BMC Women's Health最新文献

Background: Syrian refugee women in Lebanon face significant barriers to accessing family planning (FP) due to cultural norms, financial constraints, and disrupted healthcare systems.

Objectives: This study aimed to assess the knowledge, attitudes, and practices related to FP and contraception among these women.

Methods: A survey of 790 married Syrian refugee women (aged 18-50) was conducted between November 2023 and March 2024 across four Lebanese governorates. Participants were selected through stratified cluster sampling with household-level convenience sampling. Data on knowledge, attitudes, and practices regarding FP and contraception were collected through structured face-to-face interviews.

Results: The mean age of participants was 31.86 ± 8.09 years, with most showing moderate knowledge of FP (mean score: 8.08 ± 2.11). Younger women, recent arrivals, and those with lower education had lower knowledge levels. Misconceptions about oral contraceptive pills (OCPs) were widespread. Overall, 67.1% of women reported using contraception, with withdrawal (33.2%), intrauterine devices (30.4%), and OCPs (19.8%) being the most common methods. Attitudes were influenced by patriarchal norms, with male approval playing a key role in decision-making. Positive attitudes were more common among women with higher education and employment status.

Conclusion: Syrian refugee women in Lebanon face multiple barriers to effective FP use, including cultural misconceptions and limited autonomy in reproductive decisions. Educational interventions, alongside efforts to involve men in FP discussions, are essential to improve reproductive health outcomes and contribute to sustainable development efforts in Lebanon.

Introduction: The number of postmenopausal women is expected to grow dramatically in the coming decades in Iran. Adopting a health-promoting lifestyle (HPL) is essential for improving health and quality of life of this population. This study pursues two objectives: (1) to assess the HPL levels among Iranian postmenopausal women and (2) to investigate the socio-demographic and psychological variables including self-efficacy and self-esteem associated with HPL.

Methods: In this cross-sectional study with correlational design, 400 married postmenopausal women in Shiraz (southwestern Iran) were selected via stratified random sampling. The data collection tools were the Health-Promoting Lifestyle Profile-II (HPLP-II), General Self-Efficacy Scale (GSE), the Rosenberg Self-Esteem Scale, and a sociodemographic information questionnaire. Pearson's correlation coefficient test, independent samples t-tests, and stepwise multiple linear regression were used for analyzing the data in SPSS v. 22.

Results: The average age of natural menopause among participants was 49.33 ± 3.43 years, and they had relatively good HPLP (136.52 ± 21.46). The results highlighted that among all the HPLP subscales, the highest mean score was observed for health responsibility (33.62 ± 6.98), whereas the lowest scores were observed for stress management (12.26 ± 3.13) and physical activity (17.64 ± 6.52). Both self-efficacy (r = 0.445, p < 0.01) and self-esteem (r = 0.425, p < 0.01) demonstrated significant, moderate positive correlations with the total HPL score. Also, there was a significant association between the total HPLP score and two demographic variables: women's education (r = 0.17, p < 0.01) and husband's educational level (r = 0.113, p < 0.05). In addition, the HPLP total score had a significant negative relationship with the number of children (r=-0.114, p < 0.05). The stepwise multiple linear regression analysis revealed that the variables independently associated with the HPL of participants were self-efficacy (β = 0.32, p < 0.001), self-esteem (β = 0.27, p < 0.001), and occupation (β = 0.144, p < 0.001).

Conclusion: It is suggested that health care professionals implement comprehensive planning to enhance the HPL of postmenopausal women. Interventions aimed at improving HPL in this population should prioritize strategies to enhance self-efficacy and self-esteem. Particular attention should be paid to women with lower education, unemployment, and a higher number of children.

Background: Sexual assault (SA) is a pervasive global health problem with long-term psychological and physical consequences. While the mental health effects of SA are well documented, growing evidence suggests that SA may increase cancer vulnerability through biological, behavioural, and healthcare-access mechanisms.

Objective: To examine the relationship between SA and cancer-related outcomes with a focus on behavioural and infection-related mechanisms reported in empirical studies.

Methods: A scoping review was conducted of studies published between 2000 and 2025 in PubMed. Eligible studies reported cancer outcomes among SA survivors. Data were extracted on study design, population characteristics, and effect measures. This scoping review followed PRISMA-ScR reporting guidance.

Results: Twelve studies met inclusion criteria. Survivors demonstrated lower participation in cervical and breast cancer screening (reductions of 20-40%), higher cancer-related infection rates (relative risk 1.13-1.9), and greater odds of cancer or precancerous disease (OR 1.27-4.5). Qualitative findings described distress and re-traumatisation during pelvic examinations as major screening barriers.

Conclusion: Sexual assault is associated with increased cancer vulnerability through converging biological, behavioural, and structural pathways. Incorporating trauma-informed approaches into cancer prevention, screening, and treatment is essential to addressing this overlooked aspect of survivor health.

Objective: To explore the dynamic evolution of symptom clusters in patients with gynecologic malignancies during the early postoperative period and identify key transition points and influencing factors, providing evidence for precision symptom management in clinical nursing.

Methods: A longitudinal study was conducted among 324 patients using the MDASI-PeriOp-GYN on postoperative days 1 (T1), 5 (T2), and 7 (T3). Exploratory factor analysis identified symptom clusters at each time point, and growth mixture modeling (GMM) was applied to examine trajectory patterns. Latent profile analysis (LPA) and network analysis were performed at T2 to identify patient subgroups, influencing factors, and core symptoms.

Results: Five symptom clusters were identified: disease behavior, gastrointestinal, endocrine, neurological, and emotional. The emotional cluster, independent at T1 and T3, merged with the disease behavior cluster at T2. GMM indicated that all clusters declined from T1 to T2, followed by divergence after T2. LPA identified high- and low-symptom subgroups. Patients with ovarian cancer and those with KPS_1 were more likely to belong to the high-symptom group. Network analysis revealed "poor appetite" as the most central symptom at T2.

Conclusion: Postoperative day 5 (T2) represents a critical transition point in symptom evolution. Ovarian and KPS_1 are at higher risk for severe symptoms, and "poor appetite" plays a key driving role. Targeted assessment and intervention at T2 may reduce symptom burden and improve recovery outcomes in patients with gynecologic malignancies.

Background: Anemia and iron deficiency are common among patients with cancer and can have a significant impact on their prognosis. However, the current status of anemia and iron deficiency in Japanese patients with gynecological malignancies remains unclear. This study aimed to clarify the prevalence of anemia and iron deficiency at the time of diagnosis and to evaluate their influence on hemoglobin levels during cancer treatment in Japanese patients with gynecological malignancies.

Methods: Eligible patients were those diagnosed with gynecological cancers. Anemia and iron status were evaluated before and within 6 months of initiating cancer treatments at our institution between January 2022 and July 2024. Statistical comparison of risk factors was performed with the Mann-Whitney U test, Student t-test, and one-way analysis of variance. Iron status and transferrin saturation (TSAT) were classified using the National Comprehensive Cancer Network guidelines.

Results: A total of 103 patients were assessed for eligibility. The median (interquartile range) hemoglobin level was 12.5 (10.6-13.2) g/dL, and 29.1% of patients had hemoglobin ≤ 11.0 g/dL before cancer treatment. TSAT < 20% and < 50% accounted for 46.7% and 99.0% of patients, respectively; 9.9% and 11.1% were classified as having absolute and functional iron deficiency anemia, respectively. Sixty-two patients received chemotherapy or concurrent chemoradiotherapy for their cancers, and 90.3% developed anemia within 6 months of initiation of treatment. Lower hemoglobin and serum ferritin before treatment, as well as hemoglobin at its lowest point within 6 months of treatment, were found in patients with TSAT < 20%.

Conclusions: Anemia and iron deficiency were prevalent among Japanese patients with gynecological cancers. TSAT < 20% before treatment was associated with more severe anemia during treatment. TSAT may be a useful biomarker for predicting and managing treatment-related anemia. Early intervention based on TSAT levels could help maintain hemoglobin levels and prevent treatment interruption.

Background: Breast cancer remains a significant public health issue worldwide, with late diagnosis leading to poorer outcomes. In Tanzania, many women are diagnosed with advanced stages of breast cancer. The aim of this study was to identify reasons for late presentations from the patient's perspective.

Methods: Employing a qualitative study design, in-depth interviews were conducted with breast cancer patients. Purposeful sampling was used to recruit patients from inpatient and outpatient settings in the Cancer Care Center of the Kilimanjaro Christian Medical Centre. Eligible patients who were at least 18 years old, and with diagnosed breast cancer were invited for the interview immediately after their medical follow-up visit. Interview transcripts were analysed thematically.

Results: Twenty patients (ten rural and ten urban) participated in the study. The average age was 54.05 years (SD = 9.46). Three women had stage 2, three had stage 3, and 14 had stage 4 breast cancer. Factors that were mentioned for late diagnosis of breast cancer were thematically grouped on three levels: the patient, community, and healthcare system. On the patient level, common reasons reported were a misunderstanding of breast cancer (n = 19, 95%), including lack of knowledge and awareness of breast cancer signs and symptoms, as well as the costs for transportation to the healthcare centre (10, 50%). On the community level, the reasons mentioned were experiencing stigma (n = 19, 95%) initially seeking care from traditional healers (n = 18, 90%), a burdensome spousal relationship (n = 15, 75%) and having faith in God (n = 19). On the health system level, patients (n = 13, 65%) expressed concerns regarding the high costs of cancer treatment, which limited their access to health care.

Conclusion: Our findings show that, from the patient's perspective, the main reasons for delayed diagnosis of breast cancer can be grouped at the patient, the community, and the healthcare levels. Themes at the patient level are a lack of knowledge of breast cancer signs and symptoms and lack of awareness of having those symptoms. Community level themes were stigma, seeking initial care from traditional healers, and interacting with religious leaders, and themes related to healthcare included costs of cancer treatment, and negative attitudes of healthcare providers.