Woman

女人
  • 文章类型: Journal Article
    使用数字医疗保健技术来增强医疗保健服务已实现显着增长。然而,在临床量表应用于全科医生(GP)的更年期管理方面存在一个显著的研究差距.本研究旨在调查全科医生在女性更年期管理护理中使用特定更年期量表工具的意愿。
    进行了匿名在线调查,2023年收到348名法国全科医生的回复。进行了多个反向逻辑回归,以确定影响使用实用更年期管理量表意愿的因素。
    总共,87.93%的全科医生不熟悉Greene更年期量表,90.52%的全科医生不熟悉更年期Quick6量表。相比之下,90.52%的人会有兴趣获得这样的规模。使用更年期管理量表的意愿与更年期女性的护理有关(比值比[OR]=6.13,95%置信区间[CI][2.08-18.08],p=0.001),经验较少(OR=7.10,95%CI[2.05-25.22],p=0.002),健康预防在日常实践中的重要性(将“非常重要”与“不重要”进行比较,OR=12.98,95%CI[1.68-97.60],p=0.004)以及在日常实践中使用数字量表进行更年期管理(OR=2.13,95%CI[1.04-5.83],p=0.014)。
    未来的研究在代表性人群中是必不可少的,以确认这些发现在更年期管理。
    UNASSIGNED: The use of digital healthcare technologies to enhance healthcare delivery has seen significant growth. However, a notable a notable research gap exists in the application of clinical scales for menopause management by general practitioners (GPs). This study aims to investigate willingness of GPs to use specific menopausal scale tools in the care of females for menopause management.
    UNASSIGNED: An anonymous online survey was developed, which received responses from 348 French GPs in 2023. Multiple backward logistic regression was performed to identify the factors influencing the willingness to use a practical menopause management scale.
    UNASSIGNED: In total, 87.93% of GPs are not familiar with the Greene Climacteric Scale and 90.52% are not familiar with the Menopause Quick 6 scale. In contrast, 90.52% would be interested in having access to such scales. The willingness to use a menopause management scale is associated with caring for menopausal females (odds ratio [OR] = 6.13, 95% confidence interval [CI] [2.08-18.08], p = 0.001), less experience (OR = 7.10, 95% CI [2.05-25.22], p = 0.002), the importance of health prevention in daily practice (comparing \'very important\' to \'not\', OR = 12.98, 95% CI [1.68-97.60], p = 0.004) and the use of a digital scale in daily practice for menopausal management (OR = 2.13, 95% CI [1.04-5.83], p = 0.014).
    UNASSIGNED: Future research is essential in representative population to confirm these findings in menopause management.
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  • 文章类型: Journal Article
    背景:需要进行研究,以了解和解决高(≥20%终生)乳腺癌风险女性的风险管理障碍,但是招募这些人群进行研究是具有挑战性的。
    目的:本文比较了用于横截面,高危女性的观察性研究。
    方法:符合条件的参与者在出生时被分配为女性,年龄25-85岁,说英语,生活在美国,根据美国放射学会的定义,乳腺癌的风险很高。如果个人有乳腺癌病史,则将其排除在外,先前的双侧乳房切除术,磁共振成像的医学禁忌症,或者根据美国放射学会指南,筛查乳房X线照相术不是最新的。参与者从2020年8月到2021年1月使用以下机制招募:有针对性的Facebook广告,Twitter帖子,ResearchMatch(基于网络的研究招聘数据库),社区合作伙伴促销,纸质传单,和社区外展活动。有兴趣的个人被定向到一个安全的网站,有资格筛选问题。参与者在资格筛选期间自我报告招募方法。对于每个招聘策略,我们计算了合格受访者和完成调查的比率,每位合格参与者的费用,和参与者人口统计学。
    结果:我们收到了对资格筛选员的1566份独特回复。参与者通常通过Facebook广告(724/1566,46%)和ResearchMatch(646/1566,41%)报告招聘。社区合作伙伴晋升导致合格受访者比例最高(24/46,52%),而ResearchMatch的合格受访者比例最低(73/646,11%)。口口相传是最具成本效益的招聘战略(每份已完成的调查答复4.66美元),纸质传单成本效益最低(每份已完成的调查答复1448.13美元)。合格受访者的人口特征因招聘策略而异:Twitter帖子和社区外展活动导致西班牙裔或拉丁裔女性比例最高(1/4,25%和2/6,33%,分别),和社区合作伙伴的晋升导致非西班牙裔黑人女性的比例最高(4/24,17%)。
    结论:尽管招募策略对研究参与者的产量不同,总体结果支持在临床环境之外识别和招募乳腺癌高危女性的可行性.在规划针对高风险女性的未来研究时,研究人员必须平衡各种招聘策略的相关成本和参与者收益。
    BACKGROUND: Research is needed to understand and address barriers to risk management for women at high (≥20% lifetime) risk for breast cancer, but recruiting this population for research studies is challenging.
    OBJECTIVE: This paper compares a variety of recruitment strategies used for a cross-sectional, observational study of high-risk women.
    METHODS: Eligible participants were assigned female at birth, aged 25-85 years, English-speaking, living in the United States, and at high risk for breast cancer as defined by the American College of Radiology. Individuals were excluded if they had a personal history of breast cancer, prior bilateral mastectomy, medical contraindications for magnetic resonance imaging, or were not up-to-date on screening mammography per American College of Radiology guidelines. Participants were recruited from August 2020 to January 2021 using the following mechanisms: targeted Facebook advertisements, Twitter posts, ResearchMatch (a web-based research recruitment database), community partner promotions, paper flyers, and community outreach events. Interested individuals were directed to a secure website with eligibility screening questions. Participants self-reported method of recruitment during the eligibility screening. For each recruitment strategy, we calculated the rate of eligible respondents and completed surveys, costs per eligible participant, and participant demographics.
    RESULTS: We received 1566 unique responses to the eligibility screener. Participants most often reported recruitment via Facebook advertisements (724/1566, 46%) and ResearchMatch (646/1566, 41%). Community partner promotions resulted in the highest proportion of eligible respondents (24/46, 52%), while ResearchMatch had the lowest proportion of eligible respondents (73/646, 11%). Word of mouth was the most cost-effective recruitment strategy (US $4.66 per completed survey response) and paper flyers were the least cost-effective (US $1448.13 per completed survey response). The demographic characteristics of eligible respondents varied by recruitment strategy: Twitter posts and community outreach events resulted in the highest proportion of Hispanic or Latina women (1/4, 25% and 2/6, 33%, respectively), and community partner promotions resulted in the highest proportion of non-Hispanic Black women (4/24, 17%).
    CONCLUSIONS: Although recruitment strategies varied in their yield of study participants, results overall support the feasibility of identifying and recruiting women at high risk for breast cancer outside of clinical settings. Researchers must balance the associated costs and participant yield of various recruitment strategies in planning future studies focused on high-risk women.
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  • 文章类型: Journal Article
    背景:乳腺癌和宫颈癌是女性最常见的癌症,并与高发病率和死亡率有关。癌症筛查可以促进早期诊断,降低死亡率,减轻癌症的负担。社会支持和自我效能感与癌症筛查行为密切相关。本研究旨在探讨自我效能感对社会支持和癌症筛查行为的中介作用。
    方法:在2023年6月至10月进行的这项横断面调查研究中,从中国东海岸地区招募了312名35-65岁的女性。一般信息问卷,癌症筛查行为问卷,使用社会支持量表和自我效能感量表收集数据。采用描述性统计方法分析被试的一般特征;采用单因素方差分析检验被测变量的差异;采用皮尔逊相关分析描述社会支持之间的关系。自我效能感,和癌症筛查行为。使用SPSS的PROCESS宏构建和分析了中介模型。
    结果:乳腺癌和宫颈癌的平均(标准偏差)筛查行为评分为3.98(2.79),代表一个中间的水平。自我效能感与社会支持、癌症筛查行为密切相关。社会支持与自我效能感(r=0.37,p<0.01)和癌症筛查行为(r=0.18,p<0.01)呈显著正相关。自我效能与癌症筛查行为呈显著正相关(r=0.19,p<0.05)。自我效能在社会支持和癌症筛查行为之间表现出完全的中介作用。具有32%的解释力。
    结论:研究结果强调需要提高女性的社会支持水平和自我效能感,这反过来可以增加妇女在乳腺癌和宫颈癌筛查中的参与。
    BACKGROUND: Breast and cervical cancer are the most common cancers in women, and are associated with high morbidity and mortality rates. Cancer screening can facilitate early diagnosis, reduce mortality, and ease the burden of cancer. Social support and self-efficacy are strongly associated with cancer screening behavior. The present study aimed to explore the mediating effect of self-efficacy on social support and cancer screening behavior.
    METHODS: In this cross-sectional survey study conducted from June to October 2023, 312 women aged 35-65 years were recruited from the East Coast area of China. A general information questionnaire, cancer screening behavior questionnaire, social support scale and self-efficacy scale were used to collect data. Descriptive statistics were used to analyze the general characteristics of participants; one-way analysis of variance was used to test for differences in the measured variables; and Pearson\'s correlation analyses were used to describe the relationship among social support, self-efficacy, and cancer screening behavior. A mediation model was constructed and analyzed using the PROCESS macro for SPSS.
    RESULTS: The mean (standard deviation) screening behavior score for breast cancer and cervical cancer was 3.98 (2.79), representing an intermediate level. Self-efficacy was closely related to social support and cancer screening behavior. Social support showed a significant positive correlation with self-efficacy (r = 0.37, p < 0.01) and cancer screening behavior (r = 0.18, p < 0.01). Self-efficacy was also significantly positively correlated with cancer screening behavior (r = 0.19, p < 0.05). Self-efficacy showed a full mediating effect between social support and cancer screening behavior, with an explanatory power of 32%.
    CONCLUSIONS: The findings emphasize the need to increase women\'s level of social support and self-efficacy, which in turn can increase women\'s participation in breast and cervical cancer screening.
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  • 文章类型: English Abstract
    假性毛囊炎(PFB)是一种受剃须影响的慢性炎症性皮肤病。这在属于某些社会职业类别的非洲黑人中尤其常见,他们必须刮胡子。其审美和职业损害非常显著。然而,这种情况的数据很少,特别是在撒哈拉以南非洲。
    为了确定流行病学和临床方面,以及达喀尔地区发生PFB的相关危险因素。
    这是2019年3月进行的描述性横断面研究,其中包括达喀尔国家警察学院的655名警察学生,都是非洲人后裔,留着卷发,他们被要求每周刮胡子,并同意参加这项研究。PFB的诊断基于临床。使用Epi-info版本6.0软件处理数据分析。Pearson卡方检验用于双变量分析,显著性阈值为p<0.05。赔率比,95%的置信区间,用于确定风险因素。
    在655名军官中,254有PFB,患病率为38.8%。PFB的患病率男性为43.7%(554人中有242名男性),女性为11.9%(101人中有12名女性)。PFB患者平均年龄为26.80岁(±2.59),从22岁到36岁不等。PFB的发病年龄大多数在18至20岁之间(39.8%),平均发病年龄为22.2岁(±3.6)。PFB病灶为瘙痒的病例占84.6%,96.8%有丘疹,和/或脓疱占60.2%。下颌下区是受影响最大的部位(69.8%)。在90.1%的病例中以炎症后色素沉着过度(87%)和瘢痕疙瘩疤痕(3.1%)的形式出现并发症。与PFB相关的危险因素是男性(p<0.0001;OR=5.7;CI95%[3.07-10.75]),PFB家族史(p<0.0001;OR=5;CI95%[3.35-7.37]),皮肤瘢痕疙瘩(p<0.0001;OR=2.9;CI95%[1.63-4.96]),与痤疮的相关性(p<0.0001;OR=8.8;CI95%[5.55-14.08]),使用单刀片剃须刀(p<0.0001;OR=2.5;CI95%[1.69-3.70]),使用固定头剃须刀(p<0.0001;OR=1.8CI95%[1.28-2.77]),对谷物进行剃须(p<0.0001;OR=6.3;CI95%=[4.33-9.08]),未使用剃须产品(p=0.009;OR=1.5;CI95%=[1.06-2])和打蜡(p<0.004;OR=2.7;CI95%[1.33-5.77])。另一方面,使用推子(p<0.0001;OR=0.5CI95%[0.33-0.65]),剃须前产品(p<0.0001;OR=0.4CI95%[0.29-0.61])和使用带活动头的剃刀(p<0.0009;OR=0.2CI95%[0.17-0.35])是抗PFB的保护因素。
    我们的研究证实了这一非洲裔黑人人群中PFB的高发率。在PFB的发生中,必须引起剃须所揭示的遗传异常。需要进一步的遗传和免疫组织化学研究来支持这一假设。
    Pseudofolliculitis barbae (PFB) is a chronic inflammatory skin disease favoured by shaving. It is particularly common among black Africans belonging to certain socio-professional categories who are obliged to shave. Its aesthetic and professional damage is very significant. However, very few data are available for this condition, especially in Sub-Saharan Africa.
    To determine the epidemiological and clinical aspects, and the risk factors associated with the occurrence of PFB in Dakar.
    This was a descriptive cross-sectional study conducted in March 2019, including 655 police students at the National Police Academy in Dakar, all of African descent and with curly hair, who were required to shave weekly and agreed to participate in this study. The diagnosis of PFB was clinically based. Data analysis was processed using Epi-info version 6.0 software. Pearson\'s chi-square test was used for bivariate analysis with a significance threshold of p < 0.05. The Odds Ratio, with its 95% confidence interval, was used to determine the risk factors.
    Among the 655 officers, 254 had PFB, with a prevalence of 38.8%. The prevalence of PFB was 43.7% in men (242 men out of 554) and 11.9% in women (12 women out of 101). The average age of patients with PFB was 26.80 years (± 2.59), ranging from 22 to 36 years. The age of onset of PFB was between 18 and 20 years for the majority (39.8%), with a mean age of onset of 22.2 years (± 3.6). PFB lesions were pruritic in 84.6% of cases, papular in 96.8%, and/or pustular in 60.2%. The submandibular region was the most affected site (69.8%). Complications were noted in 90.1% of cases in the form of post-inflammatory hyperpigmentation (87%) and keloid scars (3.1%). The risk factors associated with PFB were male sex (p<0.0001; OR=5.7; CI95% [3.07-10.75]), family history of PFB (p<0.0001; OR=5; CI95% [3.35-7.37]), keloid-prone skin (p<0.0001; OR=2.9; CI95% [1.63-4.96]), association with acne keloidalis nuchae (p<0.0001; OR=8.8; CI95% [5.55-14.08]), use of a single-blade razor (p<0.0001; OR=2.5; CI95% [1.69-3.70]), use of a fixed-head razor (p<0.0001; OR=1.8 CI95% [1.28-2.77]), shaving against the grain (p<0.0001; OR = 6.3; CI95%= [4.33-9.08]), non-use of shaving products (p = 0.009; OR = 1.5; CI95%= [1.06-2]) and waxing (p<0.004; OR=2.7; CI95% [1.33-5.77]). On the other hand, the use of clippers (p<0.0001; OR = 0.5 CI95% [0.33-0.65]), pre-shave products (p<0.0001; OR = 0.4 CI95% [0.29-0.61]) and the use of razors with movable heads (p<0.0009; OR = 0.2 CI95% [0.17-0.35]) were protective factors against PFB.
    Our study confirms the high incidence of PFB in this population of black men of African descent. A genetic abnormality revealed by shaving must be evoked in the occurrence of PFB. Further genetic and immunohistochemical studies would be needed to support this hypothesis.
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  • 文章类型: Journal Article
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  • 文章类型: Journal Article
    目的:确定影响妇女对创伤性分娩(TCP)的认知的因素,并确定TCP之间的关系。希望避免怀孕,和性生活质量。
    方法:设计了描述性和相关性研究。数据来自225名年龄在18至45岁之间的女性。人口统计信息表格,避免怀孕的愿望量表(DAP),性生活质量问卷-女性(SQLQ-F),并使用创伤分娩感知量表(PTCS)进行数据收集。
    结果:未就业的妇女,以前生过孩子,并且没有计划他们最后一次怀孕的TCP水平往往较高。相反,在上次怀孕中没有遇到健康问题并回忆起上次分娩时非常舒适和快乐的女性,其TCP水平往往较低。非常虚弱,统计显著,DAP与PTCS评分呈正相关(r=0.168,P<0.05)。非常虚弱,统计显著,平均SQLQ-F与PTCS溃疡呈负相关(r=-0.138,P<0.05)。TCP增加1个单位与避免怀孕的愿望增加0.005个单位和性生活质量降低0.094个单位有关。
    结论:女性的TCP与避免怀孕的愿望增加和性生活质量下降有关。建议识别TCP水平高的女性,确定促成这种感知的因素,并相应地计划适当的护理干预措施。
    OBJECTIVE: To identify factors influencing women\'s perceptions of traumatic childbirth (TCP) and to determine the relationship between TCP, desire to avoid pregnancy, and sexual quality of life.
    METHODS: A descriptive and correlational research study was designed. Data were collected from 225 women aged between 18 and 45 years old. A Demographic Information Form, the Desire to Avoid Pregnancy Scale (DAP), the Sexual Quality of Life Questionnaire-Female (SQLQ-F), and the Perception of Traumatic Childbirth Scale (PTCS) were used for data collection.
    RESULTS: Women who were not employed, had given birth previously, and did not plan their last pregnancy tended to have higher levels of TCP. Conversely, women who did not experience health problems in their last pregnancy and recalled their last childbirth as very comfortable and happy tended to have lower levels of TCP. A very weak, statistically significant, positive correlation was found between the mean DAP and PTCS scores (r = 0.168, P < 0.05). A very weak, statistically significant, negative correlation was found between the mean SQLQ-F and PTCS sores (r = -0.138, P < 0.05). A 1-unit increase in TCP was associated with a 0.005-unit increase in the desire to avoid pregnancy and a 0.094-unit decrease in sexual quality of life.
    CONCLUSIONS: TCP in women is associated with an increase in the desire to avoid pregnancy and a decrease in sexual quality of life. It is recommended to identify women with high levels of TCP, determine factors contributing to this perception, and plan appropriate nursing interventions accordingly.
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  • 文章类型: English Abstract
    年龄在35岁及以上的不孕症妇女的治疗在每三分之一的病例中应用辅助生殖技术(ART)。该研究的目的是分析孕产妇健康对35岁及以上妇女在应用ART后分娩的儿童健康的影响。分析,直接观察,社会学(提问),并采用统计学方法。研究35-45岁女性应用ART方法后出生的儿童的健康状况,选择648名学龄前儿童(4-6岁)的代表性主要群体。第二对照组包括649名学龄前儿童(4-6岁),尽可能与主要群体的孩子相同,根据以下特征进行选择:母亲在孩子出生时的年龄(35-45岁),年龄(从4到6岁),都是在同一个医疗机构观察到的,从单身出生,足月(37周或以上)怀孕。主要组和对照组仅在存在或不存在ART方法时彼此不同。早产的孩子,从卵子供体计划和多胎妊娠被排除在研究之外.根据体检对儿童的健康状况进行了研究,医疗记录,儿童发展史,和母亲关于儿童健康的问卷调查数据。怀孕和分娩的过程,根据母亲的问卷调查和门诊医疗记录中的数据副本,研究了母亲的发病率和生活方式特征。确定儿童健康与母亲健康之间存在直接相关性(r=0.571;p<0.01,t=3)。在那,结果表明,由于38-45岁母亲的亚组(3353.7‰和2341.8‰对照组)的显着差异,ART后儿童和自然妊娠儿童的一般发病率水平存在差异。
    The treatment of women aged 35 years and older with infertility applies assisted reproductive technologies (ART) in every third case. The purpose of the study is to analyze impact of maternal health on health of children who were delivered by women aged 35 years and older after application of ART. The analytical, direct observation, sociological (questioning), and statistical methods were applied. To study health status of children born after application of ART methods in women aged 35-45 years, representative main group of 648 preschool children (4-6 years old) was selected. The second control group included 649 preschool children (4-6 years old), who were as identical as possible to children from the main group, selected according to following characteristics: mother\'s age at birth of child (35-45 years), age (from 4 to 6 years), all were observed in same medical organization, birth from a singleton, full-term (37 weeks or more) pregnancy. The main and control groups differed from each other only in presence or absence of ART methods. The children born preterm, from egg donor programs and multiple pregnancies were excluded from study. The children health was studied according to medical examinations, medical records, child development history, and mothers questionnaire data on children health. The course of pregnancy and childbirth, morbidity and lifestyle characteristics of mothers were studied according to their questionnaires and copies of data from their outpatient medical records. It was established that there is direct correlation between health of child and health of mother (r = 0.571; p < 0.01, t = 3). At that, it was revealed that differences in level of general morbidity of children after ART and children from spontaneous pregnancy are achieved within account of significant differences in subgroup of children of mothers aged 38-45 years (3353.7‰ and 2341.8‰ control group).
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  • 文章类型: Journal Article
    采用倾向评分匹配的Kaplan-Meier方法的回顾性队列研究。
    评估年龄≥60岁的退行性腰椎滑脱女性在进行短融合术后普遍存在的形态测量椎体骨折(VFs)是否会给后续临床VFs带来风险。
    VF是常见的骨质疏松性骨折,与生活质量低有关。随后的VFs是退行性腰椎疾病患者的器械融合的并发症。因此,必须分析融合手术后后续VFs的危险因素.基于人群的研究表明,普遍的形态VF导致绝经后妇女随后的VF发生率较高;然而,尚无研究调查退行性腰椎滑脱患者在接受融合手术后普遍形态VFs是否是随后VFs的危险因素.
    该研究共纳入237名老年女性患者:50名和187名患者有普遍的形态计量学VF(VF[+]组)和非普遍的形态计量学VF(VF[-]组),分别。使用Kaplan-Meier方法比较两组之间融合手术后后续临床VFs的时间。此外,VF(+)和VF(-)组40和80例患者,分别,通过年龄倾向评分进行分析和匹配,随访持续时间,外科手术,熔合段的数量,身体质量指数,以及接受骨质疏松症治疗的患者数量。
    Kaplan-Meier分析表明,与VF(-)组相比,VF(+)组的后续临床VF发生率更高,和Cox回归分析显示,在匹配之前,普遍存在的形态VF的存在是随后的临床VF的独立危险因素。Kaplan-Meier分析在匹配后证明了可比较的结果。
    在接受短融合术的退行性腰椎滑脱的老年妇女中,普遍存在的形态VFs可能是随后临床VFs的危险因素。
    METHODS: A retrospective cohort study using the Kaplan-Meier method with propensity-score matching.
    OBJECTIVE: To evaluate whether the presence of prevalent morphometric vertebral fractures (VFs) poses a risk for subsequent clinical VFs after short-fusion surgery in women aged ≥60 years with degenerative spondylolisthesis.
    BACKGROUND: VFs are common osteoporotic fractures and are associated with a low quality of life. Subsequent VFs are a complication of instrumented fusion in patients with degenerative lumbar disorders. Thus, risk factors for subsequent VFs after fusion surgery must be analyzed. Population-based studies have suggested that prevalent morphometric VFs led to a higher incidence of subsequent VFs in postmenopausal women; however, no studies have investigated whether prevalent morphometric VFs are a risk factor for subsequent VFs after fusion surgery in patients with degenerative spondylolisthesis.
    METHODS: The study enrolled a total of 237 older female patients: 50 and 187 patients had prevalent morphometric VFs (VF [+] group) and nonprevalent morphometric VFs (VF [-] group), respectively. The time to subsequent clinical VFs after fusion surgery was compared between the two groups using the Kaplan-Meier method. Moreover, 40 and 80 patients in the VF (+) and VF (-) groups, respectively, were analyzed and matched by propensity scores for age, follow-up duration, surgical procedure, number of fused segments, body mass index, and number of patients treated for osteoporosis.
    RESULTS: Kaplan-Meier analysis indicated that the VF (+) group had a higher incidence of subsequent clinical VFs than the VF (-) group, and Cox regression analysis showed that the presence of prevalent morphometric VFs was an independent risk factor for subsequent clinical VFs before matching. Kaplan-Meier analysis demonstrated comparable results after matching.
    CONCLUSIONS: The presence of prevalent morphometric VFs may be a risk factor for subsequent clinical VFs in older women with degenerative spondylolisthesis who underwent short-fusion surgery.
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  • 文章类型: Journal Article
    背景:研究表明,家庭成员的问题物质的使用对其他家庭成员的精神和身体健康有显著的有害影响。女性比男性更容易受到影响。这些负面的健康影响持续存在的人有问题的物质使用年龄,它们根据关系状态而有所不同。目的:这项研究的目的是更深入地了解女性如何经历其家庭成员的物质使用问题并受到其影响。方法:对11个女儿和5个有问题的老年人(>65岁)的妻子进行叙事访谈的隐喻分析。结果:我们确定了使用隐喻的四个意义领域:(1)经验(混乱,崩溃和在蛋壳上行走);(2)策略(共谋和沉默);(3)困境(欺骗或疾病以及开放或封闭的困境);(4)后果(获得或保留身份,健康和不同类型的帮助)。结论:与父母或配偶有物质使用问题的家庭生活被描述为混乱,不安全,不确定,没有变化的前景。该研究说明了如何使用隐喻来调解与基于深层负面情绪的存在性问题有关的经验和世界观,欺骗,羞耻和耻辱。隐喻构成了传达情感和主题的关键材料,这些情感和主题由于羞耻和污名而难以传达。
    Background: Research has shown that a family member\'s problematic substance use has significant deleterious mental and physical health impacts on other members of the family. Women are more often affected than men. These negative health effects persist as the person with problematic substance use ages, and they vary according to the relationship status. Aim: The aim of this study was to gain a deeper understanding of how women experience and are affected by their family member\'s substance use problems. Method: A metaphorical analysis of narrative interviews with 11 daughters and five wives of older adults (>65 years) with problematic substance use. Results: We identified four areas of signification in which metaphors were employed: (1) experiences (chaos and crash and walking on eggshells); (2) strategies (complicity and silencing); (3) dilemmas (deceit or a disease and open or closed dilemmas); and (4) consequences (obtaining or retaining an identity, health and different types of help). Conclusion: Family life with a parent or spouse with a substance use problem was described as chaotic, unsafe, uncertain and with no prospects of change. The study illustrates how metaphors are used to mediate experiences and worldviews pertaining to existential matters founded in deep negative emotions, deceit, shame and stigma. Metaphors make up a crucial material for communicating emotions and themes that are difficult to convey due to shame and stigma.
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  • 文章类型: Journal Article
    背景:尽管最近的一些研究已经检查了海湾战争(GW)部署和未部署GW时代退伍军人的女性的健康状况,这些都依赖于自我报告,这可能是不准确的,并且会受到回忆偏见的影响。这项研究使用退伍军人健康管理局(VHA)电子健康记录(EHR)调查了GW部署和未部署GW时代女性和男性退伍军人的当前健康状况。方法:我们对部署的GW和未部署的GW时代退伍军人进行了队列研究,从国防人力数据中心(DMDC)的列表中识别。我们使用了VA-脆弱指数(VA-FI),用VHA行政索赔和EHR计算,作为当前健康状况的替代衡量标准。结果:我们在VHA数据库中确定了402,869名退伍军人(部署了351,496GW;51,3373名未部署GW时代;38,555名女性)。部署的女性退伍军人的VA-FI最高(即,最脆弱),尽管比部署和未部署的男性退伍军人和未部署的女性退伍军人年轻。与部署的男性退伍军人相比,部署的女性更有可能是虚弱的,温和地,适度脆弱。部署和未部署的女性退伍军人之间的健康差异在年龄较大(60岁以上)的退伍军人中比年轻(<60岁)的退伍军人更为突出。结论:反映最近的报告,较小的VA医疗保健使用者和非使用者调查研究,这项队列研究的结果表明,使用VA医疗保健的已部署的女GW退伍军人比未部署的女GW时代和已部署的男GW退伍军人更脆弱,健康缺陷更多。因为部署的女GW退伍军人似乎有额外的医疗保健需求,这可能需要从VA医院的妇女诊所增加推广。
    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.
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