should be considered, and an immediate head CT or MRI should be arranged. In cases complicated by cerebral hemorrhage, endovascular thrombectomy and thrombolysis can be performed.

Background: Perceived health status (PHS) can be influenced by mental health. A negative correlation between high levels of depression and self-evaluation of health has been reported, but research focusing on depression as a risk factor for poor PHS has been limited in Asia. This study aimed to analyse the association between depression and PHS in Korean adult women and explore the degree of depression's association on poor PHS.

Methods: We conducted a cross-sectional study for adult women in Korea using data from the Korean National Health and Nutrition Examination Survey from 2014, 2016, 2018, 2020 and 2022. Depression was assessed using the nine-item Patient Health Questionnaire, and PHS was evaluated through a self-report questionnaire. Multivariate logistic regression analyses were used to identify the association between depression and PHS after adjusting for various covariates.

Results: A total of 15,082 Korean adult women were included. A significant inverse relationship was found between depression and PHS across all adjusted models, with an odds ratio of 3.18 (95% confidence interval 2.37-4.27; P < 0.01). Poor PHS had a stronger association with depression than with chronic diseases such as hypertension, diabetes, and dyslipidemia.

Conclusions: Depression was strongly associated with poor PHS among Korean adult women. These findings highlight the importance of the implementation of mental health policies and programs to improve PHS. Future longitudinal studies are required to further validate these findings and explore causal relationships.

Objective: Menopause is a significant period in a woman's life that can be natural or surgical. We aimed to assess the association between the type of menopause and sleep quality, especially in elderly women.

Method: This was a cross-sectional study using data from the first phase of the Ardakan Cohort Study on Ageing (ACSA) of 50 and above years of menopausal women, distributed into two groups of natural and surgical menopause. Three questionnaires were used to assess sleep quality, including Pittsburgh Sleep Quality Index (PSQI), Berlin questionnaire, and Epworth Sleepiness Scale. Multiple regression models were used to assess the association between the type of menopause and sleep quality. P-value less than 0.05 was considered significant.

Results: In total, 2,532 menopausal and postmenopausal women were included in the study, of which 669 (26.4%) had surgical menopause. The mean of the PSQI score for participants with surgical menopause was 9.29±4.30 compared to 8.78±4.10 for participants with natural menopause (P-value = 0.001). 37.1% of participants with natural menopause had sleep-disordered breathing according to the Berlin questionnaire despite 43.9% among participants with surgical menopause (P-value = 0.007). The multivariable regression models showed that surgical menopause was not significantly associated with the PSQI score differences, Epworth score, or Berlin score compared to natural menopause (OR:0.89, 1.13, and 0.85; CI 95%: 0.13-1.19, 0.68-1.86, and 0.68-1.07 respectively).

Conclusion: The findings suggest that the type of menopause is not associated with sleep quality. However, further studies employing objective sleep assessments are necessary to validate these results and guide clinicians and individuals in refraining from prioritizing the type of menopause as a significant risk factor for poor sleep quality.

Background: Inconsistent provision of subcutaneous depot medroxyprogesterone acetate (DMPA-SC) for self-injection (SI) undermines efforts to improve women's reproductive health agency and access to self-care. In Nigeria, providers feel pro-social responsibility as frontline health workers to support their clients' wellbeing. However, their pronatalist beliefs censure premarital sexual activity and inhibit access to contraceptives for young, unmarried women. How pro-social tendencies and provider biases interact to affect service delivery is a critical but underexplored question.

Methods: We conducted a mixed-methods study comparing stated pro-social tendencies and intentions to dispense DMPA-SC for SI (N = 81 in-depth interviews (IDIs)) with actual dispensing behavior during mystery client (MC) visits (N = 162 post-interaction surveys) across private and public facilities in Lagos, Enugu and Plateau. Qualitative analysis of providers' pro-social tendencies, biases, and reasons for not offering DMPA-SC for SI complemented quantitative analysis exploring the associations between pro-social tendencies and dispensing behavior.

Results: Providers showed substantial levels of both pro-social tendencies and bias against young, unmarried women. High levels of stated intentions to dispense in IDIs (91% to older, married women vs 78% to young, unmarried women) did not translate to actual willingness to dispense in MC visits (30% to older, married women vs 27% to young, unmarried women). Young, unmarried actors were twice as likely to perceive differential treatment from providers (33%) relative to older, married women actors (17%). From IDIs, providers expressed biases about the appropriateness of family planning and SI specifically based on a client's age, marital status, parity, and covert use. In some cases, pro-social tendencies reinforced bias when providers sought to uphold social norms as a gatekeeper; in other cases, pro-social tendencies on self-defined client needs helped overcome bias. Providers described other factors that deterred them from dispensing DMPA-SC for SI, including elements of self-care that posed risks to their practice or business.

Conclusions: Provider biases may limit provision of DMPA-SC for SI, which could affect contraceptive equity and women's control over their own fertility, especially for younger, unmarried women. Targeted interventions that effectively address provider biases against young, unmarried women, potentially leveraging providers' underlying pro-social tendencies, may help ensure equity in client access to contraceptive self-care.

Background: During the gynecological examination, women especially feel uncomfortable with the lithotomy position and experience shame and anxiety. This study aims to explore metaphors used by women who have experienced gynecological examinations.

Methods: This study is qualitative and phenomenological. The study group consisted of 90 women. Data were collected online using a data form in May-June 2021. It consisted of the sociodemographic characteristics of women and their metaphorical perceptions of gynecological examination. Data were analyzed and interpreted using a metaphorical analytical method inspired by Kochis and Gillespie. Metaphoric linguistic expressions, sequences, words, and sentences related to each other, were highlighted. The Consolidated criteria for Reporting Qualitative research (COREQ) checklist was used in the study report.

Results: The average age of the women was 37.29 ± 10.14, and 73.0% were high school graduates. Three different conceptual categories were created by associating each metaphor image with a certain theme concerning women's perspective on gynecological examination. The characteristics compiled during the category development phase were used to collect 24 metaphors under a specific category. The metaphor revealed that the process, instrument (examination table), and affective aspects of the gynecological examination are in interaction. In this study was found that the main metaphor image for the gynecological table was a "fork," the gynecological examination brought to mind "the pregnancy" because of the reason for the procedure, and most of the women used the metaphors of "ache/pain" for their gynecological examination experience.

Conclusions: The metaphors used for the gynecological examination expressions suggested that women's experiences were negative. Such metaphors may reflect physical and emotional discomfort experienced during the examination. Health professionals' understanding of these negative perceptions and their empathy may facilitate positive experiences for women and the detection and treatment of health problems.

Background: Breast cancer incidence is increasing among South Asian women in the United States (US). This qualitative study explored breast cancer beliefs, behaviors, and experiences among South Asian immigrant women in New Jersey (NJ).

Methods: We conducted four online focus groups with South Asian women from NJ, aged ≥ 25 years with no prior history of cancer, in English, between June 2021 and July 2022. Thematic content analysis was guided by the Social Contextual Framework.

Results: We recruited 22 participants, average age 52 (standard deviation (SD) = 8.4) years, all born in South Asia, and living in the US for an average of 26 (SD = 11.7) years. Low perceived individual risk of breast cancer was influenced by no family history and healthy lifestyles. Despite diet changes since immigrating and misconceptions held by some, women understood the benefits of mammography. Interpersonal and cultural barriers included family responsibilities and norms deprioritizing women's health and health-seeking behaviors. Access to care may be limited by structural factors including immigration status, insurance, and language barriers. Social norms regarding stigma, modesty, and self-disclosure may vary by generation and context.

Conclusions: Despite low perceived breast cancer risk and some cultural and structural barriers to screening, South Asian immigrant women generally understood mammography's early detection benefits. Culturally appropriate interventions leveraging family ties and social networks are needed to dispel misconceptions, promote health-seeking behaviors, and address structural barriers.

Background: Despite widespread use, many Lebanese women have limited understanding of oral contraceptive pills (OCP), with misinformation and cultural barriers contributing to misuse and discontinuation. Additionally, the non-contraceptive benefits of OCP are often overlooked. Addressing these gaps can promote safer use and improve women's health. This study aims to explore Lebanese women's knowledge, attitudes, and practices regarding OCP and identify associated factors.

Methods: A cross-sectional study was conducted using a structured questionnaire among Lebanese women aged between 18- and 49-years old shopping in local pharmacies. Multivariable analyses were employed to investigate the factors associated with knowledge, attitude, practices toward OCP usage.

Results: A total of 384 women participated in the study, with 36.9% reporting ever using OCP. The mean knowledge score was 4.8 (SD = 1.5) out of 13, revealing notable knowledge gaps regarding OCP. Profession (medical employment), age, monthly family income, and OCP usage were all associated with knowledge, with profession showing the strongest association (β = 0.329, p < 0.001). Meanwhile, the mean attitude score was 3.8 (SD = 0.5) out of 6, suggesting an overall positive attitude towards OCP. Educational level (college/university vs. secondary or vocational or below, unstandardized β of 0.11, standardized β of 0.119, 95% CI of 0.01-0.21, P-value = 0.032) was associated with attitude. Additionally, age (AOR 1.05, 95% CI: 1.02-1.09), knowledge (AOR 1.20, 95% CI: 1.07-1.33), and monthly family income (>$2000 vs. $1,000, AOR = 0.46, 95% CI 0.24-0.91) emerged as significant factors associated with OCP usage.

Conclusion: The study revealed gaps in Lebanese women's knowledge, attitude, and practices toward OCP, underscoring the need for accurate, patient-centered information. Providing this information in the context of decision-making empowers women to make informed contraceptive choices that align with their health needs and personal preferences.