Bakgrund: Endometrios är en kronisk, inflammatorisk och gynekologisk sjukdom däromkring var tionde kvinna i fertil ålder drabbas. Bristande kunskap inom hälso- ochsjukvården resulterar i fördröjd diagnos och behandling. Vanliga symtom videndometrios är smärta, fatigue och blödningar.Syfte: Syftet med studien var att belysa hur kvinnor med endometrios upplever attsjukdomen inverkar på deras vardagliga liv.Metod: En litteraturstudie med kvalitativ ansats. Genom databassökningar i CINAHLoch PubMed identifierades tolv kvalitativa, vetenskapliga artiklar somkvalitetsgranskades med mall för kvalitetsgranskning av studier med kvalitativforskningsmetodik - patientupplevelser utformad av Statens beredning för medicinskoch social utvärdering (SBU). Artiklarna analyserades med innehållsanalys.Resultat: Kvinnor med endometrios upplevde att sjukdomen inverkade negativt påderas vardagliga liv i många avseenden. Analysen resulterade i sex teman:funktionsförmåga; emotionellt mående; socialt liv; intima relationer; arbete, utbildningoch ekonomi; självbild och livsföring. Utöver dessa teman identifierades också tvåsubteman.Konklusion: Stöd, förståelse och bekräftelse av symtom är viktigt för kvinnornashantering av sjukdomen i det vardagliga livet. Okunskap och normalisering avmenstruationssmärtor i både samhället och inom hälso- och sjukvården gör att kvinnormed endometrios upplever ett utanförskap i samhället som kan leda till social isolering.Ökad kunskapsspridning om endometrios behövs inom både hälso- och sjukvården och isamhället för att kvinnorna ska kunna uppleva en bredare acceptans för sin sjukdom ochmötas av förståelse istället för misstro. Att synliggöra hur kvinnor med endometriosupplever att sjukdomen inverkar på deras vardagliga liv ger ökad förståelse för de härkvinnorna vilket är en förutsättning för att sjuksköterskan ska kunna ge personcentreradoch säker vård till den här patientgruppen. Sjuksköterskan kan bidra med information,samverkande åtgärder, stöd och bekräftande vilket kan minska lidande och risken försocial isolering.Nyckelord: Dagligt liv, endometrios, erfarenhet, inverkan, kvinnors hälsa, upplevelse,vardagligt liv. / Background: Endometriosis is a chronic, inflammatory and gynecological disease inwhich about one in ten women of childbearing age suffer. Lack of knowledge in healthcare results in delayed diagnosis and treatment. Common symptoms of endometriosisare pain, fatigue and bleeding.Aim: The aim of this study was to illustrate women’s experiences regarding the impactof endometriosis upon their everyday lives.Method: A literature study with a qualitative approach. Through database searches in CINAHL and PubMed, twelve qualitative, scientific articles were identified and quality-controlled with a template for quality review of studies with qualitative research methodology - patient experiences designed by the Swedish National Board for Medicaland Social Evaluation. The articles were analyzed with content analysis.Result: Women with endometriosis experienced negative impact of the disease:endometriosis affected several aspects of women's everyday lives and the analysisresulted in six themes: functional ability; emotional maturity; social life; intimaterelationships; work, education and economics; self-image and life-management. Twosubthemes were also identified.Conclusion: Support, understanding and confirmation of symptoms are important forwomen in order to cope with the disease in their everyday lives. However, women withendometriosis experience ignorance and normalization of menstrual pain in both societyand in healthcare which leads to alienation which can lead to social isolation. Increasedknowledge about endometriosis is needed in both healthcare and society in general, inorder for women to experience a broader acceptance of their illness and to be met byunderstanding rather than mistrust. Highlighting women’s experiences regarding theimpact of endometriosis upon their everyday lives leads to increased understandingwhich to the nurse is crucial information in order to guarantee a person-centered andsafe healthcare. The nurse can collaborate with other professions in healthcare andprovide information, support and confirmation to these women, which can reduce theirsuffering and risk of social isolation.Keywords: Daily life, endometriosis, everyday life, experience, impact, perception,women’s health.

Cardiovascular disease is the number one cause of death for women in the United States. Acute myocardial infarction (AMI) carries a more negative prognosis for women than men. Women with AMI have both increased mortality and disability. All researchers who have documented a difference in delay times between men and women note that women delay longer in seeking treatment. In the case of an evolving AMI, women who delay in seeking medical attention will often place themselves outside the limits of reperfusion therapies such as angioplasty and thrombolysis, thereby increasing their risk of an out-of-hospital sudden cardiac death. Several investigators have reported that reasons for delay to treatment may include the presence or absence of “somatic awareness”, that is, how a woman perceives body activity and physiological functioning. The inability of women to disregard social roles and place primacy of caring over their own health issues may limit them from seeking formal care. Social roles and obligations in a women’s life are often influenced by everyday, ordinary happenings which may have a negative impact on decision making. These everyday, ordinary happenings have been defined as “daily hassles”. The Leventhal self-regulatory model of illness behavior, which has been used to study treatment seeking behavior in response to symptoms, provides a coherent framework for interpreting the problem of delayed treatment of myocardial infarction. The Leventhal model proposes that the patients’ belief about their health is structured in a hierarchical fashion and that these structures are based on previous illness experiences and information presented in the social environment. Utilizing a descriptive design, this study examined the relationship between somatic awareness and daily hassles and how these variables influenced a women’s treatment seeking behavior in AMI. The Modified Somatic Perception Questionnaire (MSPQ) was used to measure somatic awareness; and daily hassles were measured through the Daily Hassles and Uplift Scale (DHUS). The questionnaires were administered at least 24 hours post admission to women with AMI. Though there were no significant relationships found between somatic awareness, daily hassles and time to treatment for AMI, the study revealed other pertinent findings. A significant relationship was found between daily hassles and age; revealing that younger participants revealed a higher daily hassle score. Also, a significant relationship was found between total MSPQ and prior cardiac events; indicating infrequent occurrence of intense symptoms experienced by women with a positive cardiac history. Though it is unknown what impact this new knowledge will have on treatment of women with AMI, these findings hold promise for clarifying these areas of research. Keywords: somatic awareness, daily hassles, treatment seeking behavior, women with acute myocardial infarction (AMI).

The use of various forms of contraception in Ghana gained prominence after the government resorted to investing more in family planning programs when maternal mortality was declared an emergency in the country. In Ghana, the intention to use and actual usage of contraceptives is influenced by many factors, which may lead to non-usage or discontinuation. This quantitative study was conducted to determine risk and protective factors impacting on the intention and usage of contraceptives. Survey data from the Ghana 2014 Demographic and Health Survey (DHS) (n = 9396) was used. A sub-sample of 7661 women in their reproductive age were included in this study, who reported being sexually active within the last year. Logistic regression analyses were conducted to test the association between a broad range of risk and protective factors including religion, early sexual intercourse, frequency of sex, number of lifetime sexual partners with intention to use contraception. We controlled for income, educational attainment, and age. Overall (n = 3661; 47.8%) reported no intention of contraception use. Logistic regression analysis revealed that no formal education (OR = 1.49; 95% CI, 1.29–1.72; p < 0.001), and primary school as highest educational level (OR = 1.19; 95% CI, 1.04–1.25; p < 0.001), Islamic religion (OR = 0.73; 95% CI, 0.59–0.90; p < 0.001), not currently employed (OR = 1.50; 95% CI, 1.34–1.69; p < 0.001), husband opposing contraception use (OR = 2.19; 95% CI, 1.42–3.46; p < 0.001), and currently pregnant (OR = 1.30; 95% CI, 1.09–1.54; p < 0.001) were also positively associated with no intention of use. Engaging religious leaders for advocacy in the community was identified as an approach to address barriers and increase awareness on contraceptive use. Targeted family planning programs should intensify public education on safe sex behaviors.

Background: Community engagement—the collaborative process of addressing issues that impact the well-being of a community—is a strategic effort to address community issues. The Gulf States Health Policy Center (GS-HPC) formed the Hattiesburg Area Health Coalition (HAHC) in November 2014 for the purpose of addressing policies impacting the health of Forrest and Lamar counties in Mississippi. Objectives: To chronicle the community-based participatory research (CBPR) process used by HAHC’s identification of infant and maternal health as a policy area, domestic violence in pregnancy as a priority area within infant and maternal health, and a community action plan (CAP) regarding this priority area. Methods: HAHC reviewed data and identified infant and maternal health as a priority area. They then conducted a policy scan of local prenatal health care to determine the policy area of domestic violence in pregnancy. Results: HAHC developed a CAP identifying three goals with regard to domestic violence and pregnancy that together informed policy. Changes included the development of materials specific to resources available in the area. The materials and recommended changes will first be implemented by Southeast Mississippi Rural Health Initiative (SeMRHI) through a screening question for all pregnant patients, and the adoption of policies for providing information and referrals. Conclusions: The lack of community-level data was a challenge to HAHC in identifying focus and priority areas, but this was overcome by shared leadership and community engagement. After completion of the CAP, 100% of expecting mothers receiving prenatal care in the area will be screened for domestic violence.

Syfte: Syftet med studien var att belysa hur sjuksköterskor beskriver de kommunikations- och informationsstrategier som används för att främja unga kvinnors reproduktiva hälsa på landsbygden i Maputo provins. Bakgrund: För att kunna erbjuda god hälso- och sjukvård till kvinnor på landsbygden är det av stor vikt att kunna nå ut genom kommunikation och information. Mozambique är ett av de länder i Afrika med störst mödradödlighet. Den höga siffran av dödsfall grundar sig delvis i bristen på självbestämmande hos kvinnor, avstånd till sjukhus och bristen på ekonomiskt stöd för transport samt medicinska kostnader. Det förstärks av fattigdom, ung ålder, ojämlikhet samt avsaknad av ekonomiska rättigheter till att fatta egna beslut. Metod: Semistrukturerade intervjuer genomfördes med sju olika sjuksköterskor på fyra olika sjukhus i Maputo provinsen. Den insamlade data blev transkriberad, kodad och sedan analyserad. Kvalitativ innehållsanalys tillämpades. Resultat: Två huvudkategorier framkom från den insamlade data. Den första huvudkategorin berörde vilka verktyg sjuksköterskorna använde sig av för att nå ut på landsbygden med information och kommunikation och den andra huvudkategorin som uppkom handlade om utmaningarna som sjuksköterskorna i studien ställdes inför angående kommunikation och information. De två kategorierna hade tre underkategorier vardera. I resultatet påvisades att sjuksköterskorna var tvungna att tillhandahålla information på modersmål och använda sig av anpassade kommunikationsverktyg, vilket i sin tur skulle underlätta sjuksköterskans arbete.  Konklusion: Olika strategier och verktyg identifierades av sjuksköterskorna i syfte att främja unga kvinnors reproduktiva hälsa. Sjuksköterskorna påpekade vikten av att ge information på patientens modersmål, för att nå ut till alla på landsbygden. / Aim: The aim of this MFS study is to illuminate how nurses describe the communication and information strategies used in order to promote young women's reproductive health in rural settings, Maputo province. Background: To be able to provide good healthcare to women in rural areas it is crucial for the nurses to reach out with communication and information. Mozambique has one of the highest maternal mortality rates in Africa. The high number of deaths is partly due to a lack of self-determination among women, a long distance to reach health care centers and lack of economic support for transportation and medical costs. This is intensified by poverty, young age, inequality, and less economic rights of making own decisions. Method: Semi-structured interviews were conducted on a sample of seven nurses at four different hospitals in Maputo province. The collected data was transcribed, coded and analyzed by a qualitative content analysis. Results: From the data, two main categories emerged, which focus on specific tools to give information to reach out in rural areas and the challenges that the nurses face regarding information and communication. It was shown in the result that the nurses had to provide individualized information in mother tongue and provide more aid in communication, which in turn would ease the nurse’s work. Conclusion: Different strategies and tools were identified among the nurses to promote young women's reproductive health. The nurses pointed out the importance of providing information in mother tongue to reach out in rural areas.

This study explores the possibility of designing an empowering community on a hormone-tracking application. I hereby draw inspiration from the ethos of the radical consciousness-raising groups of the 1970s to move away from the traditional individualistic approach to hormonal health. The study adopts a research-through-design approach that integrates a combination of sensitizing user engagement, somaesthetics and speculative design. By conducting interviews centred on individuals’ lived experiences surrounding hormonal health and a design workshop that emphasises collaboration and inclusion in the design process, I discuss the potential for creating a digital community that promotes a holistic and collectivist perspective for hormone-tracking applications. The aim is not to make users reliant on the community to give them knowledge. Rather, the community should enable users to collectively create a consciousness around their hormonal health and use this to empower them to better understand their hormones. The findings highlight that the design should be guided by the principles of connecting only a few people that share similar experiences and have different levels of knowledge to establish genuine human connections and collectively construct hormonal consciousness. Lastly, our study concludes that akin to the women’s health movement, the act of bringing together a group of people to discuss their health and bodies is in itself an empowering and inspiring act that fosters a sense of community. / Den här studien undersöker möjligheten att utforma en stärkande gemenskap för en hormonspårningsapplikation. Jag hämtar härmed inspiration från de radikala medvetandehöjande gruppernas etos på 1970-talet för att gå bort från det traditionella individualistiska förhållningssättet till hormonell hälsa. Studien anammar en forskning-genom-design-metod som integrerar en kombination av sensibiliserande användarengagemang, somestetik och spekulativ design. Genom att genomföra intervjuer centrerade på individers upplevelser kring hormonell hälsa och en designworkshop som betonar samarbete och inkludering i designprocessen, diskuterar jag möjligheten för att skapa en digital gemenskap som främjar ett holistiskt och kollektivistiskt perspektiv för hormonspårningstillämpningar. Syftet här är inte att göra användarna beroende av samhället för att ge dem kunskap, utan att ge dem möjlighet att starta en konversation om hormonell hälsa och koppla ihop dem för att få stöd i sina upplevelser. Resultaten visar att designen bör vägledas av principerna om att koppla samman endast ett fåtal personer som delar liknande erfarenheter och har olika kunskapsnivåer för att etablera äkta mänskliga kopplingar och kollektivt skapa kunnighet och kompetens inom hormonell hälsa. Slutligen drar studien slutsatsen att i likhet med kvinnohälsorörelsen är handlingen att sammanföra en grupp människor för att diskutera deras hälsa och kroppar i sig en förstärkande och inspirerande handling som främjar en känsla av gemenskap.

Bakgrund: Endometrios är en långvarig inflammatorisk sjukdom vars definition är att livmoderslemhinna förekommer utanför livmodern. Vanliga symtom är bäckensmärta, dysmenorré, dyspareuni, dyschezi, dysuri och ländryggssmärta. Syfte: Att beskriva kvinnors upplevelser av smärta vid endometrios. Metod: Studien genomfördes som en allmän litteraturstudie och baserades på åtta vetenskapliga artiklar. Resultatartiklarna lästes flertalet gånger och kategorier skapades genom att identifiera likheter och skillnader mellan meningsbärande enheter. Resultat: Analysen identifierade tre kategorier: Upplevelser av smärtans karaktär, Upplevelser av smärtans konsekvenser och Upplevelser av smärthantering. Smärtans karaktär varierade med olika mönster och intensitet, vanligtvis upplevdes en konstellation av flera typer av smärta. Kvinnor upplevde att smärta vid endometrios skapade begränsningar i livet med konsekvenser relaterat till både fysiska, psykiska, sociala och intima aspekter. Förmedlingen av smärtan upplevdes komplicerad, vilket minskade förståelsen från omgivningen. Genom ökad kunskap om endometrios kunde kvinnorna utveckla copingstrategier. Konklusion: Smärta vid endometrios är livspåverkande. Sjuksköterskan behöver förståelse kring smärtans påverkan på kvinnornas liv för att bygga en förtroenderelation och genomföra en korrekt smärtbedömning. Ökad kunskap kan bidra till att förbättra sjuksköterskans förutsättningar till att lindra kvinnors lidande. / Background: Endometriosis is a prolonged inflammatory disease whose definition is that endometrium occurs outside the uterus. Common symptoms are pelvic pain, dysmenorrhea, dyspareunia, dyschezia, dysuria and low back pain. Aim: To describe women’s experiences of pain in endometriosis. Method: The study was conducted as a general literature review and was based on eight scientific articles. The result articles were read multiple times and categories were created by identifying similarities and differences between meaningful units. Results: The analysis identified three categories: The experiences of the pains characteristics, The experiences of the pains consequences and The experiences of pain management. Pain characteristics varied with different patterns and intensity, usually a constellation of several types of pain was experienced. Women experienced that pain in endometriosis created limitations in life with consequences related to both physical, psychological, social and intimate aspects. Communicating the pain was experienced as complicated, which reduced the understanding from the environment. Through increased knowledge about endometriosis, the women were able to develop coping strategies. Conclusion: Pain related to endometriosis is affecting life. The nurse needs an understanding of the pain’s impact on the women’s lives in order to build a relationship of trust and carry out a correct pain assessment. Increased knowledge can contribute to improving the nurse’s abilities to alleviate women’s suffering.

Bakgrund: Graviditet och förlossning innebär en fysisk och mental påfrestning. Efter förlossning kan det vara svårt att återgå till den nivå av fysisk aktivitet som innan en graviditet. Med fluktuerande hormoner visar att vissa kvinnor kan vara mer utsatt för upplevd stress och ångest vilket kan leda till depression. Det finns ej några nationella riktlinjer för fysisk aktivitet och träning postpartum. Det finns endast ett fåtal studier som studerar sambandet mellan fysisk aktivitetsnivå och stress hos kvinnor postpartum.  Syfte: Syftet är att undersöka fysisk aktivitet och upplevd stress, samt sambandet mellan fysisk aktivitet och upplevd stress hos kvinnor i Sverige 3 – 6 månader efter vaginal förlossning.  Metod: En korrelerande och deskriptiv kvantitativ icke experimentell design användes i denna tvärsnittsstudie. Urvalet skedde via riktade svenska Facebookgrupper och självskattningsenkäter rörande fysisk aktivitetsnivå (Socialstyrelsens indikatorfrågor om fysisk aktivitet) och upplevd stress (The Perceived stress scale - 10) samlades in vid ett tillfälle från 26 kvinnor. Totalt 19 enkäter användes i undersökningen. Resultat: Studiedeltagarna skattade sin vardagsmotion till 225 minuter/vecka (IQR = 180), sin fysiska träning till 15 min/vecka (IQR = 75), samt totala aktivitetsminuter till 300 minuter/vecka (IQR = 225). Den upplevda stressnivån skattades till 16 (IQR = 10). En svag, icke signifikant negativ korrelation förelåg mellan totala aktivitetsminuter och upplevd stress (r = -0,25).  Slutsats: Denna studie är den enda studien som studerat samband mellan fysisk aktivitetsnivå och stress hos kvinnor 3–6 månader postpartum. Ingen korrelation förelåg men kvinnorna hade en relativt hög fysisk aktivitetsnivå totalt. Undersökningen har gjorts på en liten grupp individer på 19 personer och därför är slutsatser svåra att dra. / Background: Pregnancy and childbirth involve physical and mental strain. After giving birth, it can be difficult to return to the level of physical activity within a pregnancy. Having fluctuating hormones shows that some women may be more vulnerable to perceived stress and anxiety which can lead to depression. There are no national guidelines for physical activity and exercise postpartum. Only few studies study the relationship between physical activity level and stress in postpartum women. Objective: The aim is to investigate physical activity and perceived stress, as well as the relationship between physical activity and perceived stress in women in Sweden 3 – 6 months after giving vaginal birth. Method: A correlational and descriptive quantitative non-experimental design was used in this cross-sectional study. The selection took place via targeted Swedish Facebook groups and self-assessment questionnaires regarding physical activity level (The National Board of Health and Welfare's indicator questions on physical activity) and perceived stress (The Perceived stress scale-10) were collected on one occasion from 26 women. A total of 19 questionnaires were used in the survey. Results: The study participants estimated their daily exercise to be 225 minutes/week (IQR = 180), their physical training to be 15 minutes/week (IQR = 75), and a total activity level to 300 minutes/week (IQR = 225). The perceived stress level was estimated at 16 (IQR = 10). A weak, non-significant negative correlation existed between total activity minutes and perceived stress (r = -0.25). Conclusion: This study is the only study that studied the relationship between physical activity level and stress in women 3–6 months postpartum. There was no correlation, but the women had a relatively high level of physical activity overall. The study has been done on a small group of individuals of 19 people, which is why conclusions are difficult to draw.

This study investigated the health needs of immigrant women from the African Great Lakes living in South Africa in the province of Gauteng, Tshwane Metropolitan city. It described their challenges and related factors compromising their holistic wellness, and identifies their context specific health needs as a gender group. A qualitative approach was utilised concurrently with participatory action research method. Data collection involved triangulation of instruments. A literature study was conducted to select relevant information usable as basis for this study. Data analysis and interpretation revealed factors that make it difficult for immigrant women from the African Great Lakes region to gain access to health care services in South Africa, identifying their specific women’s health needs. Recommendations proposed that policy makers and implementing professionals rendering women’s health care services should consider utilising a holistic and interdisciplinary approach to meet these basic needs. / Health Studies / M.A. (Public health)

This study investigated the health needs of immigrant women from the African Great Lakes living in South Africa in the province of Gauteng, Tshwane Metropolitan city. It described their challenges and related factors compromising their holistic wellness, and identifies their context specific health needs as a gender group. A qualitative approach was utilised concurrently with participatory action research method. Data collection involved triangulation of instruments. A literature study was conducted to select relevant information usable as basis for this study. Data analysis and interpretation revealed factors that make it difficult for immigrant women from the African Great Lakes region to gain access to health care services in South Africa, identifying their specific women’s health needs. Recommendations proposed that policy makers and implementing professionals rendering women’s health care services should consider utilising a holistic and interdisciplinary approach to meet these basic needs. / Health Studies / M.A. (Public health)