Journal of women's health
-
Journal of women's health · Mar 2020
Observational StudyInfertility and Health-Related Quality of Life in United States Women Veterans.
Background: To assess associations between infertility and health-related quality of life and medical comorbidities in U. S. women Veterans. Materials and Methods: This cross-sectional observational study involved computer-assisted telephone interviews of Veterans Administration-enrolled women between ages 21 and 52 years. Patients were analyzed in two groups by self-reported history of infertility. ⋯ Infertility was also associated with higher rates of depression, other chronic pain, and cancer, which remained significant after adjusting for age (p = 0.021, p = 0.016, and p = 0.045, respectively); however, no association for all was seen after adjustment for other significant covariates. There was no difference in Veterans' mental health using the SF-12 MCS, nor differences seen in PTSD or eating disorder rates, or in cardiovascular risk factors. Conclusions: This novel investigation in U. S. women Veterans found worse physical health-related quality of life and increased rates of fibromyalgia among women reporting a history of infertility, adding to the growing literature on infertility as a marker for overall poorer health.
-
Background: Understanding the work habits, attitudes, and experiences of women physicians is critical for optimal patient care. In a gendered work environment, obstacles faced hinder women physicians from contributing to their full ability. This study investigated how women physicians' work habits are viewed, in the context of women's attitudes and experiences. Methods: An analysis of the medical literature (1990-2017) was undertaken. ⋯ Comparing women physicians to male colleagues as a standard for evaluating performance, for example, undervalues distinctive characteristics women bring to medical practice. Productivity models that focus on work hours, procedures, and publications do not encompass the full scope of patient care. Conclusions: Solutions offered mainly have been designed to help women physicians fit into existing workplace environments, but traditionally available "adapt or exit" options in response to challenges faced appear insufficient. A gender equity perspective helps to explain findings and suggests ways to reshape the health care workplace to better understand, utilize, and retain women physicians.
-
Journal of women's health · Mar 2020
ReviewAre Health Care Professionals Prepared to Implement Human Papillomavirus Testing? A Review of Psychosocial Determinants of Human Papillomavirus Test Acceptability in Primary Cervical Cancer Screening.
Background: Guidelines for cervical cancer screening have been updated to include human papillomavirus (HPV) testing, which is more sensitive compared to cytology in detecting cervical intraepithelial neoplasia. Because of its increased sensitivity, a negative HPV test is more reassuring for a woman that she is at low risk for precancerous cervical lesions than a negative Pap test. Prompted by the inadequate translation of HPV test-based screening guidelines into practice, we aimed to synthesize the literature regarding health care providers (HCPs) knowledge, attitudes, and practices related to HPV testing and the influence of psychosocial factors on HCPs acceptability of HPV testing in primary cervical cancer screening. Materials and Methods: We searched MEDLINE, Embase, PsycINFO, CINAHL, Global Health, and Web of Science for journal articles from January 1, 1980 to July 25, 2018. ⋯ Thirty to fifty percent of HCPs are not compliant with guideline recommendations for HPV testing, for example, screening at shorter intervals than recommended. Barriers, facilitators, and contradictory evidence of HCPs' acceptability of the HPV test are grouped by category: (1) factors related to the HCP; (2) patient intrinsic factors; (3) factors corresponding to HCP's practice environment; and (4) health care system factors. Conclusions: HCP's adherence to guidelines for HPV testing in cervical cancer screening is suboptimal and could be improved by specialty organizations ensuring consistency across guidelines. Targeted educational interventions to address barriers of HPV test acceptability identified in this review may facilitate the translation of HPV testing recommendations into practice.
-
Journal of women's health · Mar 2020
The Vaginal Microbiome in U.S. Black Women: A Systematic Review.
Background: Advancements in next-generation sequencing have allowed for a more complete understanding of the vaginal microbiome and its role in health and disease. The role of race/ethnicity in the composition of the vaginal microbiome and what is deemed normal/healthy microbiome is conflicting. Thus, the purpose of this review is to synthesize research that investigated the vaginal microbiome in Black women in the United States by using advanced 16S analysis. ⋯ The vaginal microbiome's influence on preterm labor and/or birth among Black women was inconclusive and warrants further investigation. Conclusions: The role that the microbiome plays in health and disease among Black women warrants further research to better elucidate the definition of a healthy versus pathogenic microbiome. The wide variability in methods for BV diagnostics and defining preterm labor/birth are significant limitations that should be considered when conducting comparative studies.
-
Journal of women's health · Mar 2020
Observational StudyNonobstructive Coronary Artery Disease at Angiography and Gender-Specific Indicators for Cardiovascular Events: 5-Year Follow-Up of the LIFE Heart Study.
Background: Patients with cardiac complaints but without confirmed diagnosis of coronary heart disease by angiography frequently develop cardiac events in the following years. This follow-up study investigated the frequency of cardiac symptoms and cardiovascular events (CVE) 5 years after initial angiography of patients with nonobstructive coronary artery disease (NobCAD, LIFE Heart study), with the aim to identify gender-specific indicators for CVE. Methods: In 2014/2015, 1462 women and men with NobCAD, defined as no or non-relevant obstructive coronary artery disease were identified among 2660 subjects participating in the observational angiographic LIFE Heart study. Questionnaires of 820 responding patients were analyzed. Results: The median observation time was 55 months. ⋯ Sex-specific risk factors comprised body mass index (BMI) ≥25 kg/m2 for women and anxiety for men. Conclusions: Patients with cardiac symptoms have about three times higher risk for CVE within 5 years than patients without cardiac symptoms. Sex differences exist in patients without symptoms where men were at higher risk for CVE. Atrial fibrillation was the strongest indicator for CVE, whereas anxiety was an indicator only in men and BMI ≥25 kg/m2 only in women, suggesting sex- and gender-specific phenotypic profiles.