Gestational weight gain and daily life impact of pregnancy symptoms in healthy women: A multivariable analysis.

OBJECTIVE: To study the relationship between gestational weight gain (GWG) and Daily Life Impact of Pregnancy Symptoms (DLIPS) scores. METHODS: A multivariable analysis of a clinical trial (the Walking Preg_Project (WPP), ClinicalTrials.gov NCT03735381) was conducted. The cohort data concerning GWG across gestational trimesters (T1, T2 and T3) was categorized into adequate, excessive, and reduced based on published criteria. DLIPS was measured using the pregnancy symptoms inventory (PSI) a validated tool, across the gestational trimesters. Univariable and multivariable analyses were employed to assess the association between the GWG categories and DLIPS scores in each trimester of pregnancy estimating the ß-coefficients and 95% confidence intervals (CI). RESULTS: There were 221 participants in the cohort. DLIPS mean score in the overall sample and within adequate, excessive, and reduced GWG categories significantly increased across pregnancy (p < 0.005). DLIPS mean score was higher in the excessive GWG category compared to adequate and reduced GWG, in T1 and T2 (p = 0.035; p = 0.031, respectively). An excessive GWG at T1 [ß-coefficient (95 % CI) = 3.88, (0.84, 6.93)] and T2 [ß-coefficient (95 % CI) = 4.47 (1.24; 7.70)] was associated with higher DLIPS score compared to an adequate GWG. CONCLUSION: The impact of pregnancy symptoms on daily life increased throughout pregnancy, overall. Excessive GWG was associated with daily life impact of pregnancy symptoms, particularly in the first and second trimester.

Mother-child bond and its relationship with maternal postpartum depression.

BACKGROUND: The mother-child bond may be related to maternal health, especially postpartum depression (PPD). Existing studies show the need for further in-depth research on the subject. AIM: To determine the relationship between bonding and the probability of the development and presence of PPD in women with a biological child between 6 weeks and 18 months of age. METHODS: A cross-sectional study was conducted. A questionnaire containing sociodemographic, psychosocial, and health variables referring to the mother and the newborn, a questionnaire measuring the mother-child bond (VAMF-bond), and the Edinburgh Postpartum Depression Scale (EDPS) were administered. RESULTS: 1114 women participated. The association between the items of the VAMF-bond subscale and the risk of PPD was statistically significant for all items (p < 0.05), except items 4 and 10. The multivariate analysis showed that the risk of PPD (EPDS scale) was lower in women with higher scores on bond (Adjusted Odds Ratio: aOR = 0.85; 95%CI: 0.81, 0.88), whose birth experience was good or very good (aOR = 0.57; 95%CI: 0.36, 0.89), who received high or very high support from their partner (aOR = 0.34; 95%CI: 0.18, 0.66), and family (aOR = 0.53; 95%CI: 0.32, 0.86). The presence of PPD was less frequent in women who presented higher scores for bond (aOR = 0.90; 95%CI: 0.84, 0.97), who had skin-to-skin contact (aOR = 0.39; 95%CI: 0.17, 0.93) and who received high or very high support from the family (aOR = 0.36; 95%CI: 0.12, 1.04). CONCLUSIONS: High scores on the subscale VAMF-bond were associated with a lower risk of PPD.

Instrument to evaluate the perception of abuse and/or disrespectful treatment during childbirth: A validation study.

AIM: To design and validate a tool to assess a woman's perception of whether she has experienced a situation of abuse or disrespect during childbirth attendance: "Childbirth Abuse and Respect Evaluation-Maternal Questionnaire" (CARE-MQ). METHODS: Multidisciplinary panel of experts (gynecologists, midwives, mothers) participated in creating CARE-MQ. A cross-sectional study was carried out on 901 Spanish women who had given birth between 1 and 3 months before to determine psychometric characteristics. Finally, an exploratory factor analysis (EFA), confirmatory factor analysis (CFA), and a convergent validity study were carried out with the Quality Questionnaire from the Patient's Perspective-Intrapartum (QPP-I), and a reliability study using internal consistency (Cronbach's α) and coefficient of intraclass correlation (CCI). FINDINGS: The KMO test gave a value of 0.935, and Bartlett's sphericity test was <0.001. The EFA identified four components ("Emotional Abuse", "Inadequate Professionalism", "Physical Abuse" y "Lost contact") that explained 55.16 % of variance. In the CFA, a good fit was observed for most of the evaluated indicators. CARE-MQ correlated negatively with QPP-I (Spearman's rho = -0.641, 95 % CI: -0.679, -0.600; p < 0.001) and was statistically associated with variables related to childbirth experience (p < 0.005) such as the use of a birth plan, use of regional analgesia, type of birth, episiotomy, presence of severe tears, skin-to-skin contact, length of hospital stay and postpartum surgical intervention. Cronbach's α value was 0.903. The ICC of absolute agreement after administering the questionnaire one week after was 0.927 (95 % CI: 0.85-0.97). CONCLUSIONS: CARE-MQ is a valid and reliable instrument to evaluate the perception of a woman regarding the situation of abuse and/or disrespect that she may have experienced during birth in a population of Spanish postpartum women.

Maternal Perception of Pregnancy Loss: Protocol for a Thematic Synthesis.

Introduction: The number of women who present this perineal loss is high. Identifying the existing knowledge about the women's experiences and perceptions of pregnancy loss is essential to understand the impact of the phenomenon on women. This identification is also crucial to adapt and improve the healthcare provided. Subjects and Methods: A systematic literature review, meta-synthesis, of qualitative studies will be developed with the goal of obtaining a comprehensive understanding of mothers' perception of pregnancy loss and identifying their specific support needs. Inclusion Criteria: This review will consider qualitative investigations that study the perceptions or experiences of adult women who have suffered prenatal loss. All studies published in English, Spanish or Portuguese between January 1, 2012, and December 31, 2022 will be considered. This systematic review will follow the Joanna Briggs Institute statement for systematic reviews of qualitative design. The Psychology and Behavioral Sciences Collection, Scopus, CINAHL®, MEDLINE® and Cochrane Database of Systematic Reviews (CDRS) databases will be utilized for research. Data extraction will be performed in-peers by the researchers, using the Joanna Briggs Institute model. Finally, the available data will be analysed using a meta-aggregation approach. Conclusion: A better understanding of this phenomenon will be useful, identifying, on the one hand, the support needs of women who have suffered fetal loss and, on the other hand, also identifying the support and interventions that can be implemented by health professionals. Systematic Review Registration Number: PROSPERO® (CRD42023407314).

Prevalence of depression and anxiety in women with pelvic floor dysfunctions: A systematic review and meta-analysis.

BACKGROUND: Female pelvic floor dysfunction (PFD) is a common condition affecting the emotional well-being of women. OBJECTIVE: To estimate the prevalence of depressive and anxiety symptoms in women with PFD. SEARCH STRATEGY, SELECTION CRITERIA, DATA COLLECTION AND ANALYSIS: Following prospective registration (PROSPERO CRD42022362095) we conducted a search of three electronic databases (PubMed, Web of Science and Scopus) from inception to April 2023 without language restriction to capture studies reporting the prevalence of depression/anxiety among women with PFD (chronic pelvic pain [CPP], urinary incontinence [UI], pelvic organ prolapse [POP], and/or fecal incontinence [FI]). Only studies with validated tools were included. Data extraction and study quality assessment were performed by two independent reviewers. Stratifying by type of PFD, rates of depression and anxiety were pooled using random effects model computing 95% confidence interval (CI) and assessing heterogeneity using the I2 statistic. Funnel plots were used to detect potential reporting biases and small-study effects. MAIN RESULTS: The search yielded 767 articles, from which 54 studies containing 632 605 women were included. All the studies were high quality. The prevalence of depression was: CPP 26.8% (95% CI: 19.2-34.4, I2 = 98.7%; 12 studies, 4798 participants with 491 cases; Egger's P value = 0.009); UI 26.3% (95% CI: 19.4-33.2, I2 = 99.9%; 26 studies, a total of 346 114 participants with 25 050 cases; Egger's P value = 0.944); POP 34.9% (95% CI: 24.3-45.6, I2 = 68%; three studies, 297 participants with 104 cases; Egger's P value = 0.973); and FI 25.3% (95% CI: 0.68-49.9, I2 = 99.7%; six studies, 14 663 participants with 1773 cases; Egger's P value = 0.780). The prevalence of anxiety was: CPP 29.5% (95% CI: 16.3-42.7, I2 = 97.7%; nine studies, 2483 participants with 349 cases; Egger's P value = 0.001); UI 46.91% (95% CI: 39.1-54.6, I2 = 99.6%; 11 studies, 198 491 participants with 40 058 cases; Egger's P value = 0.337); and POP 28% (95% CI: 13.6-42.4, I2 = 89%; three studies with 355 participants with 90 cases; Egger's P value = 0.306). CONCLUSION: The prevalence of mental health illness was variable in the different types of PFDs. This meta-analysis helps quantify the burden of depression and anxiety in PFD and will help inform the policies regarding screening of emotional well-being by healthcare professionals engaged in care of women with PFD.

Preparation and validation of a predictive model of breastfeeding initiation in the first hour of life.

OBJECTIVE: The objective was to develop and validate a predictive model of initiation of breastfeeding in the first hour after delivery. METHODS: Retrospective cohort study on women who gave birth between 2013 and 2018 in Spain. For data collection, an ad hoc questionnaire was designed to be filled in by the mothers, which was distributed to the different Spanish breastfeeding associations which, in turn, shared it with their associate partners. The development of the predictive model was made on a cohort of 3218 women (2/3) and was validated on a cohort of 1609 women (1/3). Mothers whose children were admitted to hospital at the time of birth were excluded. A multivariate analysis was performed by means of logistic regression, and predictive ability was determined by areas under the ROC curve (AUC). RESULTS: 81.0 % (2608) women started breastfeeding in the first hour in the derivation cohort, and 80.1 % (1289) in the validation cohort. The predictive factors in the final model were: the highest number of children and skin-to-skin contact at birth as flattering factors, while dystocic delivery reduced the likelihood of the onset of breastfeeding. The predictive ability (ROC AUC) in the derivation cohort was 0.89 (CI 95 %: 0.87-0.90), while in the validation cohort it was 0.89 (CI 95 %: 0.87-0.92). CONCLUSIONS: This three-variable predictive model has excellent predictive ability in both the derivation cohort and the validation cohort. This model can identify women who are at high risk of non-initiating breastfeeding within the first hour after delivery.

Development of a Predictive Model for Skin-to-Skin Contact Immediately after Birth: A Cross-Sectional Study.

The aim of this study was to develop and validate a predictive model for the establishment of skin-to-skin contact immediately after birth. A descriptive cross-sectional study was conducted during the last trimester of 2022 and the first trimester of 2023 with women who had given birth in Spain. A questionnaire containing sociodemographic, psychosocial, and health variables referring to the mother and the newborn, as well as the Bond and Attachment questionnaire (VAMF, for its name in Spanish) for the analysis of the mother-child bond and attachment, were administered. A multivariate analysis was performed, and areas under the ROC curve (AUC) with their 95% confidence intervals (CI) and the predictive characteristics of these models were estimated. In total, 1077 women participated. The prevalence of early skin-to-skin contact after delivery was 50.2% (468) in the derivation cohort and 49.8% (464) in the validation cohort. Multivariate analysis showed that prematurity, type of delivery, and birth experience were statistically significant, so they were included in the model (p ≤ 0.05). The predictive ability (AUC ROC) was good in both the derivation cohort, yielding 0.92 (95% CI: 0.89-0.95), and in the validation cohort, yielding 0.89 (95% CI: 0.85-0.93). This study developed a predictive model identifying factors facilitating early skin-to-skin contact between a mother and her newborn immediately after birth.

"Prevalence and Associated Factors of Perinatal Suicide Risk in Spanish Women".

Suicide is one of the leading causes of death worldwide, and in the perinatal period, the trend is increasing, even up to 100 times in the US. No studies have been carried out with validated instruments despite abundant recommendations to do so. This study aims to determine the prevalence of perinatal suicide risk in Spanish women, as well as the factors associated with it. A cross-sectional study was carried out with 908 women in the perinatal stage. Sociodemographic and obstetric variables, anxiety level (GAD-7), social support (DUKE-UNC), risk of intimate violence (WAST), and suicidal ideation (Paykel) were collected. Crude (OR) and adjusted odds ratios (aOR) were calculated using logistic regression for the main risk factors for suicidal ideation. The prevalence of suicidal ideation was 19.3% (175), and suicide attempt 2.4% (22). In the perinatal stage, the risk factors were anxiety [aOR of 1.08 (95% CI: 1.04-1.31)], experiencing a possible situation of intimate partner violence [aOR of 1.59 (95% CI: 1.04-2.43)], and a risk of PPD [aOR of 3.00 (95% CI: 1.86-4.81)]. Perceived social support appears as a protective factor [aOR of 0.97 (95% CI: 0.95-0.99)], along with skin-to-skin contact with the baby during childbirth [aOR 0.50 (95% CI: 0.28-0.88)]. Conclusions: Presenting anxiety or depression, little social support, and living in a possible situation of intimate partner violence are associated with a greater risk of suicidal ideation during the perinatal stage.

Midwives' approach to the prevention and repair of obstetric perineal trauma in Spain.

AIM: Different clinical practice guidelines include recommendations on how to prevent and repair obstetric perineal trauma, as well as the use of episiotomy. To evaluate the variability in midwives' professional practices for preventing and repairing perineal trauma, as well as the professional factors that may be associated with the restrictive use of episiotomy. DESIGN: Observational cross-sectional study. METHODS: Three hundred five midwives completed an anonymous questionnaire developed by the authors and distributed across various midwifery scientific societies. The main outcomes measured were the frequencies of adopting specific practices related to perineal injury prevention and repair, episiotomy technique and restrictive episiotomy use (<10%). Odds ratios (OR) and adjusted odds ratios (aOR) with 95% confidence intervals were estimated. RESULTS: Intrapartum perineal massage was not normally used by 253 (83%) of midwives, and 186 (61%) applied compresses soaked in warm water to the perineum. Regarding episiotomy, there was a great deal of variability, noting that 129 (42.3%) adopted a restrictive use of this procedure, 125 (41%) performed it between 10% and 20%, while 51 midwives (16.7%) performed it in more than 20% of cases. In addition, 165 (54.1%) midwives followed an incision angle of 60º. Concerning tears, 155 (50.8%) usually sutured first-degree tears and 273 (89.5%) always sutured second-degree tears. Midwives attending home births (aOR = 6.5; 95% CI: 2.69-15.69), working at a teaching hospital (aOR = 3.69; 95% CI: 1.39-9.84), and the ones who recently completed their professional training (aOR = 3.58; 95% CI: 1.46-8.79) were significantly more likely to adopt a restrictive use of episiotomy. CONCLUSIONS: There is a significant variability in Spanish midwives' practices for preventing and repairing perineal tears. Moreover, the restrictive use of episiotomy is associated with midwives attending home births, working in teaching hospitals and having recent professional training. PATIENT OR PUBLIC CONTRIBUTION: No patient or public contribution.

A Qualitative Exploration of the Perceptions of Women Living with Pelvic Floor Disorders and Factors Related to Quality of Life.

Background: Pelvic floor dysfunction encompasses conditions like urinary and fecal incontinence, pelvic organ prolapse, and pelvic pain, significantly affecting women's quality of life. Despite its prevalence, few studies have adopted a qualitative approach to understanding women's perceptions and emotions regarding these issues. This study aims to delve into how women with pelvic floor disorders perceive their condition and its impact on their daily lives. Methods: We analyzed qualitative data from interviews with 160 women suffering from pelvic floor dysfunctions. Using inductive qualitative content analysis, we systematically examined the data to identify variations, differences, and similarities. Results: The analysis revealed four primary themes in the women's narratives: "Physical Impacts", "Emotional and Psychological Impacts", "Social and Relational Impacts", and "Sexual Health Impacts", along with 12 subthemes. The findings predominantly highlight how pelvic floor dysfunctions detrimentally affect women's quality of life and emotional well-being, instilling fear and insecurity in daily activities, compounded by sleep disturbances and sexual dysfunction. Conclusions: Women living with pelvic floor dysfunction face multifaceted challenges that adversely affect various aspects of their lives, diminishing their overall quality of life. This includes notable impacts on sleep, physical, and sexual activities. However, not all affected women report these issues, often due to fear of stigma, choosing instead to conceal their struggles in an effort to maintain an appearance of normalcy.

Influence of Pelvic Floor Disorders on Sleep Quality in Women.

Pelvic floor disorders, the impact of their symptoms, and their association with sleep quality and sleep disorders is a little studied area. The aim of this study was to determine if an association exists between pelvic floor disorders in women and sleep disorders. An observational study was conducted among women in Spain during 2021 and 2022. A self-developed questionnaire was used to collect sociodemographic and employment data, previous medical history and health status, lifestyle and habits, obstetric history, and health problems. A validated questionnaire, the Pittsburgh Sleep Quality Index (PSQI), was used to assess the quality of sleep. The presence and impact of pelvic floor problems was assessed with the Pelvic Floor Distress Inventory (PFDI-20). Odds ratios (OR) and adjusted odds ratios (aOR) with their respective 95% confidence intervals were calculated using logistic regression. A total of 1396 women participated in the study. The total PSQI indicated that 75.36% (1052) of women have altered general sleep quality. Women with pelvic floor disorders have a higher probability of developing sleep alterations (aOR: 1.32; 95% CI: 1.22-1.42; for every 20 points). A high BMI (aOR: 1.04; 95% CI: 1.01-1.07; for each point) and the presence of musculoskeletal disorders (aOR: 3.14; 95% CI: 1.20-8.27) are also associated with sleep quality in women. Women with pelvic floor disorders are more likely to develop sleep disorders, probably due to all the discomfort they entail.

Variability of clinical practice in the care of the second stage of labor among midwives in Spain.

BACKGROUND: There are recommendations based on scientific evidence on care in the second stage of labor, but it is not known to what degree the professionals comply with these recommendations. OBJECTIVE: The aim of this study is to examine the variability in clinical practices among midwives during the second stage of labor, including positions, mobility, practices, and the maximum time allowed before initiating active pushing, and to assess their adherence to clinical practice guidelines. METHODS: A cross-sectional observational study. A self-designed questionnaire was developed and distributed online through scientific societies. The main variables studied were professional and work environment characteristics, maternal positions and mobility, practices during this stage, maximum time to start active pushing and duration of the second stage of labor. Descriptive statistics were calculated using SPSS 24.0. RESULTS: Regarding the woman's position during childbirth, 80.3% (245) of midwives frequently or always allow the woman to choose her birthing position. Furthermore, 44.6% (136) of professionals prefer using side-lying positions for the mother. Regarding drinking fluids during childbirth, 51.1% (156) of midwives allowed the woman to drink the amount of liquids she wanted, whereas 11.1% (34) said that they would allow them to do so however, this was against the protocol of their hospital. When inquiring about the Kristeller maneuver, it was reported to be excessively performed in 35.1% (107) of cases for fetal bradycardia, 33.1% (101) for maternal exhaustion, and 38.4% (117) to avoid instrumental birth. Finally, a great variability was observed in the time criteria used for the initiation of active pushing and the maximum duration of the second stage of labor. CONCLUSIONS: Certain practices, such as the Kristeller maneuver, are overused among midwives, with great variability in the use of certain procedures, the waiting times to initiate pushing and completion of the second stage of labor. Further training and awareness campaigns are needed for professionals to apply evidence-based care.

Evaluation of Knowledge and Competencies in Sexual and Reproductive Health Care Using an Escape Room with Scenario Simulations.

To determine the usefulness of combining two methodologies (OSCE and escape room) in a scenario simulation to evaluate a subject, and determine the evaluation of the students of this experience. An observational cross-sectional study was carried out with students enrolled in a sexual and reproductive health-care course as a part of their nursing degree. The students had to solve four clinical cases based on the contents of the teaching practices of the subject by solving clues that led them to carry out procedures and techniques and provide care in scenario simulators. Students evaluated the experience using the GAMEX (Gameful Experience in Gamification) scale. Mean differences were estimated with their respective 95% confidence intervals. A total of 124 students participated. Of these, 63.7% (79) solved the clinical cases with their knowledge and skills. Most (80.6%, 100) students stated that they completely remembered and applied the knowledge of the topic during the game. Almost all (98.4%, 122) would recommend this experience. The dimensions with the best rating on the GAMEX scale were "fun", with an average score of 4.7 points (0.49), followed by "critical thinking", with 4.2 (0.59). Women presented statistically better scores than men (mean difference: 1.58; 95% CI: 0.55, 2.61). The OSCE combined with an escape room using scenario simulations may be a useful tool to evaluate the subject. In addition, the students were satisfied, had fun, and recommended the experience. This study was not registered.

Factors related to a disturbance in the mother-child bond and attachment.

INTRODUCTION: Establishing an adequate bond and attachment between a mother and child is essential for preventing pathologies and developing this relationship in the future. PURPOSE: To identify the factors related to a disturbance of the mother-child bond or attachment. METHODS: A cross-sectional descriptive study was carried out with women with a biological child between 6 weeks and 18 months of age. The Mother-Child Bond-Attachment Questionnaire (VAMF, for its name in Spanish) was administered to measure the bond and postnatal attachment together with a questionnaire containing sociodemographic, psychosocial, and health variables referring to the mother and the newborn. RESULTS: 1114 women participated. The multivariate analysis showed that skin-to-skin contact (aOR = 0.58; 95% CI: 0.37, 0.90) and breastfeeding (aOR = 0.55; 95% IC: 0.35, 0.86) reduce the probability of presenting a bond disturbance. Anxiety during pregnancy, childbirth, and the puerperium (aOR = 3.95; 95% CI: 2.57, 6.05) and postpartum complications (aOR = 1.60; 95% CI: 1.03, 2.48) increase the chance of having a bond disturbance. Skin-to-skin contact (aOR = 0.61; 95% CI: 0.38, 1.00), breastfeeding (aOR = 0.47; 95% CI: 0.27, 0.80,) and an older age of the infant (months) (aOR = 0.77: 95% CI: 0.72, 0.82) reduces the probability of presenting an attachment disturbance. CONCLUSIONS: Skin-to-skin contact and breastfeeding are associated with a lower probability of impaired bonding and attachment. Anxiety states during pregnancy, childbirth, and the puerperium, and complications after childbirth increase the probability of developing a bond disorder. The older the age of the infant, the lower the frequency of having an impaired attachment. IMPLICATIONS TO PRACTICE: Identifying the factors associated with the establishment of the mother-child bond and attachment is essential for the development of prevention strategies and early identification of cases that may present alterations and avoid their consequences on the health of the mother and child.

Influence of pelvic floor disorders on sexuality in women.

OBJECTIVE: To determine the association between different pelvic floor disorders and the presence of sexual dysfunction in women. METHOD: An observational study of non-pregnant women was carried out in Spain in 2021 and 2022. To assess the presence of pelvic floor problems, the Pelvic Floor Distress Inventory (PFDI-20) was used, consisting of the subscales Pelvic Organ Prolapse Distress Inventory-6 (POPDI-6; prolapse symptoms), Colorectal-Anal Distress Inventory (CRADI-8; colorectal symptoms), and Urinary Distress Inventory-6 (UDI-6; urinary symptoms). The validated tool, Female Sexual Function (FSF), was used to evaluate female sexual function. RESULTS: In total, 1008 women participated. Of these, 288 (28.6%) had some type of sexual dysfunction. Regarding symptoms, 52 (5.2%) stated that they do not reach orgasm and 172 (17.1%) said they had never or occasionally felt sexual desire in the last month. Women with sexual dysfunctions had higher mean scores on the POPDI-6, CRADI-8, and UDI-6 subscales than those who did not have sexual dysfunction (P ≤ 0.005). Risk factors identified included being postmenopausal, with an adjusted odds ratio (aOR) of 2.98 (95% confidence interval [CI] 2.12-4.18), and a greater impact of the symptoms of pelvic floor problems as assessed by the PFDI-20 scale, in such a way that for each point increase the probability of sexual dysfunction increases with an aOR of 1.008 (95% CI 1.005-1.011). CONCLUSION: Women with pelvic floor disorders and postmenopausal women present sexual dysfunction more frequently.

Evaluation of the Use of Project-Based Learning in the Nursing Degree.

Project-based learning (PBL) is a teaching methodology that allows students to acquire knowledge and competencies through the completion of projects that respond to real-life problems. The aims of this study were to evaluate the acquisition of knowledge of students of the Aging Nursing subject through a PBL-based intervention and determine the degree of student satisfaction with the use of this methodology. A mixed, quasi-experimental, pre-post study was conducted without a control group using an educational intervention based on PBL and descriptive phenomenology with content analysis of the experiences reported after it. A knowledge questionnaire about nursing homes was administered before the start of the intervention. After using PBL to carry out the subject project, the same knowledge questionnaire and an ad hoc questionnaire on satisfaction, assessment, and improvement aspects were administered. In total, 111 nursing students participated. The difference in knowledge after the educational intervention was significant. The mean pre-intervention score was 5.56, SD 1.50, and the mean post-intervention score was 7.14, SD 1.59, (p = 0.001). In total, 74% of the students stated that they were very satisfied with the use of this methodology. The students had a positive perspective on the process of acquiring knowledge that PBL allows. The students improved their knowledge about the planning and management of nursing homes with the use of the project-based learning teaching methodology. They were very satisfied with said activity. Teachers must be adequately trained for the correct implementation of this teaching methodology. This study was not registered.

Influence of pelvic floor disorders on quality of life in women.

Objective: To determine whether the different pelvic floor disorders are associated with changes in perceived quality of life (QoL), globally and in its sub-dimensions. Methods: An observational study was conducted with women in Spain between 2021 and 2022. Information was collected using a self-developed questionnaire on sociodemographic data, employment, history and health status, lifestyle and habits, obstetric history, and health problems. The SF-12 questionnaire was used to assess quality of life. The Pelvic Floor Distress Inventory (PFDI-20) was used to assess the presence and impact of pelvic floor problems, and includes the POPDI-6 subscales for prolapse, CRADI- 8 for colorectal symptoms, and UDI-6 for urinary symptoms. Crude (MD) and adjusted mean differences (aMD) were estimated with their respective 95% confidence intervals (CI). Results: Thousand four hundred and forty six women participated in the study with a mean age of 44.27 (SD = 14.68). A statistical association was observed between all the pelvic floor disorders and QoL, overall and in all its dimensions (p <0.001), in the bivariable analysis. The lowest scores were observed in the emotional component. After adjusting for confounding factors, the pelvic floor disorders in general (aMD -0.21, 95% CI: -0.23 to -0.20), the impact of uterine prolapse symptoms (aMD -0.20, 95% CI: -0.27 to -0.12), the colorectal-anal symptoms (aMD -0.15, 95% CI: -0.22 to -0.09), and urinary symptoms (aMD -0.07, 95% CI: -0.13 to -0.03) was negatively associated on the score on the SF-12 questionnaire (p <0.05). Conclusions: Women who have a pelvic floor dysfunction, symptoms of pelvic organ prolapse, colorectal-anal symptoms, or urinary symptoms, have a worse perceived quality of life in all dimensions. Prolapse symptoms have the biggest impact, and the emotional component of QoL is the most affected sub-domains.

Pelvic floor dysfunction: prevalence and associated factors.

BACKGROUND: Pelvic floor dysfunction in women encompasses a wide range of clinical disorders: urinary incontinence, pelvic organ prolapse, fecal incontinence, and pelvic-perineal region pain syndrome. A literature review did not identify any articles addressing the prevalence of all pelvic floor dysfunctions. OBJECTIVE: Determine the prevalence of the group of pelvic floor disorders and the factors associated with the development of these disorders in women. MATERIAL AND METHODS: This observational study was conducted with women during 2021 and 2022 in Spain. Sociodemographic and employment data, previous medical history and health status, lifestyle and habits, obstetric history, and health problems were collected through a self-developed questionnaire. The Pelvic Floor Distress Inventory (PFDI-20) was used to assess the presence and impact of pelvic floor disorders. Pearson's Chi-Square, Odds Ratio (OR) and adjusted Odds Ratio (aOR) with their respective 95% confidence intervals (CI) were calculated. RESULTS: One thousand four hundred forty-six women participated. Urinary incontinence occurred in 55.8% (807) of the women, fecal incontinence in 10.4% (150), symptomatic uterine prolapse in 14.0% (203), and 18.7% (271) reported pain in the pelvic area. The following were identified as factors that increase the probability of urinary incontinence: menopausal status. For fecal incontinence: having had instrumental births. Factors for pelvic organ prolapse: number of vaginal births, one, two or more. Factors for pelvic pain: the existence of fetal macrosomia. CONCLUSIONS: The prevalence of pelvic floor dysfunction in women is high. Various sociodemographic factors such as age, having a gastrointestinal disease, having had vaginal births, and instrumental vaginal births are associated with a greater probability of having pelvic floor dysfunction. Health personnel must take these factors into account to prevent the appearance of these dysfunctions.

Impact and Influence of Urinary Incontinence on Physical Activity Levels.

Background: The benefits of physical activity are numerous on both physical and mental levels. Urinary incontinence (UI) can influence physical activity level; among US women, nearly two out of three view this problem as a barrier to physical activity, meaning that they do not exercise, exercise less, or even have to change their activity routines to accommodate this pelvic floor dysfunction. Objective: To determine whether UI influences the pattern of physical activity and whether a greater impact of urinary symptoms could influence the level of physical activity. Design setting and participants: An observational study was carried out with women in 2021 and 2022 in Spain. Outcome measurements and statistical analysis: The main dependent variable was level physical activity, as measured by the International Physical Activity Questionnaire (IPAQ). The Urogenital Distress Inventory (UDI-6) scale was used to determine the presence of UI and its impact. Sociodemographic, health status, lifestyle and obstetric data were obtained. Bivariate and multivariate analyses were performed using binary logistic regression, obtaining adjusted odds ratio (aOR) with its 95% confidence interval (95% CI). Results and limitations: A total of 1446 women participated, of whom 55.8% (807) had UI and 25.7% (371) reported low physical activity. Mixed incontinence (aOR: 1.53; 95% CI: 1.09-2.15) overall and a greater intensity of urinary symptoms (UDI-6 score; aOR: 1.014; 95% CI: 1.01-1.02) in the group of women with incontinence were statistically associated with a higher frequency of low physical activity. Other variables related to low physical activity were age, body mass index, pelvic pain, and income level (p < 0.001). Conclusions: Mixed-type UI is associated with low-level physical activity or inactivity in the whole group of women, while among women with UI, the greater impact of the symptoms increases the probability of low physical activity or inactivity. Patient summary: In this report, it is analyzed how urinary incontinence affects physical activity. It was found that women who suffer from mixed-type urinary incontinence have a low level of physical activity or inactivity, while those who experience a greater impact of urinary incontinence symptoms have an increased likelihood of having low physical activity or inactivity.

Association between sexual function in women and sleep quality.

Objective: To determine the relationship between sexual dysfunction and sleep disorders. Methods: Observational study was conducted in 2021 and 2022 including 975 Spanish women over 18 years of age. The Women's Sexual Function Questionnaire (FSM-12) was used as a source of information, and the Pittsburgh Sleep Quality Index (PSQI) was used to assess sleep quality. A bivariate and multivariate analysis was performed using binary logistic regression, adjusting for confounding variables. Crude (OR) and adjusted (aOR) odds ratios were estimated with their respective 95% confidence intervals (CI). Results: Around 29.2% (285) of the women presented some type of sexual dysfunction, and 73.4% (716) showed sleep disturbance with scores ≥5 on the PSQI scale. The mean score on the PSQI was 8.23 points (SD = 3.93). All the dimensions of the sexual function scale were statistically related to sleep disturbance (p ≤ 0.05), except for sexual activity and the reasons for sexual activity not having penetration. In the multivariable analysis, women with sexual dysfunction presented an aOR of sleep disturbance of 1.88 (95% CI: 1.29-2.76) compared to women without dysfunction. Conclusion: Global sexual dysfunction and almost all the dimensions that make up sexual function are related to changes in sleep quality.