Women's Clinic Research Articles

Ecological aspects of studying the thyroid function of the thyroid gland in women of reproductive age living in a region with iodine deficiency (Akhtynsky district, Republic of Dagestan, Russia)

Aim. To present epidemiological aspects of the study of thyroid function of the thyroid gland.The article presents the results of a clinical and laboratory examination and epidemiological aspects of studying the thyroid function of the thyroid gland in 120 women of reproductive age living in an area with iodine deficiency (Akhtynsky district, Republic of Dagestan – located at an altitude of 1.675 metres above sea level). The women were examined for thyroid diseases and for the presence of intrauterine infections: TORCH toxoplasmosis, ornithosis, rubella, cytomegalo‐ and herpesviruses.All the examined patients had thyroid diseases (the women are registered with an endocrinologist at an Endocrinological Dispensary). All women underwent correction of iodine deficiency in the form of iodine prophylaxis by taking medications containing a daily iodine requirement of up to 250 mcg to normalize thyroid function.Intrauterine infections (IUI) were found in 76 women (69 %. of the patients examined). Intrauterine infections of women registered in the women's clinic of the district hospital were also treated.

Changes in sexual activity in young women during pregnancy

Objective: To conduct changes in sexual activity during pregnancy and its related factors in pregnant women. Methods: The present descriptive cross-sectional study was conducted in 2017 on pregnant women who referred to the women's clinic of Afzalipour Hospital in the southeast of Iran. Participants were included in the study through convenient sampling. The data collection tool was a researcher-made questionnaire consisting of two parts of personal social information of the couple and questions to measure the level of sexual activity and the attitude of the subjects during pregnancy compared to before pregnancy. Results: 201 Pregnant women were included. The average age of pregnant women was (27.3±6.1) years and their average gestational age was (24.7±11.8) years. More than 62% of women had decreased sexual activity. There was a significant relationship between the amount of changes in sexual activity and delivery time (P=0.013), abortion history (P=0.001) and premature birth history (P=0.002). Most pregnant women believed that sex during pregnancy caused damage to the fetus (67.7%). A decrease in the intensity of sexual desire was reported in 63% of pregnant women. More than 60% of the subjects did not consult with doctors and midwives with regards to sexual issues (63.5%). The most common reason for not consulting was not feeling the need (32%). Most women experienced back pain during (42.8%) and after (39.8%) intercourse. Conclusions: Changes in sex life during pregnancy are often caused by the lack of sexual knowledge and the increase in misconceptions among couples, which can affect the quality of relationships. The role of education is essential. Therefore, it is suggested that by including sexual counseling along with pregnancy care, wrong beliefs and information among women will be corrected.

Sir Robert Edwards: from the science of human conception to the reality of IVF birth

With a new Netflix film Joy telling the dramatic story of IVF, Dr Kamal Ahuja recalls the inspirational role that the late Sir Robert Edwards played in his own career and in the foundation of the London Women's Clinic.

Family creation by combined use of ART and surrogacy in a transgender couple: a unique case report

In 2014 a 36-year-old healthy female-to-male transgender patient attended the London Women's Clinic to consider oocyte and embryo freezing before sex reassignment surgery. The patient began IVF treatment in 2015; from two cycles nine MII oocytes and five blastocysts were frozen. Three years later the patient returned with his partner, a 39-year-old healthy transgender male-to-female, ready to start a family with surrogacy treatment. The surrogate delivered a healthy baby girl born at term in 2021 via Caesarean section, with a second successfully delivered in 2022. To our knowledge this is the first case report of successful family creation in which both partners are transgender.

Abstract C175: Implementing cervical cancer screening services in women living with HIV in Trinidad and Tobago

Abstract Background: Women constitute 50% of people living with HIV, and cervical cancer (CCA) is among the top cancers for incidence and mortality, in the Caribbean. Women living with HIV (WLWH) are more susceptible and vulnerable to cancer due to their immune-compromised status. There is a pressing need for clinic-based CCA prevention in WLWH. Objective: A preliminary quality improvement evaluation of pilot CCA screening (Pap smear) targeting WLWH in Trinidad and Tobago from July 2020 to September 2021. Methodology: The electronic health information system from a large clinic was used to abstract Pap testing data. No personal identifiers were collected from the system to protect the privacy of individuals and abide by Trinidad and Tobago’s data protection law. Evaluation of quality improvement of interventions approach was applied. Descriptive analyses were conducted using SPSS. Results: A total of 242 WLWH attended the women's clinic (WHC) from July 2020 to September 2021. The average age was 41.2 (age range: 20-72). Most (78.9%) reported sexual activity initiation between 15-29 years old, and 2 in 3 (66.1%) had sexual activity in the last 12 months. Among our participants, 67.8% were Afro-Caribbean, 20.7% were Mixed, and 5.8% were East Indian. The majority of WLWH completed at least secondary education (69.8%). Almost half were single (49.6%), and 59.5% were employed/self-employed. Additionally, 11.6% of patients reported a family history of CCA. The WHC provided Pap test to 91.7% of WLWH, 69.3% had normal Pap test results, 9.2% had abnormal Pap test results, and 0.4% were diagnosed with CCA in situ. Additionally, 8.6% found infections including Candida Albicans, Actinomyces, and Trichomoniasis. For those with abnormal Pap tests, timely follow-up care was provided to prevent further illnesses and cervical dysplasia. WLWH with cervical cancer in situ were scheduled/referred to treatments to prevent CCA progression. Discussion: A women’s clinic approach to CCA screening was successful in providing Pap tests and promoting timely diagnostic and therapeutic care to prevent CCA. We thus recommend an implementation and dissemination science approach to create strategies for adopting, implementing, sustaining and disseminating clinic-based CCA screening and HPV-related cancer prevention to reduce cancer-related morbidity and mortality among WLWH. Citation Format: Jonathan Edwards, Gaole Song, Selena Todd, Tessa Galindo, Sharon Soyer, Gregory Boyce, Kamilah Thomas-Purcell, Jarrett Sharlene, Diadrey-Ann Sealy, Kathy-Ann Pate-Robinson, Kimlin Ashing, Jeffrey Edwards, Nyla Lyons. Implementing cervical cancer screening services in women living with HIV in Trinidad and Tobago [abstract]. In: Proceedings of the 17th AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2024 Sep 21-24; Los Angeles, CA. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2024;33(9 Suppl):Abstract nr C175.

An Evaluation of a Women's Clinic: The Healthcare and Learning Project of the Functional Unit for Women with Schizophrenia.

Gender differences exist in mental and physical health in schizophrenia, and healthcare education is part of the associated clinical approach. The main goal of the present paper is to describe a women's clinic for schizophrenia and carry out a narrative review about innovative healthcare and learning strategies in the context of women who suffer from schizophrenia, and to discuss innovative strategies for both healthcare and learning projects to be applied in this context. Observing the development of our unit, four clear innovation phases can be distinguished: the generation of new ideas (clinical and social needs), strategic planning (five observatories), the execution of these strategies (observatories/teams/interventions) and feedback, iteration and scaling. We found that the observatory for morbi-mortality adopted a retroactive proactive approach, and the observatory for hyperprolactinemia was proactive and deliberate. We describe the innovation aspects, both clinical and educational, as incremental. There was one exception, the introduction of a social exclusion and discrimination observatory, that from our perspective, was not gradual, but transformative. Future learning projects should include the role of social sciences and humanities and new technologies. Our pilot project gave us the opportunity to apply new learning methods to a relatively neglected field of care.

Welcoming new neighbors: Minnesota's rapid response model to address the urgent health needs of Afghan newcomers, 2021-2022.

As a result of the United States withdrawal from Afghanistan in fall 2021, 1,260 Afghan evacuees arrived in Minnesota between October 2021 and February 2022. Several contextual factors including an overtaxed health system under duress from COVID-19 and uncertain benefit eligibility prompted a coordinated public health response to appropriately address the acute and pressing medical concerns of our new neighbors. This community case study describes the State of Minnesota's cross-sectoral response that created a welcoming environment, identified public health concerns, and addressed acute medical needs. Medical volunteers provided an initial health and safety check for Afghan families upon arrival. Volunteers also offered onsite culturally and linguistically appropriate mental health assessments, group therapy, women's clinics, vaccine clinics, medication refills, and ongoing walk-in primary care. Care coordinators facilitated primary care and specialty care referrals. The majority (96%) of eligible arrivals were screened as part of this response and the median time between arrival to Minnesota and initial health screening was 2 days. Half of all arrivals screened reported at least one health concern and 56% were referred to a specialty for further evaluation. Almost one in four adults (24%) reported mental health concerns. Existing partnerships across local sectors can be leveraged to provide comprehensive physical and mental health services to newcomers in an emergency response.

Current Health Status of Gulf War Deployed and Gulf War Era Veterans Who Use Veterans Affairs Health Care.

Background: Although some recent studies have examined the health of female Gulf War (GW) deployed and non-deployed GW era veterans, these all relied on self-report, which can be inaccurate and subject to recall bias. This study investigated the current health of GW deployed and non-deployed GW era female and male veterans using Veterans Health Administration (VHA) electronic health records (EHR). Methods: We performed a cohort study of deployed GW and non-deployed GW era veterans, identified from a list from the Defense Manpower Data Center (DMDC). We used the VA-Frailty Index (VA-FI), calculated with VHA administrative claims and EHR, as a proxy measure of current health. Results: We identified 402,869 veterans (351,496 GW deployed; 51,3373 non-deployed GW era; 38,555 female) in VHA databases. Deployed female veterans had the highest VA-FI (i.e., were frailest) despite being younger than deployed and non-deployed male veterans and non-deployed female veterans. Compared with deployed male veterans, deployed females were more likely to be pre-frail, mildly, and moderately frail. Health differences between deployed and non-deployed female veterans were more prominent among older (60+ years) than younger (<60 years) veterans. Conclusions: Mirroring reports from recent, smaller survey studies of users and non-users of VA health care, findings from this cohort study indicate that deployed female GW veterans who use VA health care are frailer and have more health deficits than non-deployed female GW era and deployed male GW veterans. Because deployed female GW veterans appear to have additional health care needs, this may warrant increased outreach from women's clinics at VA hospitals.

Breast Cancer Knowledge Among Amish and Mennonite Women.

Breast cancer is the most common cancer diagnosis for women in the USA and ranks second in cancer-related deaths. Disproportionately higher breast cancer rates can be found in rural and Appalachian regions due to several social drivers of health, including poverty, access to healthcare, and lack of culturally sensitive health education. Amish and Mennonite communities, religious groups with distinct cultural practices and beliefs, experience lower mammography screening and higher breast cancer mortality rates (among Amish women). This study focuses on knowledge about breast cancer and causes of cancer among Amish and Mennonite women. A total of 473 women participated in the study at 26 separate women's health clinics throughout Ohio, consisting of 348 Amish and 121 Mennonite women, the largest study conducted on breast cancer knowledge spanning dozens of communities. Statistically significant differences were found in total knowledge scores between Amish and Mennonite women (rpb = .178, n = 466, p = .007), with Amish women having lower scores and stronger beliefs in myths associated with breast cancer cause and symptoms (χ(1) = 7.558, p = .006). Both groups often provided scientifically accurate descriptions of cancer etiology. The majority of participants underestimated breast cancer risk, highlighting the need for culturally appropriate health education programs that consider numeracy and health literacy. By implementing targeted interventions and fostering partnerships with community stakeholders using a multifaceted approach that incorporates cultural sensitivity, community engagement, and collaboration, significant progress can be made towards reducing breast cancer disparities and improving health outcomes.

Enhancing Primary Care and Mental Health Integration for Women Veterans with Complex Healthcare Needs Using Evidence-Based Quality Improvement.

Women Veterans with co-morbid medical and mental health conditions face persistent barriers accessing high-quality health care. Evidence-based quality improvement (EBQI) offers a systematic approach to implementing new care models that can address care gaps for women Veterans. This study examines factors associated with the successful deployment of EBQI within integrated health systems to improve primary care for women Veterans with complex mental health needs. Following a 12-site (8 EBQI, 4 control) cluster randomized study to evaluate EBQI effectiveness, we conducted an in-depth case study analysis of one women's health clinic that used EBQI to improve integrated primary care-mental health services for women Veterans. Our study sample included providers, program managers, and clinic staff at a women Veteran's health clinic that, at the time of the study, had one Primary Care and Mental Health Integration team and one women's health primary care provider serving 800 women. We analyzed interviews conducted 12 months, 24 months, and 4 years post-implementation and call summaries between the clinic and support team. We conducted qualitative thematic analysis of interview and call summary data to identify EBQI elements, clinic characteristics, and reported challenges and successes within project development and execution. The clinic harnessed core EBQI elements (multi-level stakeholder engagement, data-driven progress-monitoring, PDSA cycles, sharing results) to accomplish pre-defined project goals, strengthen inter-disciplinary partnerships, and bolster team confidence. Clinic characteristics that facilitated implementation success included prior QI experience and an organizational culture responsive to innovation, while lack of pre-existing guidelines and limited access to centralized databases posed implementation challenges. Successful practice transformation emerges through the interaction of evidence-based methods and site-specific characteristics. Examining how clinic characteristics support or impede EBQI adaptation can facilitate efforts to improve care within integrated health systems.

Power, position and social relations: Is the espoused absence of hierarchy in Open Dialogue naïve?

Open Dialogue practitioners aim to reduce social hierarchies by not privileging any one voice in social network conversations, and thus creating space for a polyphony of voices. This sits in contrast to the traditional privileging of those voices credited with more knowledge or power because of social position or professional expertise. Using qualitative interviews, the aim of this current study was to explore Open Dialogue practitioners' descriptions of challenges in implementing Open Dialogue at a women's health clinic in Australia. Findings revealed how attempts to rhetorically flatten hierarchies among practitioners created challenges and a lack of clarity regarding roles and responsibilities. As the practitioners tried to adjust to new ways of working, they reverted to taking up engrained positions and power aligned with more conventional social and professional roles for leading therapy and decision-making. The findings raise questions about equity-oriented ways of working, such as Open Dialogue, where intentions of creating a flattened hierarchy may allow power structures and their effects to be minimised or ignored, rather than actively acknowledged and addressed. Further research is needed to consider the implications that shifting power relations might have on the roles and responsibilities of practitioners in the move to equity-oriented services.

Prevalence of Trichomonas Infection in Relation to Human Papillomavirus (HPV) in Pap Smear Samples of Female Patients Referred to Shahid Sadoughi Hospital, Yazd (Iran).

Objectives Human papillomavirus (HPV) and Trichomonas vaginalis (TV) infections have been proposed as risk factors for cervical cancer. This study has been conducted with the aim of investigating the prevalence of TV and its relationship with HPV in women who underwent Pap smear testing as part of cancer screenings. Materials and methods The sampling of liquid-based cervical tissue was conducted among 500 women referred to the women's clinic of Shahid Sadoughi Hospital in Yazd, Iran. The studied samples were examined for Pap smear tests and microscopic identification of TV, as well as HPV-DNA detection and the determination of high-risk and low-risk HPV types by the polymerase chain reaction (PCR) method. The results were analyzed using the IBM SPSS Statistics for Windows, Version 24 (Released 2016; IBM Corp., Armonk, New York) software. Results The individuals included in the study were 16-72 years old. The prevalence rate of TV infection in this population was found to be 29.2%, and the frequency rate of HPV was reported to be approximately 19.4%, with high-risk HPV, including HPV-56, having the highest frequency. The Pap smear test results were reported as abnormal in 20.2%, anda significant correlation was observed between HPV infection and an abnormal Pap smear test (P < 0.05). In addition, a notable correlation was detected between TV infection and high-risk and low-risk HPV (P < 0.05). Conclusion According to the significant relationship found between the two pathogens, TV and HPV, in the abnormal Pap smear test results, TV infection can be considered a risk factor for HPV infection, as well as uterine lesions and cancer.

К вопросу о тиреоидной функции щитовидной железы беременных, проживающих в йододефицитном районе (Республика Дагестан, Ахтынский район, 1675 м над уровнем моря)

The work shows that currently diseases associated with iodine deficiency in the diet are one of the most common non-communicable human diseases. Iodine deficiency contributes to a decrease in the synthesis and secretion of thyroid hormones, during pregnancy leads to the formation of the neuropsychiatric status of the fetus. Thyroid pathology is more common in women than in men. During pregnancy, thyroid pathology increases dramatically – pregnancy itself is a provoking factor. One of the important reasons is the deterioration of the environmental and radiation situation, the changing nature of the population's diet. The impact of the ecosystem on the health of the population can be determined based on data on the incidence of thyroid diseases in women of reproductive age in rural areas with iodine deficiency. The article presents data on the examination and treatment of 120 pregnant women (First Trimester of pregnancy) aged 20–40 years who are registered in the women's clinic of the Akhtyn regional hospital.

Investigating the association of the lifestyle of pregnant women with the rate of preterm labor.

From a long time ago, preterm birth has posed life-threatening risks due to the significant complications it causes. The present study aimed to examine how the lifestyle of pregnant women is related to the incidence of preterm birth. For this cohort study, a total of 234 individuals with healthy and unhealthy lifestyles who visited the women's clinics of Azad University hospitals during the year 2021 were randomly selected to participate. Four criteria were utilized to build lifestyle questionnaires, which included smoking habits, physical activity levels, consumption of high-fiber foods, and sufficient sleep. According to the individuals' responses, 117 mothers who scored above 14, and 117 mothers who scored below 14 were followed up. The SPSS version 25 (SPSS Inc., Chicago, Ill., USA) was used to analyze the correlation between variables and preterm birth, employing statistical tests such as Mann-Whitney, Chi-square, and independent t-test. In this study, the mean age of the examined women was 27.11 ± 3.19. Out of the total number of babies, 133 (56.8%) were females, while 101 (43.2%) were males. The P value for the association between lifestyle and preterm birth was less than 0.0001, indicating statistical significance. The difference between the consumption of tobacco, fruits, and vegetables and sufficient sleep with preterm birth was not statistically significant (P value >0.05). A healthy lifestyle can serve as an important preventive measure against preterm birth. Adequate education provided by the healthcare and treatment system plays an important role in promoting the adoption of a healthy lifestyle and benefiting from its positive outcomes.

Measuring the Levels of AMH, FSH, LH, TSH, Progesterone, Estrogen, Vitamin D, Calcium, and Magnesium in Women with Premature Ovarian Insufficiency

This research was designed to study some hormonal and physiological aspects of women with Premature Ovarian Insufficiency (POI). Blood samples were collected from the Infertility and Gynecology Unit at Al-Batoul Teaching Hospital in Baqubah and private women's clinics, including ages between 20 and 40. The study took place from 12/1/2022 until 5/1/2023, and informed consent was obtained from all patients. The study included 45 women with premature ovarian insufficiency. It was compared to a control group that consisted of 45 healthy women after confirming their fertility, at ages ranging from 20 to 40 years. The study investigated the effects of specific physiological and biochemical parameters on the disease. This was done by examining hormone levels and various biochemical levels in women with premature ovarian insufficiency. Some of the hormones examined were anti-Mullerian hormone (AMH), follicle-stimulating hormone (FSH), luteinizing hormone (LH), thyroid-stimulating hormone (TSH), progesterone, and thyroid hormone. The levels of vitamin D, calcium, and magnesium were also measured. The results of the current investigation showed that the age groups had a significant difference (P\(&lt;\)0.05) with the study groups. (patients and healthy people). The age groups 31-35 and \(&gt;\)35 years recorded the highest percentages (33.3% and 31.1%) in female patients compared to the groups \(&lt;\)20-25 and 26-30 years, which recorded the lowest percentages (15.6% and 20.0%), respectively. The outcomes of the current investigation regarding the concentration of reproductive hormones showed a significant difference. (P\(&lt;\)0.05) between the AMH, FSH, and LH hormone levels in the two study groups (patients and healthy individuals). The levels of FSH and LH were higher in patients (6.780 \(\pm\) 15.54 and 5.44 \(\pm\) 12.40) compared to healthy individuals (4.75\(\pm\) 6.51 and 4.04 \(\pm\) 0.94), respectively. On the other hand, AMH levels were lower in patients (0.18 \(\pm\) 0.42) compared to healthy individuals (0.92 \(\pm\) 3.15). In terms of TSH, E2, and Progesterone hormone levels, there were no significant differences (P\(&gt;\)0.05) between the two study groups. About the physiological investigation that included measuring the concentration of magnesium, calcium, and vitamin D, the current study demonstrated a significant difference (P\(&lt;\)0.05) in the concentration of magnesium between the two groups. (patients and healthy people). The level of magnesium was low in patients (0.29 \(\pm\) 0.75) compared to healthy people (0.30 \(\pm\) 2.07). There was also a statistically significant difference (P\(&lt;\)0.05) in the level of calcium concentration between the two study groups (patients and healthy people). The calcium level was high in patients (0.45 \(\pm\) 8.33) compared to healthy people (0.58 \(\pm\) 8.02). Also, significant differences (P&lt;0.05) in the levels of vitamin D were observed between the two groups of study (patients and healthy individuals). The levels of vitamin D were low in the patients (8.62 \(\pm\) 18.88) compared to the healthy people (11.53 \(\pm\) 44.15).

Development of mobile application for cervical cancer screening in women: Protocol of a multi-phase study.

Cervical cancer is one of the most common cancers in women. It is considered preventable due to the possibility of screening. The common barriers to cervical cancer screening include lack of knowledge, lack of time, and wrong beliefs. The use of e-Health technologies is one of the approaches for health promotion. The present study is aimed to the development of a mobile application for cervical cancer screening in women. This is a multi-phase study. In the first step, a literature review will be conducted to examine factors related to cervical cancer screening and existing applications related to cervical cancer and its screening. Then, in the second step, a cross-sectional study will be conducted to investigate the factors related to cervical cancer screening in 246 women referred to comprehensive health centers and women's clinics in teaching hospitals in Isfahan, Iran. The comprehensive health centers and women's clinics in teaching hospitals will be randomly selected using a lottery method. Using convenience sampling, women who meet the inclusion criteria will be included in the study, provided they provide informed consent. The data will be collected using a questionnaire, and then the descriptive and inferential statistical tests and SPSS18 software will be used to analyze the data. In the third step, specialists (gynecologists, reproductive health specialists, and midwives) will prioritize the application content by filling out a questionnaire. Then, the research team will compile the application content draft, and this draft will be reviewed and approved by experts on the expert panel. The prototype of the application will be prepared, and experts will evaluate it in the fifth step. The results of this study will result in the development of applications for cervical cancer screening. The use of mobile applications can be useful in lifting some of the barriers to screening. Therefore, developing such applications may help improve cervical cancer screening.

The Intersection of Childcare and Health Among Women at a U.S. Safety-Net Health System During the COVID-19 Pandemic: A Qualitative Study.

Lack of childcare has been linked to missed health care appointments for adult women, especially for lower-income women. The COVID-19 pandemic created additional stressors for many low-income families that already struggled to meet childcare and health care needs. By exploring the experiences of women who were referred for childcare services at a U.S. safety-net health system, we aimed to understand the challenges women faced in managing their health and childcare needs during the COVID-19 pandemic. We conducted semistructured interviews with participants in Dallas County, TX between August 2021 and February 2022. All participants were referred from women's health clinics at the county's safety-net hospital system to an on-site drop-off childcare center by hospital staff who identified lack of childcare as a barrier to health care access. Participants were the primary caregiver for at least one child ≤age 13. Interviews were conducted in English or Spanish. We analyzed data using thematic content analysis. We interviewed 22 participants (mean age 34); participants were adult women, had on average 3 children, and primarily identified as Hispanic or African American. Three interrelated themes emerged: disruptions in access, competing priorities, and exacerbated psychological distress. Findings demonstrate how low-income women with young children in a safety-net health system struggle to address their own health needs amid childcare and other household demands. Our study advances our understanding of childcare as a social domain of health, a necessary step to inform how we build structural support systems and drive policy interventions.

Perceived family functioning within Chinese pregnant women and husband dyads: Levels, consistency, and correlates.

Understanding differences in perceived family functioning between pregnant women and their partners can protect and promote women's health. The purpose of this study was to examine consistency and differences in perceived family functioning within pregnant woman-partner dyads in China and explore correlates of effective family functioning. From 2020 to 2021, 175 pregnant women and husband dyads (100% Han nationality, Mage = 30.3 [4.5] years) were recruited from the women's psychological clinic of Changsha Hospital for Maternal & Child Health Care using convenience sampling. We assessed family functioning and depression and anxiety symptoms. We examined consistency and differences in perceived family functioning between pregnant women and their husbands. Most pregnant women (76.6%) and husbands (71.4%) perceived their family functioning as effective. Pregnant women and their husbands shared poor consistency in family functioning, with an intraclass correlation of 0.25 and most weighted kappa coefficients of individual items < 0.2. Participants reporting effective family functioning had higher education levels and lower depression and anxiety scores. Most pregnant women and their partners perceived effective family functioning, but showed poor consistency. Higher education and milder symptoms of depression and anxiety were associated with effective family functioning both in pregnant women and their partners. For primary healthcare system workers, differences in perceptions of family functioning should be fully taken into account when conducting family based integrated care for pregnant women. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Diagnostic Hysteroscopic Procedure Evaluation in Outpatient Clinic for Women with Perimenopausal Bleeding

Diagnostic Hysteroscopic Procedure Evaluation in Outpatient Clinic for Women with Perimenopausal Bleeding

Improving Patient Compliance with Vaginal Dilator Therapy by Implementation of Sexual Health Consult in Gynecologic Malignancies after Radiation Therapy

Typical vaginal dilator therapy (VDT) compliance falls short at approximately 30% of patients in reported studies, which could lead to vaginal stenosis (VS) in as high as 88% of patients who undergo radiation therapy (RT) for gynecologic malignancies. In an ongoing effort to improve adherence to VDT aimed to prevent vaginal stenosis post pelvic and vaginal RT, a prospective study was implemented to assess the feasibility and the impact on vaginal dilator therapy adherence when implementing a consult with the oncology women's sexual health clinic following the completion of radiation therapy. This was a single institution, prospective analysis and feasibility study that included patients diagnosed with a gynecologic cancer who were treated with RT to the pelvic and or vaginal tissues. Using purposive sampling, the treating radiation oncologists identified eligible patients and referred them to the oncology women's sexual health clinic for consult four to six weeks status post completion of RT in a six-month period. A post treatment survey was conducted via a telephone interview 12 weeks after the sexual health clinic initial consult to assess vaginal dilator therapy compliance. Descriptive statistics were calculated. Pre-intervention retrospective data analysis revealed poor compliance to VDT with only 3 of 40 (7.5%) patients judged as compliant. Post-intervention, 30 of 37 (81.1%) patients in the sample were judged compliant. The adherence rate in the post-intervention group was significantly higher (Fisher's Exact Test two-tailed p-value < 0.0001). With confidence of 95%, the proportion of the potential population that would adhere post intervention was between 68.5% and 93.7%. Sociodemographic and clinical characteristics did not have a statistically significant correlation with VDT compliance. Implementing a referral to an oncology women's sexual health clinic at the completion of RT for the sample population is feasible. Our project demonstrates that instituting this new sexual health clinic may have a large, positive impact on patient compliance to vaginal dilator therapy. More importantly, this may lead to decrease incidences of vaginal stenosis and improvement in patient health outcomes and quality of life (QoL).