Women's Recovery Research Articles

Treating Women With Substance Use Disorders: The Women's Recovery Group Manual by Shelly F. Greenfield (review)

Treating Women With Substance Use Disorders: The Women's Recovery Group Manual by Shelly F. Greenfield (review)

Feasibility and satisfaction of the women's recovery group for patients with co-occurring substance use and eating disorders

Feasibility and satisfaction of the women's recovery group for patients with co-occurring substance use and eating disorders

Patients' understanding and use of analgesia for postnatal pain following hospital discharge.

Background Postnatal pain is one of the limiting factors in the recovery of women from child birth. Despite the routine prescribing of analgesics for postnatal pain, limited research is available on the use of analgesics by the women in postnatal period. Objective To measure the utilisation and effectiveness of prescribed oral analgesics, the incidence and severity of pain, and factors associated with poor pain control on the fifth-day post-hospital discharge in postnatal women. Setting A tertiary referral women's hospital of Western Australia. Method Prospective cohort follow-up study of 400 postnatal women at a tertiary referral women's hospital during May and July 2014. All eligible subjects were contacted for a telephone survey 5days after their discharge from the hospital. Additional clinical data was collected from the hospital medical records. Main outcome measure Pain at discharge, analgesics prescribed on discharge, patient understanding and adherence, and postnatal pain management. Results 197 of 400 recruited women completed the telephone survey yielding a response rate of around 50%. 131 Women (66%) reported to be in pain at the fifth-day post-hospital discharge. Older women (p=0.003) and women who reported to be in pain at hospital discharge were more likely to experience pain at home (p=0.001). Women were more likely to seek consultation from a healthcare professional (p=0.001) prior to their scheduled follow up visit, purchase over the counter analgesics from pharmacy (p=0.012) and seek non-drug alternative (p=0.019) if they experienced pain at home. Conclusion Pain at hospital discharge was found to be a strong predictor of pain at home among the postnatal women in this study. We propose pain at the time of hospital discharge as a useful clinical indicator to identify postnatal women who need additional support to manage their pain at home thus minimising potential harm related to inappropriate use of medications.

P1270Effects of blood pressure variability on layer-specific longitudinal strain in hypertensionP1271 Left atrial dynamics and diastolic function in hypertensive patientsP1272Echocardiographic evaluation of right ventricular function in patients with chronic obstructive pulmonary disease in comparison with healthy groupP1273The impact of preeclampsia on myocardial recovery in women with peripartum cardiomyopahty - speckle tracking studyP1274Diagnostic accuracy of bedside lung ultrasonography in emergency (BLUE)

Our previous study showed sub-epicardial longitudinal strain (EpiLS) was an independent prognostic factor for worse outcome in regular treated hypertension but not global longitudinal strain (GLS) and sub-endocardial longitudinal strain (EndLS). Increased blood pressure variability (BPV) has been found associated with target organ damage in hypertension. However, effects of BPV on layer-specific longitudinal strain have not been well studied. The aim of this study was to investigate the effects of different blood pressure parameters on layer-specific longitudinal strain in hypertension. This study included 95 patients (57 men, age 65 ± 12 years) with uncomplicated hypertension who have been regularly treated for more than 1 year. Speckle tracking echocardiography was used for measurement of longitudinal deformation from 3 apical views of left ventricle. GLS was measured by automated function imaging (AFI). We further divided into sub-endocardial and sub-epicardial myocardium and measured their longitudinal strain by manual click-and-draw method and averaged from 3 apical views. Blood pressure parameters included office systolic blood pressure (SBP), office diastolic blood pressure (DBP), central SBP and DBP by tonometry, average 24-hour SBP and DBP, and BPV parameters by ambulatory blood pressure monitor. BPV parameters included standard deviation of daytime SBP (DSSD), standard deviation of nighttime SBP (NSSD), standard deviation of daytime DBP (DDSD), and standard deviation of nighttime DBP (NDSD). We divided subjects into low and high group according to median level of each strain. No blood pressure parameters were different between low and high EndLS group except week difference in NDSD (9.0 ± 3.4 vs. 7.8 ± 2.0 mmHg, p = 0.051). NSSD (11.2 ± 4.6 vs. 9.3 ± 2.9 mmHg, p = 0.027) and NDSD (9.1 ± 3.4 vs. 7.7 ± 2.0 mmHg, p = 0.031) were significant increased in low GLS group but not other parameters. DDSD (10.3 ± 3.0 vs. 9.0 ± 2.5 mmHg, p = 0.034), NSSD (11.4 ± 4.4 vs. 9.1 ± 3.1 mmHg, p = 0.006), and NDSD (9.2 ± 3.2 vs. 7.6 ± 2.2 mmHg, p = 0.012) were significantly increased in low EpiLS group. Only BPV parameters were associated with decreased longitudinal strain in hypertension. Effects of BPV were majorly noted in EpiLS.

Women with ovarian function after breast cancer recover half of their antral follicle count 1 year after exposure to Cytoxan-based chemotherapy

Previous data have shown that breast cancer patients treated with chemotherapy are at increased risk of reproductive compromise. The majority of women will either have persistent menses or return of menses within 1 year, but may suffer from early menopause and infertility. In this study, we sought to characterize the loss of ovarian reserve and the time to maximum ovarian recovery in women who have menstrual function after exposure to chemotherapy.

New perspectives of professional integration of the obstetric figure

Objectives: Analysis of the innovative character of application of the midwife figure in the care of gynecological pathology. Methodology: To present an innovative clinical and organizational model of care of the pathology of the lower ano-urogenital female tract in a multiprofessional network, through the enhancement of the midwife figure, as the focus of care provision. Results: The disorders of the lower female Ano-Uro-Genital tract represent a broad spectrum of diseases. The optimal management is therefore to be configured as a multidisciplinary approach of different specialists, among them, the figure of the midwife, for its transversal knowledge and skills, including the obstetrical-rehabilitative approach to the main pelvic-perineal dysfunctions, is to assume a key role in the integration of different professions, in the service of a synergistic and comprehensive care path for the protection and recovery of women's health. Conclusion: The Network model is configured as a modern field of application of the midwife figure, which enhances the multifaceted professional potential.

Perceived barriers and enablers of physical activity in postpartum women: a qualitative approach.

BackgroundPostpartum women’s recovery from birth can be assisted through increased physical activity (PA). However, women face substantial barriers to participating in exercise and require support to enable them to benefit from increased PA.MethodsThis study sought to explore women’s beliefs about and experiences of PA and exercise during the 6 weeks to 12 months postpartum period. A cohort of 14 postpartum women from a survey study of the barriers and enablers to exercise participation agreed to take part in interview sessions to provide an in-depth understanding of the women’s perceptions of the postpartum period and their physical activity during this time.ResultsFindings are presented with reference to the social ecological framework and indicate postpartum women face substantial personal and environmental barriers to PA and exercise participation: fatigue, a lack of motivation and confidence, substantial time constraints, lack of access to affordable and appropriate activities and poor access to public transport. In contrast, enablers such as possessing greater social support, in particular partner support, improved PA and exercise participation.ConclusionsThe findings encourage facilitation of exercise through mothers’ groups, mothers’ exercise clubs or postnatal classes suggesting behavioral and social change is needed. Interaction between individuals, community, organizations and policy makers is required. In addition, the provision of specifically tailored and appropriate exercise programs could potentially enable increased PA in postpartum women, thereby improving their health.Electronic supplementary materialThe online version of this article (doi:10.1186/s12884-016-0908-x) contains supplementary material, which is available to authorized users.

“I'm in this world for a reason”: Resilience and recovery among American Indian and Alaska Native two-spirit women

ABSTRACTAmerican Indian and Alaska Native sexual minority (two-spirit) women are vulnerable to substance misuse and mental health challenges due to multiple minority oppressed status and exposure to stress and trauma. Yet, these women find pathways toward healing and wellness. We conducted a qualitative data analysis of interviews derived from a national health study and gained an understanding of 11 two-spirit women's resilience and recovery patterns. Emergent from the data, a braided resiliency framework was developed which elucidates multilayered abilities, processes, and resources involved in their resiliency. We recommend that resilience-promoting strategies be incorporated into substance misuse and mental health interventions.

Accelerating gastrointestinal recovery in women undergoing ovarian cancer debulking: A randomized, double-blind, placebo-controlled trial

Accelerating gastrointestinal recovery in women undergoing ovarian cancer debulking: A randomized, double-blind, placebo-controlled trial

Post-Exercise Ultra-Short Term Heart Rate Recovery in Women with Stratified Cardiovascular Risks

Ultra-short term heart rate recovery (UST-HRR) after exercise discriminates healthy women with variable levels of fitness yet its use as a clinical marker has not been evaluated in population with different risk stratification categories for cardiovascular disease. PURPOSE: To assess UST-HRR after submaximal exercise in women with low, moderate or high risk of an acute cardiovascular event. METHODS: Exercise testing was performed in seventeen women (n = 17) as a part of general medical examination prior to their participation in a medically supervised exercise program. Participants were screened and stratified for health risk categories according to the American Heart Association and the American College of Sports Medicine guidelines. UST-HRR was monitored immediatelly after exercise, with area under the curve (AUC) for UST-HRR identified and calculated for each risk group. RESULTS: UST-HRR drop at 10 s post-exercise was significanly different among groups (P = 0.04), with recovery in women with high risk of an acute cardiovascular event was slower as compared to their medium-risk counterparts (-1.54 ± 1.6 vs. 0.6 ± 0.7; P = 0.02). AUC analysis for UST-HRR revealed similar results between groups during the 60 s post-exercise (P = 0.60). CONCLUSION: It seems that individuals with high risk for heart disease have blunted post-exercise heart rate dynamics immediately after exercise. This project was supported by the Serbian Ministry of Education, Science and Technological Development (Grant No. 175037), and the Faculty of Sport and Physical Education, University of Novi Sad (2015 Annual Award).Keywords: Cardiovascular event; Submaximal exercise; Heart rate; Recovery

Resilience to Child Sexual Abuse in Male College Students

Little is known about men's experiences in the aftermath of child sexual abuse (CSA). Consistent themes from qualitative studies were operationalized and tested for their impact on resilience. For the sample of college-enrolled men (n = 55), the themes of mattering and of traditional male attitudes were not related to resilience, but the theme of gender self-acceptance significantly predicted 23% of the variance in resilience scores. Importantly, the men's perceptions of the CSA events they experienced, whether they described these events as abusive or consensual, were not related to the men's resilience scores. The results indicated that effective counseling approaches to support men's recovery processes differ from those supporting women's recovery. These results suggest that mental health counselors should focus on encouraging male survivors' gender self-acceptance, exploring what it means to be a man in modern society, and examining points of connection with and disconnection from that cultural portrayal.

The Association Between Depression Severity and Cardiac Risk Factors Among Women Referred to a Cardiac Rehabilitation and Prevention Clinic

The Association Between Depression Severity and Cardiac Risk Factors Among Women Referred to a Cardiac Rehabilitation and Prevention Clinic

Souls in Extremis: Enacting Processes of Recovery from Homelessness Among Older African American Women.

In a midwestern city of the USA, the authors implemented the Leaving Homelessness Intervention Research Project-and its eight subprojects-to further understand homelessness as experienced by older minority women, develop intervention strategies to facilitate the movement of the participants out of homelessness, and illuminate the women's recovery process. After reviewing the social issue of homelessness among older African American women in the USA, and offering a framework on recovery and qualitative themes of recovery among participants involved in the Telling My Story subproject, the authors present a four-factor model of recovery-focused practice. The model reflects two recovery paradigms: one that is responsive to the negative consequences people experience as a result of their exposure to extreme situations, such as homelessness, and a proactive one in which assistance is designed to help people in recovery advance their own self-development and move forward their process of individuation.

Perioperative Duloxetine to Improve Postoperative Recovery After Abdominal Hysterectomy: A Prospective, Randomized, Double-Blinded, Placebo-Controlled Study.

Postsurgical quality of recovery is worse in female than that in male patients. Duloxetine has been used successfully for the treatment of chronic pain conditions, but its use for preventing acute postoperative pain has been limited to a single previous study. More importantly, the effect of preoperative duloxetine on global postoperative quality of recovery has yet to be evaluated. The main objective of the current investigation was to evaluate the effect of perioperative duloxetine on postoperative quality of recovery in women undergoing abdominal hysterectomy. The study was a prospective, randomized, placebo-controlled, double-blinded trial. Female patients undergoing abdominal hysterectomy were randomized to receive duloxetine (60 mg orally 2 hours before surgery and 24 hours after surgery) or an identical placebo pill. The primary outcome was the quality of recovery-40 score at 24 hours. Secondary outcomes included opioid consumption and postoperative pain scores. A P value <0.05 was used to reject type I error. Seventy patients were recruited, and 63 completed the study. The median difference (95% confidence interval) in global recovery scores (quality of recovery-40) at 24 hours after surgery between the duloxetine and the placebo group was 9 (4-20) (P < 0.001). Total opioid consumption was reduced at 24 hours in the duloxetine group compared with the placebo group, median (interquartile range) of 1 (0-5) mg IV morphine compared with 5.5 (0.5-9) mg IV morphine (P = 0.004). Nausea, vomiting, and time to postanesthesia care unit discharge were not significantly reduced in the duloxetine group compared with placebo. Duloxetine improves postoperative quality of recovery after abdominal hysterectomy. In addition, duloxetine reduces postoperative opioid consumption, even in the presence of a robust multimodal analgesic strategy. Duloxetine seems to be a viable pharmacologic strategy to improve postoperative quality of recovery in female patients undergoing abdominal hysterectomy.

Art, Activism, and Labor: Community and Nation in Contemporary African American Women’s Literature

This essay reviews Carmen L. Phelps’s Visionary Women Writers of Chicago’s Black Arts Movement and Courtney Thorsson’s Women’s Work: Nationalism and Contemporary African American Women’s Novels . Both monographs focus on acts of recovery in women’s African American literature in the second half of the twentieth century, seeking to revise and expand our understanding of community, black feminism, and the role of literary form in constructions of nation and identity.

Abstract 18476: Myocardial Recovery in Peripartum Cardiomyopathy: Effect of the GNB3 C825T Polymorphism in the Multicenter IPAC study

Background: Peripartum cardiomyopathy (PPCM) remains a major cause of maternal morbidity and mortality. Black race is a risk factor for the disorder and although most women recover myocardial function, previous studies suggest less recovery in black women than in whites. The genetic basis of this racial difference in risk and recovery remains unknown. A polymorphism of a G protein beta subunit (GNB3 C825T) in exon 10 has been studied extensively for a potential role in increased risk of hypertension in blacks. We investigated the impact of the GNB3 C825T polymorphism on myocardial recovery in PPCM in the multicenter IPAC study (Investigation of Pregnancy Associated Cardiomyopathy). Method: 97 women with new onset of PPCM were enrolled and genotyped for the GNB3 T/C polymorphism. Myocardial function was assessed by echocardiography at study entry, 2, 6 and 12 months postpartum and LVEF calculated at a core lab. Myocardial recovery in subjects with the GNB3TT genotype was compared to subjects with the GNB3 C allele (CC and CT combined) first for the overall cohort then separately in black and white subsets. Results: Overall the cohort was 30% black, mean age 30 + 6, and LVEF 0.35 + 0.10 at study entry 31 + 25days post-partum. For the overall cohort, the % GNB3 genotype TT/CT/CC =23/41/36 and differed markedly by Race (Black= 52/38/10 versus Whites=10/43/47, p&lt;0.001). In subjects with the GNB3TT genotype, LVEF was similar early postpartum (TT= 0.35 + 0.07; CT+CC= 0.35 + 0.09, p=0.98) but significantly lower at 2 month (TT=0.38 + 0.15; CT+CC= 0.44 + 0.10, p=0.02), 6 months (TT=0.45 + 0.15; CT+CC= 0.53 + 0.08, p=0.002), and 12 months (TT=0.45 + 0.15; CT+CC= 0.56 + 0.07, p&lt;0.001.). The difference in recovery for GNB3 TT subjects was most pronounced in black women (12 months LVEF for GNB3 TT=0.39 + 0.16; versus CT+CC= 0.53 + 0.09, p=0.02) but was still evident in whites ((TT=0.50 + 0.11; CT+CC= 0.56 + 0.06, p=0.04). Conclusion: In IPAC, Women with the GNB3 TT genotype had significantly less myocardial recovery over the first year post-partum, and its impact was particularly evident in black women. The increase prevalence of the GNB3 TT genotype in blacks may contribute to racial differences in myocardial recovery in women with PPCM

Comorbidity and functioning of substance-dependent women with sexual abuse history in the stage II women's recovery group therapy trial

Comorbidity and functioning of substance-dependent women with sexual abuse history in the stage II women's recovery group therapy trial

Resilience in eating disorders: A qualitative study

ABSTRACTThe objectives of the authors in this study were two-fold: (1) to explore the role of resilience in recovery from eating disorders (EDs), and (2) to develop a model of resilience in women with EDs. Semi-structured interviews with ten women were conducted in April 2011, along with two focus groups with women who had recovered from EDs (n = 5 women each; conducted in April 2012 at the University of Deusto, Spain), one focus group with clinical experts (n = 8; conducted in April 2012 at the Foundation Against EDs of Biskay, Spain), and six narratives from primary caregivers of ED patients living in Biskay, Spain (conducted in November 2012). All data were analyzed using a grounded theory approach. All female participants acknowledged experiencing resilience in their recovery. The analysis resulted in a conceptual model of resilience composed of the following categories: deep dissatisfaction with life, turning point, acceptance, hope, determination to change, accountability for the ED, active coping, getting social support, gaining self-knowledge, getting information about EDs, increase well-being, trait resilience, initiating new projects and living in the here and now. According to the model presented, resilience preceded the experience of recovery in women with EDs in this sample and could be a useful asset for future interventions.

Auricular acupressure relieves anxiety and fatigue, and reduces cortisol levels in post-caesarean section women: A single-blind, randomised controlled study

BackgroundAnxiety and fatigue adversely affect women's postpartum recovery, but few effective non-pharmacological interventions are known to relieve these two common and unpleasant symptoms. ObjectivesTo examine the efficacy of an auricular acupressure intervention provided during early postpartum in reducing anxiety, fatigue levels, cortisol levels, blood pressure, and heart rate. DesignA single-blind, randomised controlled trial. SettingA 40-bed postpartum unit. ParticipantsWomen who underwent caesarean section were randomly allocated to two groups: intervention (auricular pressure, n=40), and control (usual care, n=40). MethodsThe intervention group received auricular acupressure on the shenmen acupoint twice a day (9 AM and 5 PM), and the control group received usual postpartum care. Serum cortisol levels were assessed by immunochemiluminescence, with blood pressure and heart rate assessed by electric sphygmomanometer. Anxiety and fatigue symptoms were assessed using the State Anxiety subscale of the State-Trait Anxiety Inventory and the Fatigue Continuum Form, respectively. ResultsOf the 76 women who completed the study, those who received auricular acupressure had significantly lower mean cortisol levels (mean difference=4μg/dl, p<0.05), heart rate (mean difference=9.2 beats/min, p<0.001), anxiety symptoms (mean difference=3.8, p<0.01), and fatigue symptoms (mean difference=7.1, p<0.01) than women in the control group at 5 days postpartum. ConclusionsAuricular acupressure is an effective non-pharmacological method for reducing cortisol levels, heart rate, anxiety, and fatigue in early postpartum after caesarean section.

Agency and Accountability: Promoting Women's Participation in Peacebuilding

ABSTRACTThis contribution reviews international policy and practices to engage women in formal peace talks, post-conflict elections, and economic recovery, and finds a combination of factors contributing to poor performance in promoting women's agency. The fact that the privileged category for post-conflict decisions are those groups capable of acting as “spoilers” has tended to exclude women's groups from the categories considered most important to involve in decision making. Exacerbating this exclusion is the reluctance of international decision makers to encourage affirmative action measures in these contexts. This carries through to the minimal-state approach to economic recovery efforts. Provisions are needed to foster and invite women's voice in decision making, and build more active-state approaches to women's livelihood recovery.