Women's health (London, England)最新文献

{"title":"Women's mental health in the doctoral context: Protective function of the psychological capital and academic motivation.","authors":"Angel Deroncele-Acosta, Roger Pedro Norabuena-Figueroa, Emerson Damian Norabuena-Figueroa","doi":"10.1177/17455057251315318","DOIUrl":"10.1177/17455057251315318","url":null,"abstract":"<p><strong>Background: </strong>Science recognizes the anxieties, depression, stress, and \"turbulences\" that women face in doctoral studies, but women's mental health in this context is still little addressed, even though it is a critical aspect for the well-being, persistence, and success of women doctoral candidates, who continue to be underrepresented in many professional fields.</p><p><strong>Objectives: </strong>The study aims to evaluate the relationship between academic motivation, psychological capital, and university academic performance (UAP) and to identify factors of female mental health success.</p><p><strong>Design: </strong>A cross-sectional, mixed-methods study was conducted with a sample of 108 female doctoral students from a university in Lima, during the first quarter of 2024.</p><p><strong>Methods: </strong>In the quantitative phase, three standardized scales were administered to assess academic motivation, psychological capital, and university academic performance (UAP). In the qualitative phase, interviews were conducted to gather relevant information on mental health.</p><p><strong>Results: </strong>The findings emphasize five important points: (1) levels and the relationship between psychological capital, academic motivation, and performance, (2) motivational behavior according to study cycles, (3) risk and protection profiles, (4) protective functions, and (5) mental health success factors. The results indicate that 36% of the women have a low level of psychological capital, 34% have a medium level of academic motivation, and 37% have a high level of UAP, likewise \"Intrinsic Motivation toward Accomplishment\" is the positive core where most of these women converge. Significant differences were found between the study cycles with academic motivation and \"University Academic Performance,\" and a significant gap between these variables. The risk profile (which limits performance) and the protective profile which allows high performance are determined; this positive profile is identified by women who present a high level of \"Self-efficacy.\" The study demonstrates that \"Psychological Capital\" and \"Academic Motivation\" along with the dimensions of \"Self-efficacy\" and \"Intrinsic Motivation to Experience Stimulation\" serve protective functions. Fourteen success factors for women's mental health were identified and organized into four main approaches: Optimism, Hope, Resilience, and Self-efficacy.</p><p><strong>Conclusion: </strong>Limitations and future projections are discussed. The practical implications include implementing psychological support programs, fostering intrinsic motivation, integrating psychological assessments, establishing support networks, and making tailored curricular adjustments.</p>","PeriodicalId":75327,"journal":{"name":"Women's health (London, England)","volume":"21 ","pages":"17455057251315318"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11783562/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143069830","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Nursing and planetary health: A discussion article.","authors":"Salima Meherali, Saba Nisa, Yared Asmare Aynalem, Zohra S Lassi","doi":"10.1177/17455057241311955","DOIUrl":"10.1177/17455057241311955","url":null,"abstract":"<p><p>This discussion article discusses the integration of planetary health into nursing practice and education, highlighting the transformative potential of this approach in improving global health outcomes. Planetary health emphasizes the interdependence between human health and the health of our planet's ecosystems, advocating for a sustainable approach to healthcare. This article explores how nursing practice can incorporate planetary health principles to address environmental determinants of health and promote sustainable practices. It also discusses the role of nursing education in preparing future practitioners to understand and act on the links between environmental sustainability and health. By aligning nursing education with planetary health objectives and fostering leadership in this area, the nursing profession can contribute significantly to addressing global health challenges, advocating for systemic changes, and implementing practices that protect both human and environmental health.</p>","PeriodicalId":75327,"journal":{"name":"Women's health (London, England)","volume":"21 ","pages":"17455057241311955"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11905079/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143607552","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Intimate partner violence and physical health in England: Gender stratified analyses of a probability sample survey.","authors":"Ladan Hashemi, Anastasia Fadeeva, Nadia Khan, Sally McManus","doi":"10.1177/17455057251326419","DOIUrl":"10.1177/17455057251326419","url":null,"abstract":"<p><strong>Background: </strong>Gender differences in the associated health outcomes of different forms of intimate partner violence (IPV) are understudied. The long-term effects of IPV on specific physical health conditions are also under-researched in comparison to the effects on general health and mental health.</p><p><strong>Objectives: </strong>To examine gender differences in the association between IPV and specific physical health conditions, accounting for differences in the types and number of types of IPV experienced.</p><p><strong>Design: </strong>We used data from the 2014 Adult Psychiatric Morbidity Survey, a cross-sectional survey using a stratified, multistage random sampling design to cover the household population of England aged 16 years and older.</p><p><strong>Methods: </strong>Descriptive and multivariable regression analyses of 4120 women and 2764 men who had ever had a partner. Lifetime IPV by types (physical, sexual, psychological, and economic), any lifetime and recent IPV, the number of IPV types experienced, and multiple chronic health conditions experienced over the past 12 months were included in the analyses.</p><p><strong>Results: </strong>Gender differences were observed in both the prevalence of IPV and associated health conditions. Women were more likely to experience any type and a higher number of IPV types than men. Women's exposure to any lifetime and 12-month IPV were significantly associated with an increased likelihood of reporting 12 and 11 conditions, respectively, while men's exposure to any lifetime and 12-month IPV were significantly associated with 4 and 1 conditions, respectively. Specific IPV types had varied health impacts, particularly among women. A cumulative association was evident for women but not for men.</p><p><strong>Conclusion: </strong>Healthcare systems need to be mobilised to address IPV as a priority health issue for the female population. Our findings highlight the need for gender-informed approaches in IPV intervention strategies and healthcare provision, emphasising the development of IPV-responsive healthcare systems and comprehensive IPV curricula in medical and health training.</p>","PeriodicalId":75327,"journal":{"name":"Women's health (London, England)","volume":"21 ","pages":"17455057251326419"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11946296/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143712593","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Unlocking breast cancer in Brazilian public health system: Using tissue microarray for accurate immunohistochemical evaluation with limitations in subtyping.","authors":"Rubia Denise Ruppenthal, Emily Ferreira Salles Pilar, Jordan Boeira Dos Santos, Rafael Correa Coelho, Carina Machado Costamilan Henriques, Diego de Mendonça Uchôa, Marcia Silveira Graudenz","doi":"10.1177/17455057241304654","DOIUrl":"10.1177/17455057241304654","url":null,"abstract":"<p><strong>Background: </strong>Breast cancer (BC) is a significant burden on healthcare systems, especially in low- and middle-income countries where access to diagnosis and treatment is challenging.</p><p><strong>Objectives: </strong>The purpose of this study was to assess the diagnostic accuracy and cost using tissue microarray (TMA) instead of traditional immunohistochemical (IHC) evaluation for estrogen receptor (ER), progesterone receptor (PR), human epidermal growth factor 2 (HER2), and the proliferation marker Ki-67 and BC subtyping within the Brazilian public health system.</p><p><strong>Design: </strong>This is a retrospective cohort study comparing TMA slides with traditional whole-slide evaluation for IHC markers in 242 BC cases.</p><p><strong>Methods: </strong>We used formalin-fixed tissue blocks for TMA assembly. Clinical data and IHC scores for ER, PR, HER2, and Ki-67 were obtained from pathology reports. Cohen's kappa (<i>k</i>) was used to assess TMA performance.</p><p><strong>Results: </strong>BC samples were distributed in 10 TMAs and 968 cores were scored (242 BC cases × 4 markers). In 97% of these, TMA reached high quality to adequate IHC scoring with minimal technical issues. Inter-examiner agreement was almost perfect for all markers (ranging from 0.85 for HER2 to 0.91 for ER, <i>p</i> < 0.001). The intratumoral heterogeneity ranged from almost perfect agreement for ER and HER2 to moderate to substantial for PR and Ki-67. TMA offers substantial time and cost savings, with an approximately 11-fold reduction compared to traditional methods. The concordance between TMA and original reports was almost perfect, with 93% overall agreement (<i>k</i> = 0.81, <i>p</i> < 0.001). However, TMA performance varied between markers, with intratumoral heterogeneity significantly impacting discordant results, particularly for Ki-67 and HER2. This ultimately affected the accuracy of BC subtyping. TMA performed well in identifying luminal A and triple-negative cases, but misclassification was common for luminal B and HER2-positive cases.</p><p><strong>Conclusion: </strong>TMA offers accurate and lower-cost results in the individualized IHC assessment of BC markers. However, we do not recommend the use of TMA in the subtyping of BC, where analysis of the whole section remains necessary for more accurate results. We advocate more studies using the TMA approach in the Brazilian public health system to advance women's health care.</p>","PeriodicalId":75327,"journal":{"name":"Women's health (London, England)","volume":"21 ","pages":"17455057241304654"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11694303/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142916473","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Iron deficiency anemia in patients with heavy menstrual bleeding: The patients' perspective from diagnosis to treatment.","authors":"Imo J Akpan, Mohit Narang, Edio Zampaglione, Steve Marshall, Dawn Stefanik","doi":"10.1177/17455057251321221","DOIUrl":"10.1177/17455057251321221","url":null,"abstract":"<p><strong>Background: </strong>Heavy menstrual bleeding (HMB) associated with iron deficiency anemia (IDA) negatively affects quality of life (QoL). Management of IDA usually begins with oral iron supplementation or, if ineffective/poorly tolerated, then intravenous iron (IVI) is given; however, no guidance exists on transitioning from oral to IVI in patients with HMB. While various IVI products exist, safety profiles and distinct properties affecting treatment logistics make product choice important.</p><p><strong>Objectives: </strong>Assess the IVI treatment journey for patients with HMB and IDA.</p><p><strong>Design: </strong>A survey was designed to assess multiple aspects of IVI treatment to evaluate patient perspectives.</p><p><strong>Methods: </strong>Patients (⩾18 years) from the United States with IDA currently prescribed IVI completed a survey conducted by The Harris Poll in 2023. Questions covered symptoms, time to diagnosis/treatment, IVI appointment logistics, IVI infusion experience, impact on daily activities, and patient preferences.</p><p><strong>Results: </strong>Of 323 respondents, 71 (22.0%) were prescribed IVI for HMB and received ⩾2 IVI infusions monthly. The mean age for these patients was 33.5 years; they experienced a mean of 2.9 years from symptom onset until IDA diagnosis, and 1.4 years between diagnosis and IVI treatment. Most patients agreed that navigating IVI treatment logistics interfered with productivity and social commitments, and felt they must schedule their life around treatment. Patients who were also diagnosed with hypophosphatemia following IVI (12/71; 16.9%) reported a mean of 8.2 additional hospital visits. Furthermore, 36.6% of patients missed an IVI dose; of these, 80.8% preferred single-dose IVI.</p><p><strong>Conclusion: </strong>Patients with IDA and HMB experienced substantial delays from symptom onset to subsequent IVI treatment, demonstrating a gap in management. Therefore, oral iron may not be an appropriate first-line treatment for some of these patients. Multiple-dose IVI and associated appointment logistics can negatively impact patients' perspectives on treatment. Single-dose IVI preferences should be considered to improve patients' adherence and QoL.</p>","PeriodicalId":75327,"journal":{"name":"Women's health (London, England)","volume":"21 ","pages":"17455057251321221"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11869313/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143525417","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Impact of a 3-year transformational change project in family violence clinical response: Qualitative evaluation of the depth and breadth of knowledge in hospital clinicians by training level.","authors":"Kirsty Troy, Catherine Rushan, Toni D Withiel, Kim L Felmingham, Caroline A Fisher","doi":"10.1177/17455057241305264","DOIUrl":"10.1177/17455057241305264","url":null,"abstract":"<p><strong>Objectives: </strong>This study aimed to investigate the impact of different levels of training in family violence (no training, some training, clinical champions), on the clinician knowledge of key family violence response skills, using qualitative, survey obtained text-box responses.</p><p><strong>Design: </strong>A cross-sectional, online, survey of hospital clinicians in a major trauma hospital was conducted.</p><p><strong>Methods: </strong>The Assisting Patient/Clients Experiencing Family Violence: Royal Melbourne Hospital Clinician Survey tool was utilised and open for clinicians to complete, anonymously over a 6-week period. Free-text survey responses were analysed using an inductive thematic analysis approach.</p><p><strong>Results: </strong>Five hundred twenty-six clinical staff participated, 30% with no training, 52% with some training and 18% who were trained as clinical champions. A clear pattern was observed across training levels. Those with no training opted to demonstrate their family violence knowledge base less frequently. When they did, answers lacked specific information and details, showed limited knowledge of covert family violence indicators and provided a higher proportion of responses that did not align with best practice guidelines. Staff with some training showed a more sophisticated understanding in these areas. However, the quality of their responses did not match those of the clinical champions, who also provided an ongoing community of practice to further their skills.</p><p><strong>Conclusions: </strong>Providing some training in family violence yields a higher degree of family violence knowledge in clinicians, relative to no training. However, the extra resourcing required to train and maintain a clinical champions model in family violence provides demonstratable benefits, via a more sophisticated and nuanced understanding of indicators, enquiry and disclosure response skills, that align with best practice guidelines.</p>","PeriodicalId":75327,"journal":{"name":"Women's health (London, England)","volume":"21 ","pages":"17455057241305264"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11869259/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143525412","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Person-centered maternity care and satisfaction with post-abortion care: A facility-based cross-sectional survey in Northern Uganda.","authors":"Samson Udho, Emmanuel Ekung, Deborah Andrinar Namutebi, Josephine Aryek-Kwe, Abraham Rubaihayo, Marvin Musinguzi, Eustes Kigongo, Annaloice Penduka, Yvonne Delphine Nsaba Uwera, Bosco Opio, Jasper Ogwal-Okeng","doi":"10.1177/17455057251318897","DOIUrl":"10.1177/17455057251318897","url":null,"abstract":"<p><strong>Background: </strong>The experience of post-abortion care (PAC) is crucial to the quality of PAC services. However, there is limited literature on women's experience with PAC, particularly the aspects of person-centered maternity care (PCMC) and satisfaction with PAC services.</p><p><strong>Objective: </strong>To examine the relationship between PCMC and satisfaction with PAC services.</p><p><strong>Design: </strong>A facility-based analytical cross-sectional study.</p><p><strong>Methods: </strong>A survey was conducted among 370 women aged 15-49 who sought PAC services at public health facilities in Lira city, Northern Uganda. Data were collected using a validated questionnaire. Data analysis included descriptive statistics, the Spearman correlation test, and multiple linear regression.</p><p><strong>Results: </strong>The mean age of study participants was 26.1 (±6.3) years. The overall PCMC median score was 21.5 (interquartile range (IQR): 11) out of 36. The median scores for the sub-scales were as follows: 6 (IQR: 6-6) for dignity and respect out of 9; 9 (IQR: 5-13) for communication and autonomy out of 18; and 8 (IQR: 6-9) for supportive care out of 9. Satisfaction with PAC services' score ranged from 6 to 42, and the median satisfaction score was 30 (IQR range: 28-32). Bivariate analysis revealed a weak but significant correlation between the overall PCMC scale and satisfaction with PAC services (<i>r</i> = 0.21, <i>p</i> < 0.001). Sub-scales of dignity and respect and communication and autonomy also had a weak but significant correlation with satisfaction with PAC services (<i>r</i> = 0.16, <i>p</i> = 0.002, and <i>r</i> = 0.21, <i>p</i> < 0.001 respectively). In a linear regression model, communication and autonomy score was significantly associated with higher satisfaction with PAC score (<i>β</i> = 0.10; 95% confidence interval (CI): 0.01, 0.19; <i>p</i> < 0.001).</p><p><strong>Conclusions: </strong>PCMC, particularly the aspects of communication between clients and providers and the promotion of clients' autonomy, is associated with higher satisfaction with PAC services. Efforts to increase clients' satisfaction with PAC should focus on strengthening communication between clients and providers and promoting clients' autonomy during care.</p>","PeriodicalId":75327,"journal":{"name":"Women's health (London, England)","volume":"21 ","pages":"17455057251318897"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11826833/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143416381","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Benefits of breast self-examinations for medically underserved populations: A systematic review.","authors":"Caroline M Cassidy, Christopher I Choi, Benjamin Herdman, Taryn K Kilbane, Jessica F Lannen, James P McConnell, Michelle M Moufawad, Beth A Bailey","doi":"10.1177/17455057241311400","DOIUrl":"10.1177/17455057241311400","url":null,"abstract":"<p><strong>Background: </strong>Breast self-examination (BSE) was previously recommended to help early-stage breast cancer detection to improve prognosis. However, BSE is not recommended in the United States anymore due to the findings that it fails to significantly decrease mortality while increasing biopsy cases, causing unnecessary harm. Nonetheless, international researchers have continued to investigate the benefits of BSE in medically underserved regions. These studies raise the possibility that BSE could be beneficial in rural America, where people face higher mortality from chronic diseases compared to the general population.</p><p><strong>Objectives: </strong>Determine if BSE has benefits for medically underserved populations to inform a potential reevaluation of breast cancer screening recommendations.</p><p><strong>Design: </strong>Systematic review.</p><p><strong>Data sources and methods: </strong>A systematic review was conducted using a set of terms to identify articles on breast cancer survival and BSE in rural and/or underserved populations within the past 10 years. The search yielded over 200 articles across 3 databases (PubMed, CINAHL, and SCOPUS), and they were further screened to include studies that show rural populations performing BSE, effects of BSE in breast cancer diagnosis and/or mortality of breast cancer patients, factors contributing to the efficacy of BSE, factors that affect women's willingness to perform BSE, and effects of BSE on breast cancer awareness/behaviors to seek further screening.</p><p><strong>Results: </strong>The final synthesis from 12 articles suggests that BSE is associated with early breast cancer detection (4/12), increased accessibility to breast cancer screening (2/12), and positively influence women to seek further breast cancer screening in rural populations (3/12). It also identifies a potential need for improved education on breast cancer and screening, including BSE practices, to promote early breast cancer detection (3/12).</p><p><strong>Conclusion: </strong>The reevaluation of the current recommendations to determine if exceptions should be made to specific populations would be helpful in addressing late detection and poor prognosis in medically underserved populations.</p>","PeriodicalId":75327,"journal":{"name":"Women's health (London, England)","volume":"21 ","pages":"17455057241311400"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11881123/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143560299","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Social media to understand the endometriosis patient journey: Listening to influences driving treatment choices.","authors":"Vicky Britton, Alexis Sohn, Nicole T Ansani, Brett Hauber, Michele Cole, Martine C Maculaitis, Ruth Kim","doi":"10.1177/17455057241311765","DOIUrl":"10.1177/17455057241311765","url":null,"abstract":"<p><strong>Background: </strong>Previous research has identified treatment attributes and outcomes for endometriosis patients, highlighting the need for tailored interventions to improve patient care. These studies emphasize the need to understand patient experiences, focusing on pain symptoms and factors that impact quality of life.</p><p><strong>Objectives: </strong>This study aimed to provide an in-depth description of patient experiences with endometriosis related to treatment attributes and outcomes, including three key types of pain symptoms: Non-menstrual pelvic pain, dyspareunia, and dysmenorrhea, and non-pain factors such as out-of-pocket costs.</p><p><strong>Design: </strong>In this retrospective qualitative study, 47,745 public social media posts from the United States from December 2021 to December 2022 were analyzed.</p><p><strong>Methods: </strong>Boolean queries were created incorporating criteria to identify public posts referencing endometriosis and language indicative of patients expressed in the first-person point of view. Data were summarized via descriptive statistics.</p><p><strong>Results: </strong>Findings confirmed the relevance of non-menstrual pain, dyspareunia, and dysmenorrhea for treatment decision-making. Dysmenorrhea, described as excruciating and debilitating, was the most discussed symptom (10% of posts) followed by dyspareunia (3% of posts), with emotional and physical impacts detailed. Non-menstrual pain was specified in 1% of posts, including the follicular, ovulatory, and luteal phases of the menstrual cycle. Key themes that emerged organically included the impact of endometriosis on daily functioning, mental health, intimacy, fertility, and the role of online misinformation. Discussions detailed the struggle to balance symptom relief with long-term solutions, and frustration with diagnosis.</p><p><strong>Conclusion: </strong>The current study highlights the difficulties patients experience with dysmenorrhea, dyspareunia, and non-menstrual pain and the challenges to treatment decisions. The relevance of social media for patient expression of their disease experience, the importance of recognizing the individualized needs of patients necessitating their active involvement in treatment decision-making, and the need for education about treatment options beyond surgery also emerged in the findings.</p>","PeriodicalId":75327,"journal":{"name":"Women's health (London, England)","volume":"21 ","pages":"17455057241311765"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11956510/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143756419","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Modern contraceptive discontinuation and associated factors among adolescent girls and young women in Tanzania: An analysis of a nationally representative data.","authors":"Victoria J Solomon, Shadrack E Kibona, Elevatus N Mukyanuzi, Christopher H Mbotwa","doi":"10.1177/17455057251318379","DOIUrl":"10.1177/17455057251318379","url":null,"abstract":"<p><strong>Background: </strong>Contraceptive use is vital in reducing the risk of unintended pregnancies and early motherhood. Despite the well-established benefits, the uptake of modern contraceptive methods among adolescent girls and young women (AGYW) is sub-optimal in sub-Saharan Africa. Furthermore, the discontinuation rate of modern contraceptive use poses a significant challenge to its effectiveness.</p><p><strong>Objective: </strong>We aimed to determine a 12-month modern contraceptive discontinuation rate, reasons for discontinuation, and associated factors among AGYW in Tanzania.</p><p><strong>Design: </strong>Retrospective nested within the cross-sectional utilizing quantitative approach.</p><p><strong>Methods: </strong>We retrospectively analysed calendar data on contraceptive use collected in the 2022 Tanzania Demographic and Health Survey (2022 TDHS). The 2022 TDHS data collection was implemented between February and July 2022. The study population comprised AGYW aged 15-24 years. The unit of analysis was the contraceptive episode of use, defined as the period between the start of use and the termination of the method. Our analysis was mainly based on the discontinuation due to dissatisfaction with the method. We used a life-table method to estimate the contraceptive discontinuation rates. A frailty model was employed to assess the factors associated with the discontinuation rate.</p><p><strong>Results: </strong>A total of 668 AGYW with a mean (±standard deviation) age of 21.5 ± 2.1 years were included in the analysis. The overall prevalence of 12-month discontinuation rate due to dissatisfaction with the method was 32.3%. Higher discontinuation rates were observed among injectable and pills. The main reasons for discontinuation were side effects (13.7%) and change in menstrual cycle (8%). Factors associated with higher discontinuation rates included higher age (adjusted hazard ratio (aHR) 1.64, 95% confidence interval (CI) 1.06-2.51 for the 20-24 age group), residing in households headed by a female (aHR 1.40, 95% CI 1.05-1.85), and residing in the western zone (aHR 1.87, 95% CI 1.21-2.90).</p><p><strong>Conclusion: </strong>This study revealed a high prevalence rate of modern contraceptive discontinuation among AGYW in Tanzania. The management of side effects needs to be incorporated into programs aimed at promoting the sustained use of modern contraceptive methods.</p>","PeriodicalId":75327,"journal":{"name":"Women's health (London, England)","volume":"21 ","pages":"17455057251318379"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11806490/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143367025","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}