University students' attitudes toward gender roles and infertility: A descriptive and correlational study.

PURPOSE: To examine the relationship between university students' attitudes toward gender roles and infertility. DESIGN AND METHODS: This descriptive and correlational study was conducted with 743 university students between September and December 2020. Data were collected using a personal information form, the Gender Roles Attitude Scale, and the Attitudes Towards Infertility Scale through online forms. FINDINGS: It was found that attitudes toward gender roles and infertility could be influenced by some sociodemographic factors, for instance, students' sex, education, and family type. There was also a moderate and positive correlation between attitudes toward gender roles and infertility. PRACTICE IMPLICATIONS: The present study contributes to a better understanding of the social construction and attitudes toward gender roles and infertility. For a better future, it is recommended that nurses help and support university students in raising awareness about such an important social problem.

Evaluation of women's sexual quality of life, depression, and sexual functions in the pregnancy and postpartum periods: A multi-centered study.

AIM: This multi-centered, longitudinal, and prospective study aims to identify women's sexual functions, sexual quality of life, and depression and their relationships with each other in the pregnancy and postpartum periods. METHODS: The participating pregnant women (n = 113) were interviewed six times: once in each trimester, and once in the eighth week third month, and sixth month postpartum. This study was conducted in three regions of Turkey including Marmara, Mediterranean, and Central Anatolia regions. Data were collected through the "Socio-demographic Form," "Female Sexual Function Index (FSFI)," Sexual Quality of Life-Female Questionnaire (SQLQ-F), and "Center for Epidemiologic Studies-Depression Scale (CES-D)." While the first interviews were administered face to face, successive ones were administered via phone. RESULTS: The sexual dysfunction rates of the participants were found to be high in the pregnancy and postpartum periods, and their sexual quality of life, which decreased as the pregnancy months progressed, was found to increase significantly with the progress in the postpartum period. The sexual dysfunction increased and sexual quality of life decreased significantly with the increase in depression symptoms in the pregnancy and postpartum periods. When the depressive symptoms decreased especially in the sixth month postpartum, sexual quality of life was also found to increase. CONCLUSIONS: As a result, in the pregnancy and postpartum periods, it is highly important to provide women with diagnosis through a holistic approach by creating available environments to assess their psychological health and sexual functions and refer them to the related physicians when necessary.

The effect of a counseling and training program on the treatment of women with overactive bladder.

Anticholinergic drugs and behavioral interventions are effective methods for the treatment of OAB and UUI. This randomized controlled, prospective, and quasi-experimental study determined the effect of healthy lifestyle behavior training, based on the Health Promotion Model (HPM), on the treatment of women with Overactive Bladder (OAB). The study sample included intervention and control groups with a sample size of 100 women diagnosed with OAB who received pharmacological treatment and agreed to participate in the study. The data were collected using an Introductory Information Form, Urinary Diary, OAB Questionnaire (OAB-V8), King's Health Questionnaire (KHQ), Healthy Life Style Behavior Scale II (HLSB II), Brief Symptom Inventory (BSI), and 24-hour Pad Test. The intervention group was administered a 45-minute training program based on Pender's HPM. There was a statistically significantly higher level of decrease in urgency (z = -3,259;p = 0,001), nocturia (z = -3,691;p < 0,001), urge urinary incontinence (z = -2,391;p = 0,017), and urinary frequency (χ2 = 17,420;p < 0,001) in the intervention group during the posttest period. The study found a significant decrease in the total posttest scores of the women in the intervention group on the OAB-V8 (t = -6.955;p < 0.001), KHQ (t = -5.354;p < 0.001), and BSI (t = -6.463;p < 0.001) scales whereas a statistically significant increase was found in their total score on the HLSB II (t = 9.139;p < 0.001) scale. The study concluded that HLSB training, which was prepared based on HPM, reduced OAB symptoms among women, improved the quality of their lives, changed their HLSBs, and positively affected their psychological symptoms.

Evaluation of Gender Courses Offered in Accord with the Curriculum of the Faculties of Health Sciences in Turkish Universities.

AIM: This study, with the presence of gender course in mind, aimed to examine the core education programs, which provide the fundamental standards for the determination of the curriculum background and needs of the Turkish undergraduate programs in healthcare and for the improvement of the quality of the curriculum. METHODS: The research was prepared in a descriptive study. In this context, between April 1, 2018 and April 30, 2018, the study analyzed whether gender course was included in the curricula of the faculties of health sciences in 183 Turkish universities. To evaluate this, the study made use of the Bologna information system. RESULTS: The screening concluded that 56 faculties and departments of only 36 universities included the gender course. Courses related to gender was included in the curricula of 51 faculties and departments, and only 5 identified gender as a subject within the content of different courses rather than including the course in their curricula. CONCLUSION: To conclude, an analysis of the curricula of the faculties/departments that provide education in healthcare revealed that the courses related to gender were not included in the curricula at the desired level, and the gender course that is supposed to be taught in the first year was included in later semesters.

Spiritual and Religious Issues of Stigmatization Women with Infertility: A Qualitative Study : Spiritual and Religious Issues of Stigmatization.

The purpose of this study is to determine the perceptions of women with infertility on stigma and religious and spiritual issues of stigmatization. The phenomenological method was used for the study consisting of a research sample of 12 women with infertility who were selected through the criterion sampling method. This study found that women related their experience of infertility to stress and the will of God. They were extremely sad and unhappy and went through an exhausting and fearful process. They faced social isolation, spiritual problems when their friends and relatives told other people their story of infertility.

The effect of health-promoting lifestyle education program provided to women with gestational diabetes mellitus on maternal and neonatal health: a randomized controlled trial.

Gestational diabetes is associated with adverse health outcomes for mother and offspring. The purpose of this study is to investigate the effects of the Health-Promoting Lifestyle Education Program provided to women with gestational diabetes on maternal lifestyle, quality of life, depression symptoms and neonatal health. A randomized controlled study was conducted in the perinatology clinic. While the intervention group (n = 46) was provided with the education program and usual care, the control group (n = 42) was provided with only usual care. Healthy lifestyle behaviors, quality of life and level of depression of women with gestational diabetes were evaluated. And postpartum characteristics of neonates in both groups were assessed. The education program was found to improve the healthy lifestyle behaviors and quality of life in the intervention group. The rates of macrosomia were low for the neonates in the intervention group. The Health-Promoting Lifestyle Education Program was a health-promoting practice for the women with gestational diabetes.

How do urinary incontinence types affect sexual function and quality of life for Turkish women?

OBJECTIVE: Urinary incontinence (UI) subtypes may have some effects on sexual function because of diverse pathophysiological mechanisms. The objective of our study is to compare UI subtypes' effects on women's sexual function and quality of life (QoL). METHODS: In this descriptive and comparative study, a total of 239 women with UI were included (89 with stress urinary incontinence [SUI], 65 with urge urinary incontinence [UUI], and 85 with mixed urinary incontinence [MUI]). Sexual function was assessed with the Pelvic Organ Prolapse/Urinary Incontinence Sexual Questionnaire (PISQ-12), and QoL was assessed with the Incontinence Impact Questionnaire-7 (IIQ-7). RESULTS: In our study, the mean total PISQ-12 score for the UI subtypes was 29.49 ± 6.38 for SUI, 31.43 ± 5.46 for UUI, and 23.12 ± 5.54 for MUI. Women with MUI had significantly more sexual dysfunctions than the other groups (P < .001). The mean total IIQ-7 score according to UI subtypes was 60.61 ± 31.49 for SUI, 64.40 ± 28.20 for UUI, and 70.51 ± 25.09 for MUI. As regards the scores of the IIQ-7, UI had a negative impact on QoL for women of all groups, especially for women with MUI and UUI, but was not significantly different between the groups (P > .05). CONCLUSION: The sexual function of women with MUI was affected more adversely than the other UI subtypes. There was no statistically significant difference between the UI subtypes according to IIQ-7 scores, but when we examined the scores, MUI and UUI were found to have more negative effects on QoL. Clinicians and continence nurses should make routine evaluations of sexual function and QoL for women according to UI subtypes.

Sexual function and urinary incontinence complaints and other urinary tract symptoms of perimenopausal Turkish women.

Urinary incontinence (UI) and other lower urinary tract symptoms (LUTS) which are quite common among women, have a significant level of impact on women's sexual function. Improving sexual function improves the quality of life. The purpose of this study is to evaluate the relationship between UI complaints with comorbid LUTS and sexual functions in Turkish women. The study is cross-sectional and descriptive. A total of 436 women was included in the study. Data were collected through Personal Information Form, The Bristol Female Lower Urinary Tract Symptom Questionnaire (BFLUTS) and The Pelvic Organ Prolapse/Urinary Incontinence Sexual Questionnaire (PISQ-12). The mean total of BFLUTS score was 31.99 ± 11.46, while the mean total of PISQ-12 score was 28.72 ± 6.92 in women. The most common symptoms were identified as storage and incontinence. There was a negative significant correlation between the total PISQ-12 scores and sub-dimension of BFLUTS scores (p < 0.01). Results of the study suggest that sexual function is negatively affected as the severity of symptoms increases.

Quality of life and sexual function in obese women with pelvic floor dysfunction.

This prospective study was conducted in the urogynecology and gynecology outpatient clinics of Istanbul Faculty of Medicine from December 2014 to March 2015. The objective was to identify the association between obesity and sexual function and quality of life in women with pelvic floor dysfunction (PFD). A total of 387 sexually active women diagnosed with urinary incontinence and/or pelvic organ prolapse were included and categorized as obese (n = 200) or nonobese (n = 187). Mean body mass indexes were 25.7 ± 2.41 kg/m2 for nonobese women and 34.9 ± 3.92 kg/m2 for obese women. The Pelvic Organ Prolapse/Urinary Incontinence Sexual Questionnaire-12 total score was significantly lower in obese (27.66 ± 7.12) than in nonobese women (30.18 ± 6.54) (p < .05). Quality of life mean scores were higher in obese women for both the Incontinence Impact Questionnaire total score (67.24 ± 26.8 versus 49.12 ± 27.5) and Urogenital Distress Inventory total score (65.02 ± 21.4 versus 55.07 ± 24.7) (p < .001). Obese women with PFD had symptoms for longer durations, had more frequent urinary incontinence, and worse sexual function and quality of life than nonobese women. Health-care professionals caring for obese women should be aware of the coexistence of obesity and PFD. Future studies should evaluate whether obesity-associated PFD can be reduced through successful weight reduction interventions.

The Prevalence of Diurnal Urinary Incontinence and Enuresis and Quality of Life: Sample of School.

PURPOSE: Enuresis can cause loss of self-esteem in children, change relations with family and friends, and decrease the school success. This study was conducted to determine the prevalence of urinary incontinence (UI) in school children aged between 11-14 years and identify the emotions and social problems of enuretic children. MATERIALS AND METHODS: A mixed methods approach was used on a group of students who reported UI by combining quantitative data from school population-based cross-sectional design with qualitative data using in-depth interview techniques. The data of this descriptive and cross-sectional study were collected from 2750 primary school students aged between 11-14 years in Istanbul. RESULTS: The overall prevalence of UI was 8.6% and decreased with age. Prevalence of the diurnal enuresis in children was 67.9% and all of them had non-monosymptomatic enuresis. 83.3% of the children were identifiedwith secondary enuresis for 1-3 years. UI was significantly more common in boys and those who had frequent urinary infections, whose first degree relatives had urinary incontinence problem in childhood, and who reportedlow socioeconomic level in the family. The emotional and social effects of urinary incontinence were given in the context of children's own expressions. CONCLUSION: Urinary incontinence is an important problem of school-age children. In this study the prevalence of UI was found to be 8.6%, diurnal UI and secondary enuresis were very common, and all of the children werenon-monosymptomatic. Enuresis has negative emotional and social effects on children.

Effects of Transobturator Midurethral Sling Surgery on Sexual Functions: One-Year Follow-Up.

AIM: To evaluate sexual functions of women having stress urinary incontinence (SUI) preoperatively and 6 months and 12 months after undergoing a transobturator tape (TOT) ± pelvic organ prolapse (POP) surgery. METHODS: One hundred-ninety-five women with SUI ± POP were recruited and 150 sexually active women who had clinical ± urodynamic SUI and underwent TOT ± POP surgery were included in this prospective study. Urogynecologic symptoms were evaluated preoperatively, at 6 months, and 12 months by Female Sexual Function Index (FSFI). RESULTS: One hundred fifty women completed the study. Seventy-four underwent TOT-only and 76 underwent TOT + concomitant surgery. Mean total scores of FSFI were 21.7 ± 7.8, 22 ± 8.7, and 22.1 ± 8 in the preoperative period, postoperative 6, and 12 months, respectively. There was significant improvement in desire and total scores in the TOT-only group, whereas there was no significant difference in the TOT + concomitant surgery group except for significant worsening in the lubrication domain. The frequency of sexual intercourse increased while that of coital incontinence decreased after surgery. CONCLUSIONS: In our study, TOT was associated with decrease in coital incontinence and significant improvement in desire. In addition, there was significant improvement in FSFI desire and total scores in the TOT-only group, whereas no significant difference was observed in the TOT + concomitant surgery group except for the worsening of lubrication.

Coping and Help-Seeking Behaviors for Management of Urinary Incontinence.

OBJECTIVES: To describe the coping strategies and help-seeking behaviors of women and men with urinary incontinence (UI). METHODS: In cross-sectional study, 156 women and 106 men Turkish with UI were interviewed using a questionnaire covering 29 questions. RESULTS: It was determined that 50.6% of women and 34.0% of men seek help in first for treatment of UI. Forty eight percent of men consulted a physician in the first 6 months after the UI occurred, 44.9% of women consulted a physician 2-5 years later after the UI occurred. Coping behaviors of both groups for management of the UI were as follows: keeping feet warm, performing hot application to perineum, reducing the amount of daily drinking water, using pad, cloth pads, restricting physical activity, refraining from social life and praying etc. CONCLUSIONS: While women mostly do not prefer to seek medical advice for UI, men tend to go to doctors more often than women. Except for treatment seeking behaviors, both men and women are practicing coping methods for the management of UI such as going frequently to the toilet, keeping feet warm, hot application to perineum etc.

Approaches to Cope with Stress and Depression in Individuals with Urinary Incontinence.

AIM: The aim of study was to assess individuals with urinary incontinence (UI) with respect to depression and to determine coping mechanisms with stress. METHODS: One hundred sixty female and 110 male participants that applied to Istanbul Faculty of Medicine, Urology and Urogynecology Department with UI complaints and accepted to participate in the study were included in the study. Depressive symptoms were assessed with Center for Epidemiological Studies Depression Scale (CES-D). The mechanisms of coping with stress were evaluated using Ways of Coping with Stress Inventory (WCSI). RESULTS: Females (57.5%) scored 16 points and more from the CES-D scale, while the rate was significantly higher in males (79.1%). The scores obtained in 5 subdimensions of the WCSI showed that females utilized a desperate approach (female 1.39 ± 0.63, male 1.11 ± 0.51, p < 0.000), self-confident approach (female 1.98 ± 0.60, male 1.70 ± 0.42, p < 0.000), and social support approach (female 1.90 ± 0.57, male 1.48 ± 0.44, p < 0.000) statistically and significantly more than males in coping with stress. CONCLUSION: Males experienced more depression symptoms when compared to females. Females were significantly more self-confident and utilized social support mechanisms and desperate approaches more than males in order to cope with stress.

The effect of health-promoting lifestyle education on the treatment of unexplained female infertility.

OBJECTIVE: This study aimed to reveal the 1) awareness, 2) improvements of a health-promoting lifestyle on women with unexplained infertility having at least one of the risk factors that have been indicated to negatively affect fertility (smoking, body mass index lower than 18.5kg/m2 and more than 25kg/m2, over-exercising or not exercising at all, alcohol consumption, caffeine consumption of more than 300mg/day, and high levels of stress) by means of health-promoting lifestyle education, 3) the effect of this improvement on the result of assisted-reproduction treatment in terms of clinical pregnancy. STUDY DESIGN: 64 women diagnosed with unexplained infertility were divided into a group receiving Health-Promoting Lifestyle (HPL) education and a control group. 1) Risk Factors Questionnaire (BMI, Smoking, Alcohol, Stress, Exercise, Caffeine), 2) Depression, Anxiety and Stress Scale, 3) Health-Promoting Lifestyle Profile II. The health promoting lifestyle was given to the education group. The Risk Factors Questionnaire; Depression, Anxiety, Stress Scale and Healthcare-Promoting Lifestyle Profile II were also administered after the first-second-third month of education but before ART treatment. RESULTS: A statistically significant decrease was found in the average levels of four variables as; BMI (p<0.001)-stress (p<0.001)-caffeine consumption (p<0.001)-lower exercise levels (p<0.001). Moreover, the total number of risk factors that females had between the first and third interview decreased significantly. Clinical pregnancy rate after ART was 12 (46.1%) and 5 (19.2%) in education and control group consequently (p=0.02). CONCLUSION: Health-promoting lifestyle education was found to be effective in reducing the lifestyle risk factors for infertility and increasing the success rates of assisted reproduction treatment by correcting these risk factors.

Lower Urinary Tract Symptoms in Women With Type 2 Diabetes Mellitus.

PURPOSE: The aim of the study was to compare lower urinary tract symptoms (LUTS) in women with and without type 2 diabetes mellitus (DM). SUBJECTS AND SETTING: The sample was drawn from community-dwelling women in the province of Istanbul who were cared for in the diabetes outpatient clinic of Istanbul Medical School between January and June 2012. Two hundred forty-nine women with DM were compared to 255 women without DM cared for in the obstetrics and gynecology department of the same university hospital. The mean ages of the groups were 55.1 and 53.7 years, respectively. METHODS: Participants completed a questionnaire that queried sociodemographic and clinical characteristics; the Bristol Female Lower Urinary Tract Symptoms-Short Form (BFLUTS-SF) was used to evaluate LUTS. The questionnaire required 10 to 15 minutes to complete; participants completed the questionnaire in a private room of each of the respective outpatient clinics. RESULTS: No statistically significant differences were found when groups (women with and without DM) were compared based on age and cigarette smoking (P > .05). In contrast, BMI scores were significantly higher in the women with DM (P < .001). The cumulative BFLUTS scores and the filling and incontinence symptoms subscale sores (P < .001) were significantly higher in women with DM. No differences were observed in voiding symptoms (P = .347), sexual function (P = .380), and health-related quality of life (P = .142) subscale scores. The prevalence of storage symptoms nocturia, voiding frequency, urge incontinence, stress incontinence, frequency of incontinent episodes were higher among women with DM. In addition, women with DM were more likely to report the need to change clothing because of urinary leakage, effect of incontinence on daily tasks, and overall interference with daily activities of living. CONCLUSIONS: Women with type 2 DM are more likely to experience LUTS as compared to women without DM. Women with type 2 DM should routinely be assessed for LUTS.

Sexual function in women after urinary incontinence and/or pelvic organ prolapse surgery.

AIMS AND OBJECTIVES: To determine how the sexual function is affected in women who underwent surgery for urinary incontinence and/or pelvic organ prolapse. DESIGN: The study was conducted as a descriptive and prospective research. BACKGROUND: Approximately 11·1% of the cases with pelvic organ prolapse or urinary incontinence require surgical intervention. Some authors report improved function after surgical correction of pelvic floor disorders, whereas others report deterioration of function. METHODS: The research was carried out with totally 116 patients in three groups of women who underwent surgery for urinary incontinence and/or pelvic organ prolapse. Sexual function and low urinary tract symptoms were assessed preoperatively and at six months postoperatively, with the Pelvic Organ Prolapse/Urinary Incontinence Sexual Questionnaire 12 and Bristol Female Lower Urinary Tract Symptoms Scale. RESULTS: Prolapse/Urinary Incontinence Sexual Questionnaire-12 total scores increased significantly, and sexual function improved at postoperative six months in all groups. In the evaluation of sexual function in each group at preoperative and postoperative six months, Prolapse/Urinary Incontinence Sexual Questionnaire-12 scores of UI, and UI and POP were found to be increased significantly, while there was no change in sexual function in women in the pelvic organ prolapse surgery group at postoperative six months compared with preoperative period. CONCLUSION: As a result, it was determined that lower urinary tract symptoms were improved and sexual function of women changed positively at six months after UI and/or POP surgery. RELEVANCE TO CLINICAL PRACTICE: It is important to provide counselling on potential development of postoperative sexual function and the possibility of impairment of sexual function for women undergoing UI and/or POP surgery.

Risk-taking behaviours and beliefs about fertility in university students.

AIMS AND OBJECTIVES: To investigate the risk-taking behaviours and beliefs about fertility among university students in Turkey. BACKGROUND: Young people are usually ignorant about reproductive health and engage in risky practices. DESIGN: A descriptive cross-sectional study. METHODS: The convenience sample of the study was consisted of 1030 undergraduate students. Data were collected using a self-administered question form, and students' reproductive health and lifestyle behaviours related with infertility, their beliefs about the risk factors and fertility myths were questioned. RESULTS: The mean age of the students was 20.4 (SD = 2) and ranged between the ages of 16-37. Sexual activity rate was higher among men and 47% of men had more than one sexual partner. Condom use rate was low among women. Underweight was more common among women, while overweight was seen more among men. Students mostly did not exercise regularly. Alcohol was not common, and the rates of smoking were 15% and 23% for women and men, respectively. Only 35-50% of students thought that smoking, alcohol, stress, sexually transmitted diseases, infections, pollution, chemicals, radiation and cancer treatment could be risk factors for fertility. Advanced age and obesity were seen as risk factors for women. Of the students, 50-65% believed that having more than one sexual partner, being underweight, high-level exercise, excessive caffeine, chronic disease and medications could not have an effect on fertility. Women were more concerned about being infertile, and half of students believed that infertility is preventable. CONCLUSION: Turkish university students have insufficient knowledge of reproductive health, and they have false beliefs that might affect their risk perception or views about fertility. RELEVANCE TO CLINICAL PRACTICE: Reproductive healthcare services for young adults should be made more widespread and accessible, and nurses, health providers and instructors should be supportive of them in these matters.

Comparison of the effects of electrical stimulation and posterior tibial nerve stimulation in the treatment of overactive bladder syndrome.

AIM: To compare the effects of transvaginal electrical stimulation (ES) and posterior tibial nerve stimulation (PTNS) in the treatment of overactive bladder syndrome (OAB). METHODS: Women applying with symptoms of urgency, frequency, and nocturia with or without incontinence and diagnosed with OAB were divided into an ES or PTNS group. Bladder diary, urodynamics, 1-hour pad test, and King's Health Questionnaire were performed before and after treatment. ES was applied for 20 min, 6-8 weeks with pulses of 10-50 Hz square waves at a 300-µs or 1-ms pulse duration and a maximal output current of 24-60 mA with 5-10 Hz frequency, three times per week. PTNS was applied for 30 min once a week for 12 weeks. RESULTS: Thirty-five patients received ES, 17 patients received PTNS. Pad test, urinary diary, and quality of life parameters after both treatments decreased significantly; the decrease in the ES group was greater. The number of patients who describe themselves as cured was higher in the ES group. CONCLUSION: PTNS and ES are both effective in the treatment of OAB with significant improvement in objective and subjective parameters. Objective results show no significant difference between the two groups; however, the number of patients who describe themselves as cured in the ES group was significantly higher.

Effects of infertility on gender differences in marital relationship and quality of life: a case-control study of Turkish couples.

OBJECTIVES: Although there are many studies trying to evaluate the effect of infertility on marital relations (MR) and quality of life (QoL) in developed counties, there have been no studies in Turkey. As in many societies around the world, lack of pregnancy and the resulting childlessness are often highly stigmatized, leading to profound social suffering for infertile couples in Turkey. STUDY DESIGN: This study was planned as a case-control study in order to investigate the effects of infertility on MR and QoL. It was conducted among 58 primary infertile and 51 fertile couples. The Dyadic Adjustment Scale (DAS) and the World Health Organization QoL Scale (WHOQOL-BREF) were applied at the infertility department of the Istanbul University's faculty of medicine. The t-test, Mann-Whitney U, ANOVA and Pearson's correlation coefficient were used. RESULTS: The socio-demographic properties were similar for both groups. The QoL average score was higher for the infertile group. There were no gender differences in QoL for infertile couples. The total DAS score was higher than the cut-off score for both groups (114.44 ± 18.53 for infertile, 110.29 ± 18.28 for fertile couples; p>0.05). Infertile women's DAS and QoL scores were higher than the fertile women's (p<0.05). Other than in the social domain, all QoL scores were higher for infertile men than fertile men (p<0.05). There was a positive correlation between the DAS and QoL scores. CONCLUSIONS: It was determined that infertility did not have a negative impact on MR and QoL measurements. There were no gender differences.