BackgroundFemale sexual dysfunction affects 41% of reproductive-age women worldwide, making it a highly prevalent medical issue. Predictors of female sexual dysfunction are multifaceted and vary from country to country. A synthesis of potential risk factors and protective factors may aid healthcare practitioners in identifying populations at risk, in addition to revealing modifiable factors to prevent sexual dysfunction among reproductive-age women.MethodsObservational studies which assessed the prevalence and predictors of female sexual dysfunction in reproductive-age women were systematically sought in relevant databases (2000–2014). Significant predictors were extracted from each included publication. A qualitative analysis of predictors was performed with a focus on types of sexual regimes and level of human development.ResultsOne hundred thirty-five studies from 41 countries were included in the systematic review. The types of predictors varied according to the location of the study, the type of sexual regime and the level of gender inequality in that country/region. Consistently significant risk factors of female sexual dysfunction were: poor physical health, poor mental health, stress, abortion, genitourinary problems, female genital mutilation, relationship dissatisfaction, sexual abuse, and being religious. Consistently significant protective factors included: older age at marriage, exercising, daily affection, intimate communication, having a positive body image, and sex education. Some factors however had an unclear effect: age, education, employment, parity, being in a relationship, frequency of sexual intercourse, race, alcohol consumption, smoking and masturbation.ConclusionsThe sexual and reproductive lives of women are highly impacted by female sexual dysfunction, and a number of biological, psychological and social factors play a role in the prevalence of sexual dysfunction. Healthcare professionals who work with women should be aware of the many risk factors for reproductive-age women. Future prevention strategies should aim to address modifiable factors, e.g. physical activity and access to sex education; international efforts in empowering women should continue.Electronic supplementary materialThe online version of this article (10.1186/s12905-018-0602-4) contains supplementary material, which is available to authorized users.
Prevalence estimates of FSD vary substantially. Nonetheless, results show that FSD is a significant public health problem that affects 41% of premenopausal women around the globe. More research and improved standardization are needed in this field.
Patients actively seek information about how to cope with their health problems, but the quality of the information available varies. A number of instruments have been developed to assess the quality of patient information, primarily though in English. Little is known about the reliability of these instruments when applied to patient information in German. The objective of our study was to investigate and compare the reliability of two validated instruments, DISCERN and EQIP, in order to determine which of these instruments is better suited for a further study pertaining to the quality of information available to German patients with eczema. Two independent raters evaluated a random sample of 20 informational brochures in German. All the brochures addressed eczema as a disorder and/or therapy options and care. Intra-rater and inter-rater reliability were assessed by calculating intra-class correlation coefficients, agreement was tested with weighted kappas, and the correlation of the raters’ scores for each instrument was measured with Pearson’s correlation coefficient. DISCERN demonstrated substantial intra- and inter-rater reliability. It also showed slightly better agreement than EQIP. There was a strong correlation of the raters’ scores for both instruments. The findings of this study support the reliability of both DISCERN and EQIP. However, based on the results of the inter-rater reliability, agreement and correlation analyses, we consider DISCERN to be the more precise tool for our project on patient information concerning the treatment and care of eczema.
BackgroundSexual function is an essential component of life. For this reason, sexual dysfunction can have a negative impact on the wellbeing of men and women alike. Since the turn of the 21st century, research on female sexual dysfunction (FSD) has gained momentum. While FSD is often assessed in people with ill health, sexual dysfunction is an illness of its own entity and is also prevalent in non-patient populations. A critical review of current literature on female sexual dysfunction in general populations will shed light on possible determinants as well as at-risk groups. Thus, the aim of this systematic review is to assess the prevalence and the predictors of female sexual dysfunction in general populations.Methods/DesignA systematic review of current literature on FSD will be performed. Studies will be considered for review if they report quantitative data on the prevalence of female sexual dysfunction. Outcome measures will include the prevalence of FSD, the time period assessed, and significant predictors for each domain of FSD. The scientific databases MEDLINE, EMBASE, PsycINFO, and Web of Science will be systematically searched in cooperation with a medical research librarian. Hand searches for further relevant publications will also be undertaken. Screening of search results and extraction of data from included studies will be conducted cooperatively by two authors. The quality of the studies will be appraised and documented. Results will be compiled and presented in evidence tables.DiscussionIn the past decade, population-based studies on female sexual dysfunction have increased in number and grown more varied in their cultural settings. This review aims to provide a current overview of the prevalence of female sexual dysfunction in populations from various countries, cultures, and age groups in order to provide a better understanding of its effect on women's lives today.
Expedited partner therapy (EPT) is an evidence-based practice in which partners of patients with chlamydia are given antibiotics or a prescription for antibiotics without prior medical evaluation. This practice facilitates partner treatment and prevents reinfection of the patient. EPT remains underutilized due to multilevel implementation barriers. Barriers may exist at the level of legislation, policy, health care system, health care provider (HCP), pharmacist, patient, or partner. Qualitative interviews were performed with 11 EPT experts across the United States to uncover barriers in implementation. Thirty-four barriers were identified and grouped into 1 of 15 themes. The themes that surfaced most frequently were liability and adverse events (policy and HCP level), funding (policy level), electronic medical records (health care system level), and awareness (HCP and pharmacy level). Tailored implementation strategies are needed to increase awareness among HCPs and pharmacists, to establish funding and to streamline processes in health care systems.
Although participation and empowerment are hallmarks of the WHO vision of health promotion, it is acknowledged that they are difficult to evaluate. Devising adequate study designs, indicators and methods for the assessment of participation and empowerment should consider the experiences, concerns and constraints of health promotion practitioners. The aim of this study was to investigate health promotion practitioners' perspectives on general and methodological aspects of evaluation of empowerment and participation. Semi-structured interviews were conducted with 17 experienced practitioners in community-based health promotion in New South Wales, Australia. The interviews covered benefits of and barriers to the evaluation of participation and empowerment, key indicators and methodological aspects. Interview transcripts were examined using thematic content analysis. The idea of evaluating empowerment and participation is supported by health promotion practitioners. Including indicators of empowerment and participation in the evaluation could also emphasise-to practitioners and citizens alike-the value of involving and enabling community members. The interviews highlighted the importance of a receptive environment for evaluation of empowerment and participation to take root. The resistance of health authorities towards empowerment indicators was seen as a challenge for funding evaluations. Community members should be included in the evaluation process, although interviewees found it difficult to do so in a representative way and empowering approach. Qualitative methods might capture best whether empowerment and participation have occurred in a programme. The positive experiences that the interviewees made with innovative qualitative methods encourage further investment in developing new research designs.
Background: Expedited partner therapy (EPT), the practice of prescribing antibiotics for sexual partners of patients, is underutilized in Georgia. This qualitative study in a large urban institution aimed to (1) characterize the clinical specialties that predominantly treat sexually transmitted infections (STIs), (2) identify perceived barriers to EPT, and (3) describe strategies to advance routine EPT use.Methods: Providers in obstetrics/gynecology (OB/GYN), infectious disease (ID), and emergency medicine (EM) were interviewed using a structured discussion guide. Transcripts were double-coded and iteratively analyzed using qualitative content analysis. Barriers and strategies were summarized and supported with quotes from providers (n = 23).Results: Perceived EPT barriers overlapped across OB/GYN, ID, and EM, yet the settings were diverse in their patient populations, resources, and concerns. Providers in OB/GYN were the only ones practicing EPT, yet there was a lack of standardization. Providers in ID noted that an EPT prescription from an ID provider could inadvertently disclose the HIV status of a patient to a sexual partner, posing an ethical dilemma. Providers in EM exhibited readiness for EPT, although routine empiric treatment for index patients in EM (estimated at 90%) gave some providers pause in prescribing for partners: "I do not know what I'm treating." Point-of-care testing could increase providers' confidence in prescribing EPT, yet some worried it could contribute to overutilization of the emergency department as a sexually transmitted infection clinic. All settings prioritized setting-specific training and protocols.Conclusions: Providers in OB/GYN, ID, and EM report unique hurdles, specific to their settings and patient populations; tailored EPT implementation strategies, particularly provider training, are urgently needed to improve patient/partner outcomes.C hlamydia trachomatis (CT) is the most frequently reported sexually transmitted infection (STI), with nearly 2 million reported cases each year. 1 Millions of cases of CT remain undiagnosed, as up to 75% of females and 50% of males exhibit no From the
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