Women's Views Research Articles

DrawingOut – An innovative drawing workshop method to support the generation and dissemination of research findings

A growing body of literature has explored the potential for arts-based methods to generate and disseminate research, particularly on sensitive or complex topics. This article presents DrawingOut, a metaphor-centred drawing workshop designed to collect visual and textual data about individuals’ experiences of sensitive or taboo health experiences. The visual data, consisting of the artwork produced by participants, and the textual data, all conversations and discussions occurring during the workshop, can also be used to create engaging outputs for dissemination. We piloted DrawingOut in a study of nine women with a minority ethnic or religious background in Cardiff, UK. The women were invited to participate in a series of structured drawing activities. The conversations occurring during the workshop were recorded and then subjected to thematic analysis. Results showed that women’s views and experiences could be grouped in eight major themes covering their wellbeing, relationship with others, and healthcare views and experiences. We produced an A5 16-page booklet that presents the pilot study results, illustrated with participants’ own drawings and quotes, which was disseminated among participants, their community and other relevant stakeholders. This pilot study supports the view that healthcare actors can use the DrawingOut method to engage people to talk about sensitive health topics, while simultaneously providing them with an enjoyable and empowering research experience. In our pilot study the DrawingOut was successful in eliciting rich visual and textual data that captures a diversity of views and experiences, with the added benefit that these can be used to produce engaging outputs for dissemination.

Female condom acceptability and use amongst young women in Botswana.

BackgroundThe female condoms are a barrier method of contraception. The FC1 female condom is made from soft thin plastic called polyurethane and has been replaced by FC2 female condom, which is made of synthetic latex. The female condom is worn inside the vagina and acts as a barrier to prevent semen getting to the womb. It is about 75% – 82% effective with normal use. When used correctly all of the time, female condoms are 95% effective. Despite evidence of its effectiveness, the use of the female condom has continued to face resistance from both women and men.ObjectivesThe objectives of this study were to determine clients’ level of knowledge of female condom, identify predominant methods of contraception, examine young women’s views regarding the female condom and identify barriers to the use of female condoms by young women.MethodA simple random sampling approach was used to recruit young women between 15 and 34 years in Jwaneng, Botswana. Data were collected using self-administered structured questionnaire from women accessing healthcare services in the three health facilities in 2015. Descriptive statistics, exploratory factor analysis and the chi-square test techniques were applied using the Statistical Package for the Social Sciences (SPSS) statistical programme version 23 for Windows to analyse data.ResultsThe findings based on factor loadings show low utilisation of the female condom and highlights the significant challenges about the material, size, shape and timing of insertion. Respondents had stronger views on the structure of the condom. There was no significant relationship between attitude and method of contraception.ConclusionAcceptability of the female condom involves complex factors such as women position and decision-making power in a relationship, attitude and knowledge. Attitude, knowledge and power relations play a role in the extent to which women would want to try or use it. Various strategies need to be developed to effectively promote the female condom amongst young women.

Socioeconomic determinants of rural women's desired fertility: A survey in rural Shaanxi, China.

There has been evidence demonstrating that China has had a persistently low and below-replacement level fertility since early 1990s, causing concerns of a rapidly aging population and sustainability of the Chinese economy. To avoid adverse effects of excessively low fertility, the Chinese government has recently changed its family planning policy from "one-child policy" to "two-child policy." Nonetheless, the effectiveness of the newly initiated two-child policy is questionable if women's average desired number of children or desired fertility for their lifetime is below the threshold fertility allowed by the two-child policy. Therefore, this study argues that it would be interesting and pertinent to know women's fertility desires under the circumstances of no policy restrictions and understand major factors that may affect their desired fertility. Based on a multi-stage stratified cluster sampling survey with 2,516 women respondents in rural Shaanxi, this study tries to estimate desired fertility of rural women and evaluate the impact of important socioeconomic factors on their desired fertility. The results of this study reveal that the average lifetime desired fertility for rural women of childbearing age in Shaanxi is about 1.71, below the total fertility rate at the replacement level. The findings of this study suggest that women's marriage age, the pecuniary costs of having children, women's income forgone for having children, and social security benefits available for rural residents at retirement age, are significantly and negatively related to desired fertility. However, rural women's cultural views towards fertility are significantly but positively related to their desired fertility. This study further confirms that China has entered an era of low fertility, and thus, any policy restrictions on fertility may no longer be necessary. Instead, government programs which support childbearing and childrearing are needed to prevent excessive low fertility and rapid aging of the population.

The Views of Women in Prison about Help-Seeking for Intimate Partner Violence: At the Intersection of Survivor and Offender

ABSTRACTIntimate partner violence (IPV) is the most prevalent form of violence against women, with particularly high rates of victimization experienced by those who are involved in the justice system. For women leaving prison, the dual status of ‘survivor’ and ‘offender’ introduces a range of additional factors that have the potential to limit access to those services that can keep them safe. In this qualitative study, 22 women in an Australian women’s prison discussed help-seeking for IPV. The analysis of their experiences highlights the importance of providing services that address multiple determinants of help-seeking in ex-prisoners.

Capsule Commentary on He et al., How Do Women View Risk-Based Mammography Screening? A Qualitative Study.

Capsule Commentary on He et al., How Do Women View Risk-Based Mammography Screening? A Qualitative Study.

Decision-making about cervical screening in a heterogeneous sample of nonparticipants: A qualitative interview study.

ObjectiveAccording to the precaution adoption process model, cervical screening nonparticipants represent a heterogeneous group including those who are unaware of, unengaged with, or undecided about screening, as well as intenders and decliners. We aimed to explore beliefs about cervical screening among these different types of nonparticipant.MethodsSemistructured interviews were carried out with women aged 26 to 65 years living in Britain (n = 29). Women were purposively sampled to represent different nonparticipant types. Interviews were transcribed verbatim, and data were analysed thematically using framework analysis.ResultsThe salience of some barriers to screening varied between different types of nonparticipant. Bad experiences were prominent in the discussions of women who had decided not to attend, while practical barriers were more prominent among intenders. There was also some overlap between nonparticipant types. For example, many of the undecided women described not wanting to go for screening, but with less certainty than decliners. Some intenders (particularly those who had not been screened before) described not really wanting to attend but feeling they ought to. Women's views on the invitation/reminder process also varied; intenders and maintainers appreciated written reminders and general practitioner (GP) prompts but decliners sometimes perceived these as “badgering.” Throughout the interviews, women described changing views on screening in the wider context of ageing and motherhood.ConclusionsThe salience of screening barriers varies by nonparticipant type, offering possibilities for tailored interventions. However, the fluidity of women's stage of screening adoption might have implications for this approach to intervention design.

Women's views and experiences of having their mental health needs considered in the perinatal period

ObjectiveTo explore women's views and experiences of having their mental health needs considered in the perinatal period in an Irish maternity hospital setting. DesignA qualitative design using semi-structured interviews was used to explore women's views and experiences. Data were analysed using Thematic Analysis (Braun and Clarke, 2006). SettingA voluntary maternity hospital in Dublin, Ireland which had access to a perinatal mental health team. ParticipantsIn total 8 women who met the inclusion criteria were recruited and participated in this study. The women were interviewed in the early postpartum period. FindingsThe study offers important insights into how women feel about having their mental health needs considered in the perinatal period. Women reported pregnancy was an emotional time, feeling expected to be happy, and women with significant mental health histories preferred not to be referred to available services unless they asked for help. Women reported barriers to disclosure including stigma/shame, lack of time. Screening tools were viewed with mixed opinions. In getting help, the baby was a motivator for some women, attitudes of healthcare professionals and lack of time affected this. Key ConclusionsWomen appreciated all methods of enquiry about their mental health and being given time to discuss concerns with healthcare professionals. Perceived busy staff workloads was a barrier in asking for help, as was lack of continuity of care. Screening tools were viewed as a tick box exercise, but also as a ‘modality’ to assist detection of women at risk. Mental health enquiry focused on depression and anxiety, with little or no enquiry about less common disorders. Women with significant histories were less likely to engage or accept referral to perinatal mental health services, preferring to access help if they felt they needed to. Implications for practiceHCPs should enquire regularly about women's emotional wellbeing at every antenatal and postnatal contact, offering support where required. Detailed enquiry about mental health should encompass the broad spectrum of perinatal mental health problems, including but not limited to depression and anxiety. Screening tools can assist in the identification of women at risk of developing perinatal mental health problems. A specialist mental health midwife should link with high-risk women at the first antenatal booking visit and provide information on early intervention and access to services.

How Do Women View Risk-Based Mammography Screening? A Qualitative Study.

Decades of persuasive messages have reinforced the importance of traditional screening mammography at regular intervals. A potential new paradigm, risk-based screening, adjusts mammography frequency based on a woman's estimated breast cancer risk in order to maximize mortality reduction while minimizing false positives and overdiagnosis. Women's views of risk-based screening are unknown. To explore women's views and personal acceptability of a potential risk-based mammography screening paradigm. Four semi-structured focus group discussions about screening mammography and surveys before provision of information about risk-based screening. We analyzed coded focus group transcripts using a mixed deductive (content analysis) and inductive (grounded theory) approach. Convenience sample of 29 women (40-74years old) with no personal history of breast cancer recruited by print and online media in New Hampshire and Vermont. Twenty-seven out of 29 women reported having undergone mammography screening. All participants were white and most were highly educated. Some women accepted the idea that early cancer detection with traditional screening was beneficial-although many also reported hearing inconsistent recommendations from clinicians and mixed messages from media reports about mammography. Some women were familiar with a risk-based screening paradigm (primarily related to cervical cancer, n = 8) and thought matching screening mammography frequency to personal risk made sense (n = 8). Personal acceptability of risk-based screening was mixed. Some believed risk-based screening could reduce the harms of false positives and overdiagnosis (n = 7). Others thought screening less often might result in missing a dangerous diagnosis (n = 14). Many (n = 18) expressed concerns about the feasibility of risk-based screening and questioned whether breast cancer risk estimates could be accurate. Some suspected that risk-based mammography was motivated by a desire to save money (n = 6). Some women thought risk-based screening made sense. Willingness to abandon traditional screening for the new paradigm was mixed. Broad acceptability of risk-based screening will require clearer communication about its rationale and feasibility and consistent messages from the health care team.

What women think about consent to research at the time of an obstetric emergency: a qualitative study of the views of a cohort of World Maternal Antifibrinolytic Trial participants.

ObjectiveThe World Maternal Antifibrinolytic (WOMAN) Trial was the first in the UK to use the option of waiver of informed consent at the time of an obstetric emergency. This qualitative study aimed to investigate participants’ views of the acceptability of the recruitment methods used.DesignQualitative study using in‐depth interviews with women who did and did not give consent at the time of their recruitment to the WOMAN Trial.SettingHighest UK recruitment site for the WOMAN Trial (129/569). Interviews were conducted in participants’ homes.PopulationAbout 40 of the 129 women who were recruited to the WOMAN Trial at one UK site were invited to take part, 15 women were interviewed.MethodsQualitative, interview study.Main outcome measuresFacilitators and barriers to successful recruitment during obstetric emergencies. Guidance for future researchers.ResultsFindings revealed that what is important is not so much the consent process used or a signature on a form, but the way in which consent is obtained. Clinicians who successfully negotiate consent to research during childbirth emergencies engage in a ‘humane choreography’ of words and actions. This emphasises the importance of prompt decision‐making and treatment, while respecting the woman's personal situation and experience.ConclusionsOur findings do not support a single pathway to consent in the context of an obstetric emergency. Women understand that consent to research in an emergency is complex. Clinicians’ skills in considering the clinical, ethical, and emotional aspects within the context of the clinical emergency can hamper or promote women's satisfaction.Tweetable abstractStudy reports on women's views of consent to research in an obstetric emergency.Plain Language SummaryWhy and how was the study carried out?We undertook this study to find out what women thought about being included in a research study called the WOMAN Trial at the time they were being treated for heavy bleeding after giving birth. Some women had been asked if they wanted to be a part of the research at the time they were bleeding. Others were asked later, after they had recovered. We conducted interviews with 15 women who had been involved and asked what they thought about the way they had been asked, their preferences and ideas for improvements in future similar studiesWhat were the main findings?Women understood how difficult it was for their doctors and midwives to ask them about the research study. They were pleased to have been included in the research and were mostly happy with the way they gave consent. Women's views were similar whether they were asked about the research at the time of the bleeding or after they had recovered. The most important thing was that doctors and midwives carefully thought about the situation the woman found herself in and how this might make her feel, so they could tailor their approach accordingly.What are the limitations of the work?This study only involved women from one hospital. The WOMAN Trial included women from many areas of the UK and other countries around the world. We do not know how their experiences or views may differ.What is the implication for professionals?Careful use of actions and words by birth attendants was the difference between a good or bad experience for the woman and her family. This is an important skill that could be developed as part of professional training.

Women's decision-making regarding risk-stratified breast cancer screening and prevention from the perspective of international healthcare professionals.

IntroductionIncreased knowledge of breast cancer risk factors may enable a paradigm shift from one-size-fits-all breast cancer screening to screening and subsequent prevention guided by a woman’s individual risk of breast cancer. Professionals will play a key role in informing women about this new personalised screening and prevention programme. Therefore, it is essential to explore professionals’ views of the acceptability of this new programme, since this may affect shared decision-making.MethodsProfessionals from three European countries (the Netherlands, United Kingdom, and Sweden) participated in digital concept mapping, a systematic mixed methods approach used to explore complex multidimensional constructs.ResultsAcross the three countries, professionals prioritised the following five themes which may impact decision-making from the perspective of eligible women: (1) Anxiety/worry; (2) Proactive approach; (3) Reassurance; (4) Lack of knowledge; and (5) Organisation of risk assessment and feedback. Furthermore, Dutch and British professionals expressed concerns regarding the acceptability of a heterogeneous screening policy, suggesting women will question their risk feedback and assigned pathway of care. Swedish professionals emphasised the potential impact of the programme on family relations.ConclusionsThe perspectives of Dutch, British, and Swedish professionals of women’s decision-making regarding personalised breast cancer screening and prevention generally appear in line with women’s own views of acceptability as previously reported. This will facilitate shared decision-making. However, concerns regarding potential consequences of this new programme for screening outcomes and organisation need to be addressed, since this may affect how professionals communicate the programme to eligible women.

Midwives' and women's views on accessing dental care during pregnancy: an Australian qualitative study.

Maternal behaviours during pregnancy are likely to play a significant role in the development of dental caries in children. Although midwives are well placed to discuss oral health and provide information to women, dental attendance by women during pregnancy is minimal. This study aimed to explore midwives' experience of facilitating pregnant women's access to dental care and to document women's experience of receiving dental information and care during pregnancy. Focus groups with midwives and telephone interviews with women who were referred to Monash Health Dental Services were conducted to explore their perspectives and experiences. The qualitative data was thematically analysed. Three focus groups with 13 midwives and telephone interviews with eight women who recently gave birth were conducted. Three key themes were identified: maternal oral health knowledge; barriers to accessing dental information and care during pregnancy; and suggested recommendations. This study highlighted the barriers that exist for midwives to discuss oral health with women and refer women to dental care, and women's experiences of accessing dental care during pregnancy. Ongoing collaboration between the maternity and dental services is required to strengthen midwives' knowledge, confidence and practise in supporting women to access dental care during pregnancy.

Uterotonic agents for preventing postpartum haemorrhage: a network meta-analysis.

Uterotonic agents for preventing postpartum haemorrhage: a network meta-analysis.

Womanhood, reproduction, and pollution: Greek Cypriot women's accounts of menstruation

Through in-depth interviews with 20 Greek Cypriot women between the ages of 23 and 73 living in Cyprus, I explore and examine the multiple and diverse meanings Greek Cypriot women of different generations attribute to the embodied experience of menstruation. Analyzing womanhood and reproduction as the most common meanings attributed to menstruation, as well as the experiencing of the menstruating body as a dirty, polluting, and dangerous body, I explore the significant role that religious ideology play in women's constructions of their bodies and discuss the cultural understandings and the implications of ‘being a woman’ and ‘having a woman's body’ in the contemporary Cypriot society. The women's views of menstruation, which remain largely unchanged across generations, are illustrative of the strong cultural association between women and impurity, as well as of the ‘compulsory’ nature of heterosexuality, marriage, and motherhood. I argue that researching menstruation, and especially how women themselves experience, interpret, and negotiate their experiences, can provide significant insight into the multiple and diverse socio-cultural parameters that shape embodiment, as well as into what it means to be a woman in a particular context at a particular time.

Gender‐Related Attitudes and Beliefs Predict White Women's Views of Candidates in the 2016 United States Presidential Election

AbstractWhite women's general failure to vote for Hillary Clinton in the 2016 United States presidential election (only 43% of White women did so) was largely unexpected. We tested the hypothesis that White women's gender‐related attitudes and beliefs, including their (i) feminist identification, (ii) views of societal gender discrimination, (iii) personal experiences with gender discrimination, and (iv) beliefs about female role models, were related to their levels of support for Hillary Clinton and her opponents (Sanders, Trump). A sample of White women (N = 314; 18–75 years, M = 32.71, SD = 13.37) recruited during June and July of 2016 from MTurk and college campuses completed surveys of their gender‐related attitudes and beliefs, as well as political preferences. Results indicated that women's gender‐related attitudes and beliefs predicted their views of both Clinton and Trump, after accounting for political ideology. For example, feminist identification was positively related to support for Clinton. Additionally, stronger endorsement of the notion that societal gender discrimination persists in the United States predicted both more favorable ratings of Clinton and less favorable ratings of Trump. More frequent personal experiences with discrimination, in contrast, predicted weaker support for Clinton.

Ten Chinese Books That Changed Our View of Women’s History

Scholars of Chinese women’s history in the West have often ignored the scholarship of their colleagues in China. For much of the twentieth century, Chinese academia was in chaos. With so little good research coming out of China, Western scholars became accustomed to ignoring the works of Chinese academics. Since the 1980s, however, Chinese scholarship has steadily improved, reaching international standards of quality. Chinese scholars remain highly influenced by their rich intellectual legacy. A post-Marxist mindset makes them extremely sensitive to the importance of social class. And the study of imperial philology has taught them the importance of textual criticism and close reading. This article discusses ten representative Chinese books covering different eras of women’s history, which exemplify the contributions that Chinese scholars are currently making to the field.

Building capacity and wellbeing in vulnerable/marginalised mothers: A qualitative study.

The persistence of health inequalities in pregnancy and infancy amongst vulnerable/marginalised groups in the UK. During pregnancy and early motherhood some women experience severe and multiple psychosocial and economic disadvantages that negatively affect their wellbeing and make them at increased risk of poor maternal and infant health outcomes. To explore vulnerable/marginalised women's views and experiences of receiving targeted support from a specialist midwifery service and/or a charity. A mixed-methods study was undertaken that involved analysis of routinely collected birth-related/outcome data and interviews with a sample of vulnerable/marginalised women who had/had not received targeted support from a specialist midwifery service and/or a charity. In this paper we present in-depth insights from the 11 women who had received targeted support. Four key themes were identified; 'enabling needs-led care and support', 'empowering through knowledge, trust and acceptance', 'the value of a supportive presence' and 'developing capabilities, motivation and confidence'. Support provided by a specialist midwifery service and/or charity improved the maternity and parenting experiences of vulnerable/marginalised women. This was primarily achieved by developing a provider-woman relationship built on mutual trust and understanding and through which needs-led care and support was provided - leading to improved confidence, skills and capacities for positive parenting and health. The collaborative, multiagency, targeted intervention provides a useful model for further research and development. It offers a creative, salutogenic and health promoting approach to provide support for the most vulnerable/marginalised women as they make the journey into parenthood.

Turkish Women’s Knowledge, Attitudes, and Behaviors on Wet-Nursing, Milk Sharing and Human Milk Banking

Purpose The aim of this study was to determine Turkish women's knowledge, attitudes, and behaviors on wet-nursing, milk sharing, and human milk banking in a primary care setting located in a semi-rural area. Description Donated human milk is a feasible option for feeding infants and children. Currently, there is a debate on the topic starts with the preparations to launch a human milk bank in a large city in Turkey. Several previous papers reported women's opinions in large hospital based studies. Little is known about women's views and practice on donated human milk in the rural areas of Turkey. Assessment The study sample was recruited among married women aged 15-49 years who had given birth within the past 5 years and who were in a family health center for any reason in Honaz, Denizli, Turkey. A total of 240 women were included in the study. The data were collected by questionnaire created by the researchers and consisting of two parts: sociodemographic characteristics, and women's knowledge, attitudes, and behaviors on wet-nursing, milk sharing and human milk banking. Results Thirty women (12.5%) had had a wet-nurse; 20 women (8.7%) wet-nursed babies before; and 17 (7.2%) of the women's children had a wet-nurse. If necessary, 80.9 and 78.3% were willing to accept to do wet-nursing and milk sharing, respectively. 150 (62.5%) heard of human milk banks; 55 (22.9%) approved of the establishment of milk banks. However, only 46 women (19.1%) were willing to donate to the bank. Possibility of marriages between milk siblings (76.8%) was the main reason for not considering the donation. Women's education was another factor affecting their opinion on breast milk sharing and donation to human milk banks. Less educated women were sympathetic to milk sharing (p = 0.02), however, more educated mothers had a propensity to donate to milk banks (p = 0.02). Conclusion Wet-nursing decreased over the years in Turkey, but still an ongoing small child feeding method. Most of the women tend to become a wet nurse or do milk sharing if it is needed, but they are hesitant to donate their milk to human milk banks, mostly due to religious concerns.

A systematic review of health promotion interventions to increase breast cancer screening uptake: from the last 12 years.

BackgroundThe outcome of breast cancer treatment largely depends on the timing of detection. The health promotion interventions have an immense contribution to early detection and improved survival. Therefore, this review aimed to provide evidence on the efficacy of the health promotion interventions to increase the uptake of breast cancer screening and to develop effective interventions targeting women.MethodsOnline databases (PubMed/MEDLINE/PubMed Central, Ovid/MEDILINE, EMBASE, Web of Science and Google Scholar) were searched for studies published between January 2005 and January 2017. A quality coding system was assessed using Cochrane checklists for randomized controlled trial (RCT) and Downs and Black checklists for non-RCT. The score was rated for the included articles by each researcher independently and the average score is given accordingly. This study was registered in PROSPERO as [PROSPERO 2017: CRD42017060488].ResultsThe review dovetailed 22 studies. Thirteen studies (59.10%) were conducted in the Unite States, 4 in Iran (18.18%), 2 in India (9.09%) and 1 each in Turkey, Saudi Arabia and Israel. The interventions were classified as ‘individual-based’, ‘community-based’, ‘group-based teachings and training’ and ‘behavioral model based’. The majority of the studies showed favorable outcomes after health promotion interventions, including improvements in women’s view of breast screening, breast self-examination and knowledge of breast screening.ConclusionThe review confirmed that most of the health promotion interventions targeting women boosted the breast screening in one or another way. However, the limited quality of the included studies showed that further research is needed to improve the trials in the next future.

Challenges and opportunities facing successful women in Morocco

ABSTRACTOver a decade since the passage of a revised family status code (mudawana) in Morocco, the literature varies in its assessment of the code's impact on women's rights and opportunities. While some studies point to the formal support for gender equality reflected in the revised code, others note that Moroccan women continue to face challenges in the social and symbolic spheres. Drawing on interviews conducted by the authors with women leaders in Morocco in 2016, this paper investigates the opportunities and obstacles these women have encountered in their personal journeys. The paper explores the extent to which elite background, work sector, religion, and legal codes affect women's ascent to leadership roles and shares the women's own views regarding improving women's status.

A comparative study of American and Chinese college students’ motives for food choice

Previous cross-cultural research has examined college students' food choice decisions in different countries. The current study aimed to add to the literature by examining similarities and differences in motives for food choice between American (N = 328) and Chinese (N = 333) college students. The Food Choice Questionnaire (FCQ) was used to measure the participants' motives for food choice. Students’ perceptions on the importance of diet and on their body satisfaction were also obtained. Results show that, while there are many similarities between the two cultural groups on the FCQ items, there are also significant differences. Specifically, the two groups view sensory appeal, weight, health, mood, and familiarity in a similar way, but the American participants score higher on price and convenience whereas the Chinese score higher on natural content and ethical concerns. We believe contextual cultural factors of each country may be related to these results. Women view sensory appeal and weight as significantly more important than men. Interactions between culture and gender are also found. For example, American women score significantly higher than American men on mood whereas there is no gender difference in the Chinese group; on the other hand, Chinese men score significantly higher on price than Chinese women whereas there is no gender difference in the American group.