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Women are experiencing reproductive health abnormalities at younger ages, and the incidence of cervical cancer in women in their 20s and 30s is increasing. Various factors hinder visits to obstetrics and gynecology. This cross-sectional study aimed to explore how health knowledge, reproductive health-promoting behavior, and sexual communication influenced the degree of intention to visit obstetrics and gynecology in unmarried women. Methods: The participants included 170 Korean unmarried women in their 20s and 30s. The data were collected via an online survey from December 11 to 22, 2023. Data analysis was conducted using descriptive statistics, the t-test, one-factor analysis of variance, Pearson correlation coefficients, and hierarchical multiple regression. Results: On average, participants were 24.64±0.31 years of age. The intention to visit obstetrics and gynecology was high (11.46±3.51). Visiting obstetrics and gynecology was positively correlated with knowledge of reproductive health (r=.26, p=.001), reproductive health-promoting behavior (r=.43, p<.001), and sexual communication (r=.37, p<.001), all with statistical significance. Experience of visiting obstetrics and gynecology (β=0.40, p<.001), reproductive health-promoting behavior (β=.25, p<.001), sexual experience (β=0.22, p<.001), sexual communication (β=0.20, p=.001), and reproductive health knowledge (β=0.12, p=.033) explained 54.2% of variance in intention to visit obstetrics and gynecology in unmarried women. Conclusion: The findings of this study can be used to develop programs for unmarried women to improve reproductive health-promoting behavior, sexual communication, and reproductive health knowledge, and increase the intention to visit obstetrics and gynecology.

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Validity and reliability of the Turkish version of the Maternal Health Literacy Inventory in Pregnancy scale: a methodological study

Yeşim ALTUNTAS ; Ayse Kilic UCAR

Women’s Health Nursing.2024;30(4):330-339. doi:10.4069/whn.2024.10.18

This study aimed to translate the Maternal Health Literacy Inventory in Pregnancy (MHELIP) scale into Turkish and evaluate its validity and reliability for use in the Turkish population. Methods: The participants in this methodological study included 250 pregnant women who presented to the antenatal clinic of the Florence Nightingale Hospital in Istanbul, Turkiye. Content validity was assessed using expert approval. Confirmatory factor analysis, exploratory factor analysis, and structural equation modeling were used to assess the validity. Criterion validity was evaluated using the shortform health literacy survey tool, the Short-Form Health Literacy Questionnaire (HLS-SF12). To assess reliability, Cronbach’s alpha, item analysis, and the test-retest method were used. Results: The mean age of the participants was 32.02±4.15 years. The content validity index of the scale was .99. The scale had a four-factor structure that fit well with 48 items. “Maternal health knowledge,” “maternal health information search,” “maternal health information assessment,” and “maternal health decision making and behavior” subscales had Cronbach’s alpha values of .91, .76, .85, and .90, respectively. The MHELIP and HLS-SF12 scores were significantly correlated (r=.422, p<.001). Conclusion: The MHELIP was found to be a valid and reliable measurement tool in pregnant Turkish women.

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Do individual or organizational factors influence cultural competency of maternal newborn nurses?: a cross-sectional study

Semi LEE ; Hyunkyung CHOI

Women’s Health Nursing.2024;30(4):318-329. doi:10.4069/whn.2024.11.03

Cultural competency is a very important ability of nurses in women’s hospitals in providing nursing care during pregnancy and childbirth. This study explored how multicultural attitudes, multicultural efficacy, intercultural communicative competency, and hospital support for cultural competency influence the cultural competency of nurses in women’s hospitals. Methods: A cross-sectional correlational study design was used. The study involved 150 nurses from five women’s hospitals located in Gyeongsangbuk-do and Gyeongsangnam-do, South Korea. Participants completed a packet of structured self-report questionnaires, which included the Korean version of the Cultural Competence Scale for Clinical Nurses, the Multicultural Attitude Scale Questionnaire, the Intercultural Communicative Competence Questionnaire, the Transcultural Self-Efficacy Scale, and the Organizational Support among Cultural Competence Assessment Instrument. We analyzed the collected data using descriptive statistics, the t-test, one-way analysis of variance, Pearson correlation coefficients, and hierarchical multiple regression analysis. Results: Among the general characteristics, educational level, religion, and experience with overseas travel were identified as factors influencing cultural competency. In the final model, multicultural attitudes (β=.46, p<.001) and intercultural communicative competency (β=.19, p=.025) emerged as significant individual factors that affected cultural competency. This model accounted for 49.8% of the variance in cultural competency. Conclusion: This study identified multicultural attitudes and intercultural communicative competency as significant individual factors contributing to the cultural competency of nurses in women’s hospitals. Therefore, enhancing these nurses’ multicultural attitudes and intercultural communicative competency is essential for improving their overall cultural competency

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Dietary interventions to reduce heavy metal exposure in antepartum and postpartum women: a systematic review

Su Ji HEO ; Nalae MOON ; Ju Hee KIM

Women’s Health Nursing.2024;30(4):265-276. doi:10.4069/whn.2024.12.16

Heavy metals, which are persistent in the environment and toxic, can accumulate in the body and cause organ damage, which may further negatively affect perinatal women and their fetuses. Therefore, this systematic review was conducted to evaluate the effectiveness of dietary interventions to reduce heavy metal exposure in antepartum and postpartum women. Methods: We searched five databases (PubMed, Embase, Scopus, Web of Science, and Cochrane Library) for randomized controlled trials that provided dietary interventions for antepartum and postpartum women. Quality assessments were conducted independently by two reviewers using the Cochrane Risk-of-Bias tool, a quality assessment tool for randomized controlled trials. Results: A total of seven studies were included. The studies were conducted in six countries, with interventions categorized into “nutritional supplements,” “food supply,” and “educational” strategies. Interventions involving nutritional supplements, such as calcium and probiotics, primarily reduced heavy metal levels in the blood and minimized toxicity. Food-based interventions, including specific fruit consumption, decreased heavy metal concentrations in breast milk. Educational interventions effectively promoted behavioral changes, such as adopting diets low in mercury. The studies demonstrated a low overall risk of bias, supporting the reliability of the findings. These strategies underscore the effectiveness of dietary approaches in mitigating heavy metal exposure and improving maternal and child health. Conclusion: The main findings underscore the importance of dietary interventions in reducing heavy metal exposure. This emphasizes the critical role of nursing in guiding dietary strategies to minimize exposure risks, ultimately supporting maternal and fetal health during pregnancy.

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Are the effects of stress on antenatal depression mediated by self-esteem and moderated by social support?: a cross-sectional study

Eunjoo LEE

Women’s Health Nursing.2024;30(4):299-308. doi:10.4069/whn.2024.10.18.1

Social support and self-esteem play crucial roles in influencing the mental health of pregnant women. This study explored the moderating role of social support and the mediating role of self-esteem in the relationship between pregnancy-related stress and antenatal depression among pregnant women. Methods: This cross-sectional study included 180 pregnant women who visited the obstetrics outpatient clinic at a hospital in Changwon, Korea, between November 22 and December 30, 2022. Data were collected through structured questionnaires that assessed antenatal depression, pregnancy stress, self-esteem, and social support. The data were analyzed using descriptive statistics, Pearson correlation coefficients, and PROCESS Macro model 5. Results: The mean gestational age of the participants was 23 weeks. The mean score for pregnancy stress was 63.51±14.33, indicating a moderate level of self-esteem and social support were high, with scores of 31.06±4.83 and 41.96±7.73, respectively. Prenatal depression was notably low, averaging 6.51±4.59. It showed a significant positive correlation with pregnancy stress (r=.52, p<.001) and negative correlations with self-esteem (r=–.49, p<.001) and social support (r=–.24, p=.001). Self-esteem acted as a mediator in the relationship between pregnancy stress and antepartum depression among pregnant women, with an indirect effect of .05 and a 95% confidence interval of .02 to .08. Additionally, social support moderated the impact of pregnancy stress on antepartum depression (B=–.01, p=.036). Conclusion: The study emphasizes the need for a comprehensive approach to maternal mental health during pregnancy, which should include stress management, self-esteem enhancement, and social support interventions. Addressing these interconnected factors is crucial for promoting maternal well-being and reducing the incidence of prenatal depression.

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Factors associated with future fertility intentions among Korean women of childbearing age in Seoul: a cross-sectional study

Thi Thanh Lan NGUYEN ; Van Cuong NGUYEN

Women’s Health Nursing.2024;30(4):288-298. doi:10.4069/whn.2024.12.06.1

South Korea currently has the lowest fertility rate among Organization for Economic Co-operation and Development countries, with a total fertility rate of less than one child per woman. This study explored the factors influencing future fertility intentions (FFI) among Korean women of childbearing age. Methods: Using a cross-sectional design, we analyzed data from the 2022 Survey on Low Birth Policy Demand in Seoul, conducted by the Seoul Women and Family Foundation. This study focused on women of childbearing age. Bivariate analyses and a multivariate logistic regression model were employed to investigate the FFI rate and its associated factors. Results: The observed overall FFI rate among Korean women of childbearing age was 25.6%, with rates of 27.9% among unmarried women, and 22.0% among married women. Factors associated with FFI included education level, employment status, weekly working hours, number of children, age at first sexual education, monthly income, and perspectives on marriage, childbearing, and gender inequality. High FFI rates were noted among self-employed individuals (33.3%); those who received sexual education in adulthood (48.6%), those who believed in having children after marriage (44.0%), those who thought children strengthen relationships (32.5%), and those who perceived gender equality in family or workplace culture (31.7%). Conclusion: This study assessed the FFI rate among Korean women of childbearing age, identifying the sociodemographic characteristics and perspectives on marriage, childbearing, and gender inequality that influence it. The findings provide valuable insights for policymakers and nurses to engage with women and increase birth rates in Seoul and throughout South Korea.

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