The Impact of Childhood Sexual Abuse on Adult Female Sexual Function and Sexual Distress: A Systematic Review and Meta- Analysis. / Çocukluk Çaginda Cinsel Istismara Maruz Kalmanin Kadin Cinsel Islevi ve Cinsel Sikintisi Üzerine Etkisi: Bir Sistematik Gözden Geçirme ve Meta-Analiz.

OBJECTIVE: In this study, it was aimed to examine the impacts of exposure to childhood sexual abuse (CSA) on women's sexual function and sexual distress. METHOD: In this systematic review and meta-analysis study, eight international (EBSCO, Psyc-Info, Proquest, PubMed, Science Direct, Scopus, Ovid, Web of Science) and two national electronic databases (Dergipark and Thesis Database of the Turkish Council of Higher Education) were searched. Studies reporting outcomes of sexual function and sexual distress in women with and without a history of CSA were included. The data were synthesized by meta-analysis and narrative methods. RESULTS: Two dissertations and five research articles published between 2010 and 2021 were included in the study. In some studies that were not included in the meta-analysis, it was reported that there was no difference in the prevalence of sexual dysfunction, and sexual satisfaction in women with and without a history of CSA. Meta-analysis results demonstrated lower sexual function (sexual arousal, MD: -0.83, p<0.001; sexual desire, MD: -0.55, p<0.001; lubrication, MD: -0.78, p<0.01; pain, MD: -0.52, p<0.001) and more sexual distress (SMD: -0.79, p<0.05) in women with CSA history. CONCLUSION: This study showed that CSA negatively affects female sexual function and increases sexual distress. Healthcare professionals should be aware that women with a CSA history may have worse sexual functions and more sexual distress. More research is needed on the role of CSA in the etiology of sexual function problems and its possible mechanisms of action.

The use of hydrotherapy in the first stage of labour: A systematic review and meta-analysis.

AIM: To explore the effect of hydrotherapy applied in the first stage of labour on the health of mother and newborn. METHODS: This systematic review and meta-analysis was carried out by following PRISMA. The studies were obtained by scanning EBSCO, PubMed, Science Direct, Ovid, Web of Science and Scopus electronic databases. Twenty studies published between 2013 and 2023 were included. RESULTS: The total sample size of the studies was 8254 (hydrotherapy: 2953, control: 5301). Meta-analyses showed that the perception of pain decreased, comfort level and vaginal birth rate were higher and assisted vaginal birth rate and APGAR scores in the first minute were lower in women who underwent hydrotherapy. There was no difference between groups in terms of the duration of the first and second stage of labour, episiotomy, perineal trauma, intrapartum and postpartum bleeding amounts, use of pain medication and labour augmentations, APGAR scores in the fifth minute, positive neonatal bacterial culture and neonatal intensive care unit need. CONCLUSION: This study revealed that the results that hydrotherapy decreased the perception of pain and assisted birth, increased the rate of vaginal birth and comfort level and did not adversely affect the health of the mother and baby during the birth process.

Development and psychometric properties of the Respectful Maternity Care Scale (RMCS).

AIMS/BACKGROUND: The Respectful Maternity Care Scale (RMCS) was developed specifically to assess the health care that women receive during pregnancy, labour and the postnatal period. The aim of this study was to investigate the validity and reliability of the RMCS. DESIGN/METHODS: This study used a methodological design. The RMCS, a self-report instrument, was developed in consultation with professionals and women who had given birth, based on the literature. It was tested for content and construct validity. Reliability was assessed using Cronbach's alpha, test-retest method, and adjusted item-total correlation. The study sample consisted of 405 women between 6 weeks and 12 months postpartum who were admitted to a family health centre in Istanbul between April and June 2023. RESULTS: The scale's content validity index is 0.92. The scale consists of 29 items and 3 sub-dimensions, which explain 61% of the total variance. χ2/df was less than 5 and RMSEA was less than 0.08, which confirms the validity of this model. The corrected item-total correlations were acceptable, and the Cronbach's alpha coefficient was 0.96. CONCLUSION: The RMCS has been shown to be valid and reliable and can be used to assess respectful maternity care among Turkish women.

The prevalence of obstetric violence experienced by women during childbirth care and its associated factors in Türkiye: A cross-sectional study.

Objective This study determined the prevalence of obstetric violence experienced by women during childbirth and related factors in Türkiye. Design Cross-sectional study Setting This study was conducted in the mother-child health and gynecology outpatient clinics of the training and research hospital in Türkiye. Participants The study was completed with 513 women who gave birth in the last two years between January and May 2022. Methods Data were collected using a questionnaire prepared by the researchers. Bivariate and multivariate logistic regression analyzed the relationship between obstetric violence and socio-demographic and obstetric characteristics. Findings Obstetric violence was reported by 76.4% of the women: 44.4% physical abuse, 44.4% abandonment of care, 26.5% non-consented care, 25.1% non-dignified care, 3.3% non-confidential care, and 0.4% discrimination. Low income (OR=1.98), physician-attended birth (OR=2.91), vaginal birth (OR=6.04), and newborn admission to the neonatal care unit (OR=2.99) were associated with higher reporting of obstetric violence. Primiparous women (OR=0.51), whose pain was controlled by non-pharmacological methods (OR=0.34) and who received companion support (OR=0.24) were less likely to report experiencing obstetric violence (p < 0.05). Key conclusions Approximately three out of four Turkish women report that they have been exposed to obstetric violence during childbirth. In Türkiye, vaginal birth is the type of childbirth with the highest rate of obstetric violence reporting. Women who are low-income and multiparous, who are deprived of midwife, companion, and pain control support during childbirth, are more likely to experience obstetric violence. Implications for practice Supporting low-income women, protecting women from traumatic acts and unnecessary interventions in a vaginal birth, increasing births under the attendance of midwives, and providing pain control with non-pharmacological methods, and companion support during labor may be protective factors against obstetric violence.

Relationship between menopausal symptoms and sleep quality in women during the climacteric period: a cross-sectional study.

The aim of this study was to evaluate the relationship between the menopausal symptoms and sleep quality in women in the climacteric period. This cross-sectional study was conducted on 383 women aged 40-64 years at the Cancer Early Diagnosis Screening and Training Centre. The data were collected with the questionnaire form, Menopause Rating Scale (MRS) and the Pittsburgh Sleep Quality Index (PSQI). The sleep quality was poor in 77.8% of the women in the study. A significant relationship was found between PSQI scores and the somatic and psychological subscale scores of the MRS in the presence of other variables that could affect sleep according to multiple linear regression analysis (p < .05). We recommend training and consulting services provided by health care professionals and further experimental studies on the subject to decrease the negative effects of the somatic and psychological symptoms found to worsen sleep quality in women in the climacteric period. IMPACT STATEMENTWhat is already known on this subject? Sleep problems are a common health problem in women in the climacteric period.What do the results of this study add? The most common menopausal symptoms were joint and muscle problems, physical and emotional fatigue, nervousness, hot flushes, unhappiness, anxiety, and sleep problems in order of frequency. There was a weak positive significant relationship between the total PSQI score and the psychological and urogenital subscale scores of the MRS, in addition to a moderate positive significant relationship between the total PSQI scores and the total and somatic subscale scores of the MRS.What are the implications of these findings for clinical practice and/or further research? We believe effective management of the somatic and psychological symptoms during the climacteric period with health care staff providing training and consultancy services to the women aimed at decreasing the symptoms according to evidence-based procedures could help improve the sleep quality. Conducting multicenter studies with a larger subject group where the effect of menopausal symptoms on sleep quality in addition to that of multifactorial causes are evaluated in depth is recommended.

Noncyclical and cyclical mastalgia in Turkish women: Prevalence, risk factors, health-care seeking and quality of life.

Our aim in this study was to determine the prevalence of cyclical and noncyclical mastalgia, its underlying risk factors, and to examine its effect on women's quality of life. This study was conducted on 415 women, among whom the prevalence of mastalgia was found as 20.7%. It was found that experiencing intense stress, daily coffee and chocolate consumption, breast surgery history and the menstruation pattern were risk factors associated with mastalgia. Some domains of quality of life were found to be negatively affected in women who had mastalgia. Awareness among women about the risk factors of mastodynia and lifestyle changes is needed to improve mastalgia management.

The breastfeeding experiences of COVID-19-positive women: A qualitative study in Turkey.

AIM: The aim of the study was to determine the breastfeeding experiences of COVID-19-positive women. METHODS: This was a qualitative study of 14 women diagnosed with COVID-19. One-to-one telephone interviews were conducted and recorded. The data were analyzed thematically. RESULTS: Three main themes were identified. Theme 1 was "increased emotional load," outlining the emotional effects of the disease in the women, such as feeling sad and inadequate, in addition to anxiety and fear. Theme 2 was "breastfeeding during the disease," which illustrated the effects of the treatment process on the women, the disease-related symptoms, their influence on breastfeeding attitudes and behavior, and the effects of social media and television. Theme 3 was "perceived social support and need," defining the social support perceived and expected by the women during isolation with needs. CONCLUSION: Women who could not get the professional support they expected had to face the difficult choice between taking medical treatment and breastfeeding. Many women refused drug treatment for COVID-19 and continued to breastfeed with all the resultant emotional and physical difficulties, as they believed in the benefits of mother's milk. The experiences of the women were discussed with an approach that enabled developing health care services further. It was concluded that Turkish health care professionals need to develop an evidence-based and female-centered approach for COVID-19 management in breastfeeding women.

Sleep Quality and Health-Related Quality of Life in Pregnancy.

The aim of this study was to investigate sleep quality and health-related quality of life in pregnancy. In a cross-sectional design, 492 women (292 pregnant and 200 nonpregnant healthy controls) were included in this study between November 2014 and June 2015. Participants completed a survey on sociodemographic characteristics, the Pittsburgh Sleep Quality Index (PSQI), and the European Quality of Life-5 Dimensions (EQ-5D). The PSQI total and EQ-5D scores of pregnant women were significantly worse than the controls (P = .017 and P < .001, respectively). Linear regression analysis showed that only pregnancy status was related to PSQI scores (ß = .117; P = .009). Compared with the first trimester, the risk of poor sleep quality increased 2.11-fold in the second trimester (P = .048) and 1.86-fold in the third trimester (P = .054). Compared with the first trimester, EQ-5D scores significantly decreased in the second (P = .038) and third (P < .001) trimesters. Sleep quality and health-related quality of life of pregnant women were worse than those of nonpregnant healthy controls. Healthcare professionals need to be aware of deteriorations in sleep quality and health-related quality of life of pregnant women.

Effect of lifestyle interventions of pregnant women on their dietary habits, lifestyle behaviors, and weight gain: a randomized controlled trial.

BACKGROUND: Although it is known that lifestyle behaviors of pregnant women are closely related to maternal and fetal health, number of data concerning efficacy of intervention on lifestyle during pregnancy is limited. The purpose of this study is to determine the effect of lifestyle interventions on improving dietary habits and lifestyle behaviors, ensuring gestational weight gain (GWG) within recommended levels and limiting postpartum weight retention (PWR). METHODS: The study was conducted as a randomized controlled trial in a family health center located in Istanbul, Turkey, between June 2011 and July 2012. The primary outcomes were GWG, and the proportion of pregnant women whose GWG was within the Institute of Medicine (IOM) guidelines. One hundred two pregnant women with gestation ≤12 weeks, age ≥18 years, gravidity ≤2, and who did not intend to lose weight in prepregnancy period were randomly included in this study as intervention (n = 51) and control (n = 51) groups. The study was completed with 45 women for each group. The control group received routine antenatal care. The intervention group was received an individualized lifestyle intervention focusing on healthy lifestyle, diet, exercise, and weight monitoring as four sessions at 12-15, 16-18, 20-24, and 37 weeks gestation. Lifestyle behaviors were evaluated with Health-Promoting Lifestyle Profile-II. Dietary habits were assessed by 3-day dietary recalls, and weight was followed from pregnancy until 6 weeks postpartum. RESULTS: The lifestyle interventions had a significant effect on improving lifestyle behaviors, protein intake, percentage of energy from protein, calcium, magnesium, iron, zinc, and vegetable intakes when adjusted for confounders (p < 0.05). The proportion of women who were within the IOM recommendations was higher in the intervention group (51.1 %) than in the control group (28.9 %) The odds ratio for GWG within IOM was statistically significant between the groups (OR = 0.59, 95 % CI, 0.45-0.72). There were no difference between groups in terms of the other dietary intakes, total GWG, and PWR (p > 0.05). CONCLUSIONS: Lifestyle intervention improves the lifestyle behaviors during pregnancy and increases the appropriate GWG for prepregnancy body mass index (BMI), but it has a limited effect in terms of improving dietary habits and has no effect on PWR.

The Relationship of Premenstrual Syndrome Symptoms with Menstrual Attitude and Sleep Quality in Turkish Nursing Student.

INTRODUCTION: Symptoms induced by premenstrual syndrome (PMS) adversely affect the women in reproduction period and decrease their quality of life. In literature, it is a common opinion thought that PMS could be associated with both sleep quality and menstrual attitudes. However, there has been no sufficient number of studies to define in what ways the PMS symptoms are correlated with sleep quality and menstrual attitudes. The objective of this study was to examine the relationship of PMS symptoms with menstrual attitude and sleep quality. METHODS: The data were collected from 183 nursing students at Health School of Artvin Çoruh University by using a correlational design. Voluntary students completed a questionnaire involving socio-demographic characteristics, Premenstrual Syndrome Scale (PMSS), Menstrual Attitude Questionnaire (MAQ), and Pittsburgh Sleep Quality Index (PSQI). RESULTS: Average age was 19.9 (1.8). The study determined a positively significant correlation between score of PMSS and mean scores of PSQI (r=0.306; P<0.001), and a negatively significant correlation between score of PMSS and total mean score of MAQ (r=-0.317; P<0.01). Similarly, multiple linear regression analysis showed that PSQI total score (ß=5.412; P<0.001) and MAQ total score (ß=-27.455; P=0.001) significantly affected total score of PMSS. CONCLUSION: The intensity of PMS symptoms is associated with poor sleep quality and negative menstrual attitudes. Determining the methods of coping with PMS and strengthening the young girls on this subject may enhance their quality of future life.

The approach of prehospital health care personnel working at emergency stations towards forensic cases.

OBJECTIVES: The objective of this study is to determine the states of health care personnel, working at 112 emergency stations in the province of Artvin, to encounter with regarding forensic cases and determine their practices aimed at recognizing, protecting, and reporting the evidences that may affect the forensic process. MATERIALS AND METHODS: This descriptive study was conducted with nurses and emergency medicine technicians working at 112 emergency stations in Artvin between January 2013 and February 2014. RESULTS: Of 141 health personnel that constituted sample of the study, 48.9% were nurses, 9.9% emergency medicine technicians, and 41.1% ambulance and emergency care technicians. The rate of feeling sufficient in coping with forensic cases and incidents was 20.6%. There was a lower rate of receiving education about the approach towards forensic cases (15.6%). In the study, the frequency of encountering with at least one forensic case was 88.7%. Traffic accidents (72.5%), suicides (41.5%) and assaults (41.5%) were among the most frequent reasons of forensic cases. The practices of nurses were more successful in woundings by firearms compared to other health personnel (p < 0.05). The rate of recognizing the evidences was 81.6-96.5%. Almost one fourth of the personnel had no sufficient information about storing and protecting the evidences. CONCLUSIONS: The personnel working at 112 emergency stations in the province of Artvin frequently encounter with forensic cases. The personnel with higher educational level and nurses have more successful practices in forensic cases. Health personnel have approaches that may negatively affect the solution of forensic cases.

Biodiversity in morphological properties and nutritional values of forage grass species.

This study was conducted under humid and warm climatic conditions in 19 Ondokuz Mayis University, Kurupelit campus area (1300 ha) during March and July in 2004. The study aimed to evaluate the forage grass species, which have been protected for over 30 years, and to observe the biological diversity by determining their morphological characters and forage qualities. Some morphological characters and chemical properties of 20 grass species were examined. Statistically significant differences were determined regarding all morphological characters and chemical properties within species and individual species. In examined grass species, number of tiller per plant and main stem length ranged from 5.5 to 40.5 and 39.38 to 96.18 cm, respectively. Root crown diameter, dry matter of root, dry forage weight changed between 6.24 and 21.60 mm, 0.27 and 20.33 g plant(-1), 0.80 and 46.76 g plant(-1), respectively. Protein content of the samples varied from 4.37 to 9.42%. Trace elements content of the samples such as Ca (0.08-0.79%), Mg (0.06-0.17%) and K (0.76-3.03%) were also determined. Potassium contents of dry grass forages were excessively high, however their phosphor contents were generally insufficient, calcium and magnesium contents were fairly insufficient and K/Ca+Mg ratios were over the critic value (2.20) except for two species. In general, Fe, Zn and Mn in dry grass forage samples were found adequate.