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支持职场女性月经、月经失调和更年期的政策、指南与实践:一项重要的全球范围综述

Policies, Guidelines, and Practices Supporting Women's Menstruation, Menstrual Disorders and Menopause at Work: A Critical Global Scoping Review.

作者信息

Howe Danielle, Duffy Sarah, O'Shea Michelle, Hawkey Alex, Wardle Jon, Gerontakos Sophia, Steele Linda, Gilbert Emilee, Owen Lara, Ciccia Donna, Cox Emma, Redmond Rebecca, Armour Mike

机构信息

NICM Health Research Institute, Western Sydney University, Sydney 2145, Australia.

School of Business, Western Sydney University, Sydney 2751, Australia.

出版信息

Healthcare (Basel). 2023 Nov 10;11(22):2945. doi: 10.3390/healthcare11222945.

Abstract

(1) Objectives: This paper presents a scoping review of global evidence relating to interventions (i.e., policies, practices, guidelines, and legislation) aimed at supporting women to manage menstruation, menstrual disorders, and menopause at work. (2) Methods: Databases including Medline (Ebsco), CINAHL (Ebsco), Scopus, Web of Science, APA PsychInfo (Ebsco), Humanities International Complete (Ebsco), Academic Search Premier (Ebsco), HeinOnline and OSH Update, and Google Scholar were searched in May 2022. (3) Results: Of 1181 unique articles screened, 66 articles are included. Less half of the articles (42%, 28/66) presented/reviewed an intervention related to women's workplace health. A total of 55 out of the 66 articles are set across 13 countries with the remaining 12 articles described as multi-country studies or reviews. Half of the articles presenting/reviewing an intervention were grey literature, with several undertaken in UK and EU member countries. Interventions focusing on supporting women with menopause at work were the most common (43%, 12/28), followed by menstruation (25%, 7/28) and menstrual disorders (7%, 2/28). Across the reviewed articles, recommendations were categorised as adjustments to the physical work environment, information and training needs, and policy and processes. Few articles explicitly presented or affirmed a design-process and/or evaluation tied to their intervention. In lieu of design-process, this review categorises the rationales driving the development of an intervention as: pronatalist, economic rationalism, gendered occupational health concern, cultural shift towards gender equity objectives, and efforts to reduced shame and stigma. (4) Conclusions: There is a growing body of evidence aimed at understanding women's experiences of managing their menstrual and reproductive health in the workplace and how this impacts their work/career trajectories. However, little research is explicitly concerned with exploring or understanding interventions, including their design or evaluation. Most articles report menopause guidelines and are typically confined to the UK and EU-member countries. Despite the prevalence of menstrual disorders (e.g., endometriosis and polycystic ovarian syndrome (PCOS)) there is limited literature focused on how women might be supported to manage symptoms associated with these conditions at work. Accordingly, future policies should consider how women can be better supported to manage menstruation and menstrual disorders at work and recognise the importance of co-design during policy development and post-intervention evaluation. Further research needs to be undertaken on the impact of workplace policies on both employers and employees.

摘要

(1)目标:本文对全球范围内有关旨在支持女性在工作中应对月经、月经失调和更年期的干预措施(即政策、实践、指南和立法)的证据进行了范围界定综述。(2)方法:2022年5月检索了包括Medline(Ebsco)、CINAHL(Ebsco)、Scopus、Web of Science、APA PsychInfo(Ebsco)、Humanities International Complete(Ebsco)、Academic Search Premier(Ebsco)、HeinOnline和OSH Update以及谷歌学术在内的数据库。(3)结果:在筛选的1181篇独特文章中,纳入了66篇。不到一半的文章(42%,28/66)介绍/综述了与女性职场健康相关的干预措施。66篇文章中有55篇来自13个国家,其余12篇被描述为多国研究或综述。介绍/综述干预措施的文章中有一半是灰色文献,其中几篇是在英国和欧盟成员国开展的。关注支持职场更年期女性的干预措施最为常见(43%,12/28),其次是月经(25%,7/28)和月经失调(7%,2/28)。在所综述的文章中,建议被归类为对工作物理环境的调整、信息和培训需求以及政策和流程。很少有文章明确介绍或肯定与其干预措施相关的设计过程和/或评估。作为设计过程的替代,本综述将推动干预措施发展的基本原理归类为:生育主义、经济理性主义、性别化职业健康关注、向性别平等目标的文化转变以及减少羞耻和污名的努力。(4)结论:越来越多的证据旨在了解女性在工作场所管理月经和生殖健康的经历以及这如何影响她们的工作/职业轨迹。然而,很少有研究明确关注探索或理解干预措施,包括其设计或评估。大多数文章报告了更年期指南,且通常局限于英国和欧盟成员国。尽管月经失调(如子宫内膜异位症和多囊卵巢综合征(PCOS))很普遍,但关注如何支持女性在工作中管理与这些病症相关症状的文献有限。因此,未来的政策应考虑如何更好地支持女性在工作中管理月经和月经失调,并认识到在政策制定和干预后评估中共同设计的重要性。需要进一步研究职场政策对雇主和雇员的影响。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/90fe/10671631/3357cd2478c6/healthcare-11-02945-g001.jpg

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