Background Many women experience reproductive symptoms that impact on their wellbeing but do not seek help for a range of different reasons. In this rapid review we explored the factors that enable or hinder women to seek help for unwanted or debilitating reproductive symptoms. We also aimed to examine whether existing interventions address these factors and identify opportunities for alternative interventions.
Methods We searched electronic databases MEDLINE, PsycINFO and CINAHL in October 2019 and contacted experts to identify grey literature and additional interventions. The search strategy included terms covering behaviour and intervention combined with terms relating to common reproductive symptoms such as, dysmenorrhoea and menopause. We limited to articles published in English since 2009. We included any study that presented facilitators and barriers to seeking help for reproductive symptoms that was conducted with women in the United Kingdom. We also included articles on relevant interventions. One reviewer screened titles and abstracts with 10% double screened by a second reviewer. Full texts were screened independently by two reviewers. We extracted study characteristics using a pre-piloted form and used the Mixed Methods Appraisal Tool for quality assessment. Data extraction and quality assessment were performed by one reviewer and a sample checked by a second reviewer. We coded information on barriers and facilitators from each study into themes using NVivo. Results were summarised descriptively.
Results We screened 12474 citations, 102 full-text articles and retained 22 articles for analysis. Ten help-articles focused on interventions. Of the 12 articles reporting barriers and facilitators, the most common barriers to seeking help were embarrassment, perception that symptom is too private to talk about, dissatisfaction with the information received from healthcare professionals, poor knowledge, perception that symptom is part of aging and difficulty explaining the symptoms to others. Facilitators were having access to useful information/information pitched at the right level, an information source women felt comfortable with and supportive work environments (including awareness among managers and flexible working).
Conclusion This review identified a range of barriers and facilitators spanning across capability, opportunity and motivation. We have categorised the barriers and facilitators into the Theory and Techniques Tool (TaTT) mechanisms of actions (MoAs). Our next step is to assess whether the existing intervention contents match those deemed theoretically appropriate using TaTT in order to identify missed opportunities for intervention. This will enable us to make recommendations for interventions to support women to seek help for reproductive symptoms when necessary.
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