ORCID Profile
0000-0002-0874-6494
Current Organisation
University of Otago Wellington
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Publisher: Elsevier BV
Date: 05-2021
Publisher: Springer Science and Business Media LLC
Date: 12-06-2020
DOI: 10.1186/S12905-020-00986-8
Abstract: Although Abnormal Uterine Bleeding (AUB) can have serious medical consequences and significantly impacts daily life, the overall trend is that most women do not seek care for these symptoms. The objective of this review was to synthesise factors impeding women’s access care for AUB. Systematic literature review of qualitative studies (interview and focus group) regarding the lived in experiences of women with abnormal menstrual symptoms, followed by a thematic analysis of these studies. We screened CINAHL, SCOPUS, ProQuest, OVID and Pubmed for qualitative studies. Studies were assessed using the Clinical Appraisal Skills Programme checklist and thematic synthesis was used to develop themes from the findings of the studies. The review yielded 12 studies that satisfied the inclusion criteria. Three themes were developed that described barriers for women seeking care for AUB: health literacy (understanding of normal periods, role of cervical Pap smears and lack of access to appropriate information), taboo/normalisation (fear and embarrassment of symptoms, prioritising others) and health care provider (lack of accessible and trusted female GPs and poor experiences with GPs). For 20 years women have consistently reported poor experiences in accessing care for AUB. The findings from our review indicate that drivers to impeding access are multiple therefore any approaches to improve access will need to be multi-level – from comprising local sociocultural considerations to improved GP training.
Publisher: Informa UK Limited
Date: 04-08-2023
Publisher: Wiley
Date: 31-08-2022
DOI: 10.1111/AJO.13606
Abstract: The Covid‐19 vaccine has been recommended for pregnant people (hapū māmā) in Aotearoa New Zealand since June 2021. We surveyed people birthing in a tertiary hospital regarding their vaccination status and reasons for this. There were 74% (142/191) of pregnant people who were fully vaccinated. Motivators for vaccination included protection against Covid‐19 and antibody transfer to the baby (pēpē). Unvaccinated participants worried about vaccine safety. Concerns were raised about the change in official advice without well‐communicated reasons for the change. Future vaccine and booster rollouts must be delivered equitably and hapū māmā must be a priority group.
Publisher: Authorea, Inc.
Date: 24-04-2023
DOI: 10.22541/AU.168229624.49096596/V1
Abstract: Background: Healthcare for transgender people can be unsafe and inequitable. Objectives : To explore the experiences of care surrounding hysterectomy as part of female to male (FtM) gender affirming surgery. Design: Qualitative observational study Setting: Aotearoa/New Zealand Participants: Ten people (out 12 people) who underwent FtM over a four-year period. Results: No one person’s experience of the FtM journey was affirming across the whole surgery journey. Transgender health literacy was central to inclusive practice as it mediated bodily autonomy being upheld. FtM (hysterectomy) surgery was described as “ life-saving ”. The physical care environment influenced the experience of the healthcare encounter. For ex le, the waiting room was intimidating, with a gendered clinic name and toilets. Some participants took a female support person artner so that “ people looking would assume that I was there supporting her, not the other way around .” Communication misalignments were evident around information provided/understood about fertility and ovarian preservation, requirement of a pre-operative pregnancy test, and post-operatively, about bleeding and when sexual intercourse could be resumed. Participants were also placed in the position of both receiving care and providing education: “ I also shouldn’t have to be going in there for treatment, and then being expected to educate the medical professional that’s meant to be helping me… I’m not getting paid to give you a TED talk on how my trans body works .” Conclusions: A whole care pathway approach to increasing transgender health literacy will facilitate better alignments in communication, uphold bodily autonomy and lead to equitable inclusive practice.
Publisher: Wiley
Date: 12-2021
DOI: 10.1111/AJO.13461
Publisher: Wiley
Date: 22-09-2023
DOI: 10.1111/AJO.13751
Publisher: Wiley
Date: 12-09-2019
DOI: 10.1111/AJO.13057
Abstract: Incidence of endometrial cancer is increasing rapidly in the developed world and is the most common gynaecological cancer in Australia and New Zealand. In line with obesity rates, the landscape and average age of women diagnosed with endometrial cancer are changing. There is still unmet need in early diagnosis, directed treatment, management of comorbidities and prevention strategies. This opinion piece aims to reflect on the current status of endometrial cancer in New Zealand in parallel to Australia, drawing out areas for future research and discussion.
Publisher: BMJ
Date: 11-2020
DOI: 10.1136/BMJOPEN-2020-041853
Abstract: To gain a deeper understanding of women’s experiences of accessing care for abnormal uterine bleeding (AUB) in order to inform future strategies to improve care pathways, including the early detection of endometrial cancer. We conducted semistructured interviews with 15 women who attended their first gynaecological specialist consultation for AUB at Wellington Regional Hospital between October and December 2019. Inductive thematic analysis was used to explore experiences and barriers to seeking care. The median age of the participant cohort was 45 years, with women self-identifying as New Zealand European (9/15), Māori (2/15) and Pasifika (4/15). All women had sought investigation for their AUB in primary care, for some women this was over a timeframe of many years. For all women, AUB had a significant and traumatic impact on their quality of life including their relationships and their work or education. Women described how they felt they often received inadequate care for AUB, and reported negative experiences with their general practitioner. Timely access was further compounded by feelings of embarrassment and that AUB was a taboo subject, and being able to discuss it with family, friends and their general practitioners was difficult. Women in our cohort experienced a multitude of compounding influences that acted as barriers to them having access to appropriate and timely care. Information c aigns that create awareness around ‘abnormal periods’ alongside better health provider practice guidelines for AUB investigation need to be a priority.
No related grants have been discovered for Sara Filoche.