RESUMO
Polycystic ovary syndrome (PCOS) is the most common endocrine syndrome that disproportionally affects women of childbearing age (~8% to 13% of women worldwide). If unmanaged, it can lead to chronic, lifelong complications. Over the past decade, improvements in diagnostic guidelines have not produced an expected reduction in the diagnostic timeframe. We examined the potential reasons underlying this diagnosis delay. Participants first constructed a diagnostic timeline and then charted and reflected on their diagnosis journeys. Through a reflexive thematic analysis, five themes represented the most common diagnostic trajectory: (a) dismissal of adolescents' early symptoms, (b) negative diagnostic encounters, (c) wariness of treatment options, (d) uncertainty for the future, and (e) self-education and advocacy. Our findings lead us to argue for education of physicians and allied professionals to strengthen patient-centered care delivery to women with a focus on building in training supports that include critically informed, social justice foundations.
Assuntos
Síndrome do Ovário Policístico , Adolescente , Feminino , Humanos , Ontário , Síndrome do Ovário Policístico/diagnósticoRESUMO
BACKGROUND: Patient decision aids (PDAs) are tools that facilitate informed shared decision-making between patients and health care providers. To address a previously identified need in treatment decision-making in hidradenitis suppurativa (HS), we developed an HS-PDA. METHODS: Development of the HS-PDA was based on International Patient Decision Aids Standards. Evidence was derived from the North American Clinical Management Guidelines for HS. RESULTS: Content from guidelines was transformed into patient-friendly language and reviewed by three physicians and two patient representatives. Feedback on HS-PDA content, presentation and practicality was obtained from 7 HS patients and 5 physicians. Revisions were made following thematic analysis. All patients felt the content on treatment options contained the right amount of information and 5 found it helpful to see these options contextualized to their values. Each stated they would use the HS-PDA during treatment decision-making. Three and four physicians respectively indicated the content was accurate and language was patient-friendly. LIMITATIONS: Small sample sizes may limit generalizability. CONCLUSION: This HS-PDA was developed in accordance with international standards based on current HS guidelines with input from patients and physicians. It is available online without cost.
Assuntos
Técnicas de Apoio para a Decisão , Hidradenite Supurativa/terapia , Participação do Paciente , Tomada de Decisões , Medicina Baseada em Evidências , Humanos , Satisfação do Paciente , Guias de Prática Clínica como Assunto , Inquéritos e QuestionáriosRESUMO
Feminist researchers have demonstrated that engagement in silencing of the self (i.e., self-restrictive and sacrificial behaviors reflecting how women "should" be in relationships) remains a prevalent strategy for relationship maintenance. However, little is known about (young) women silencing themselves in relationships where abuse is present. Young women's experiences of silencing and other partner-focused behaviors (e.g., sexual compliance) within their relationships were thus explored. Young, partnered women (Mage = 21; N = 146) completed an online survey and open-ended questions about their current intimate relationships. Comparing between groups (abuse, n = 108; non-abuse, n = 38), the former scored higher on measures of total self-silencing, sexual compliance, and non-constructive communication and lower on measures of constructive communication (all p < .001). A mixed inductive and deductive content analysis found that while the importance of communicating with their partner was a preferred strategy for conflict management, multiple participants still emphasized self-suppression as an important part of their experience of relational conflict. Also, most participants indicated feeling as though they could be their authentic selves in their relationships, which suggests that their silencing may be situational and strategic in nature. These findings nuance previous understandings of self-silencing as inherently harmful and instead frame it as something sporadic and done strategically. They also bring forth questions about the extent to which young women's emphasis on communication and insistence that they can be authentic are a product of changing societal expectations of women in today's society compared to the 1980s/1990s when much of the foundational work on self-silencing was being done.
RESUMO
Scholars have long explored the expectations of women to maintain intimate relationships and the gendered discourses governing those expectations. Despite the dating landscape changes, having intimate relationships remains important for young women. Amid these changes and the impacts of #MeToo/#TimesUp, investigating the discourses at play within women's talk about intimate relationships produces a current snapshot that contrasts with past literature. Young, heterosexual women of diverse racial, educational/work, and relationship backgrounds aged 18-24 years (N = 28) attended one of five online videoconferencing focus groups. Using an eclectic theoretical approach informed by feminist post-structuralism and discursive psychology, we analyzed women's talk about doing relationships. Mobilizing a discourse of intimate relationship necessity/importance, young women (a) were positioned as "the silenc(ed/ing) woman," demonstrating a shared understanding of the necessity of silence when doing intimate relationships; and/or (b) actively took up "the communicative woman," which they conceptualized as the hallmark of a healthy relationship. Tensions between these subject positions were evident (e.g., needing to be "cool"). Also, women described no-win situations in relationships despite attempts to contend with these contradictions and limitations. These findings may contribute to educational materials and youth programming delivered in high school or college.
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In linguistics, there is little consensus on how to define, measure, and compare complexity across languages. We propose to take the diversity of viewpoints as a given, and to capture the complexity of a language by a vector of measurements, rather than a single value. We then assess the statistical support for two controversial hypotheses: the trade-off hypothesis and the equi-complexity hypothesis. We furnish meta-analyses of 28 complexity metrics applied to texts written in overall 80 typologically diverse languages. The trade-off hypothesis is partially supported, in the sense that around one third of the significant correlations between measures are negative. The equi-complexity hypothesis, on the other hand, is largely confirmed. While we find evidence for complexity differences in the domains of morphology and syntax, the overall complexity vectors of languages turn out virtually indistinguishable.
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Polycystic ovary syndrome is the most common endocrine disorder among women aged from 18 to 40 years. Its debilitating menstrual/obesity-related symptoms challenge conceptions of femininity. To date, age-related differences in women's body esteem and physicians' symptom management recommendations have not been investigated. Age moderated the relationships between symptom concerns and both sexual attractiveness and physical condition, but only for midlife, not for emerging adult women. Midlife women received holistic management information from physicians, while emerging adult women received weight management information. This study highlights the need for physician training to manage women's health and age-targeted body acceptance interventions for women diagnosed with polycystic ovary syndrome.
Assuntos
Síndrome do Ovário Policístico , Adolescente , Adulto , Feminino , Feminilidade , Humanos , Obesidade , Síndrome do Ovário Policístico/terapia , Comportamento Sexual , Saúde da Mulher , Adulto JovemRESUMO
BACKGROUND: Patient decision aids are tools that facilitate shared decision making when clinical evidence and patient values and preferences inform the process. Evidence-based guidelines have been developed for clinicians in hidradenitis suppurativa management. To address treatment decision-making needs of hidradenitis suppurativa patients, we developed a hidradenitis suppurativa patient decision aid. OBJECTIVE: To assess the efficacy of the hidradenitis suppurativa patient decision aid during treatment decision making. METHODS: An online, participant-blinded, parallel-group, randomized controlled trial of the hidradenitis suppurativa patient decision aid versus Mayo Clinic hidradenitis suppurativa website content (Mayo) was conducted with hidradenitis suppurativa patients. Outcomes were knowledge, decisional conflict, and preparation for decision making. RESULTS: Forty participants fulfilled inclusion criteria and were randomized to hidradenitis suppurativa patient decision aid or Mayo. In the hidradenitis suppurativa patient decision aid group, data from 16 and 15 participants were analyzed at phases 1 and 2, respectively. In the Mayo group, data from 15 and 13 participants were analyzed at phases 1 and 2, respectively. Increased knowledge (P < .01) and preparation for decision making (P < .01), as well as reduced decisional conflict (P < .01), were observed in the hidradenitis suppurativa patient decision aid compared with the Mayo group. LIMITATIONS: The online methodology and recruitment from online hidradenitis suppurativa support groups limits generalizability of findings. CONCLUSION: A hidradenitis suppurativa patient decision aid increased knowledge and preparation for decision making and reduced decisional conflict.