| Title: |
Beyond the physical: exploring the complexities of Women’s health after severe perineal trauma : a cross-sectional study on predictors of health-related quality of life in Sweden |
| Authors: |
Tjernström, Katharina; Lindberg, Inger; Wiklund, Maria; Persson, Margareta |
| Publisher Information: |
Umeå universitet, Institutionen för omvårdnad; Umeå universitet, Avdelningen för fysioterapi |
| Publication Year: |
2026 |
| Collection: |
Umeå University: Publications (DiVA) |
| Subject Terms: |
cross-sectional study; health-related quality of life; long-term; obstetric anal sphincter injury; patient-reported outcome measures; predictors; RAND-36; severe perineal trauma; Nursing; Omvårdnad |
| Description: |
Introduction: Severe perineal trauma (SPT), defined as third- or fourth-degree lacerations during childbirth, is a known risk factor for adverse postpartum health-related quality of life (HRQoL). Although HRQoL may improve within six months postpartum, up to 30% of affected women in Sweden report long-term health problems beyond one year. While qualitative studies highlight the broad negative impact, quantitative findings remain inconclusive, particularly regarding the role of pelvic floor symptoms and the degree of SPT, underscoring the need for further research. The aim is to assess and compare HRQoL in a sample of women with SPT, and to identify predictors of physical and mental health at least 18 months postpartum. Methods: A nationwide cross-sectional study was conducted in Sweden using an online questionnaire to assess HRQoL via the validated RAND-36 instrument. Linear regression analysis was employed to explore associations. Results: Two hundred and twenty-one women with SPT and varying symptom bother from SPT, at least 18 months after the childbirth, responded. The study population exhibited worse-than-average RAND-36 scores across most dimensions (apart from physical functioning and pain) compared to normative data for women in Sweden. Further, the mean physical health score was significantly lower in our study sample (M = 70.7, SD = 22.1) compared to the reference population of women in Sweden (M = 73.63, SD = 29.45), t [df (degrees of freedom) 220] = −1.99, p = 0.047, Cohen's d = 0.13. The mean mental health score was significantly lower in our study sample (M = 63.2, SD = 21.4) compared to normative Swedish women (M = 71.7, SD = 27.15), t (df 220) = −5.90, p < 0.001, Cohen's d = 0.40. Health change over the past year remained relatively static with a slight trend towards improvement (mean 54.5; SD 21.6; CI 95% 51.6–57.4). Physical health was predicted by the extent of symptom bother, perceived work ability, educational attainment, and level of physical activity. Mental health was predicted by age, ... |
| Document Type: |
article in journal/newspaper |
| File Description: |
application/pdf |
| Language: |
English |
| Relation: |
Frontiers in Global Women's Health, 2026, 7; ISI:001700675500001 |
| DOI: |
10.3389/fgwh.2026.1734365 |
| Availability: |
http://urn.kb.se/resolve?urn=urn:nbn:se:umu:diva-250119; https://doi.org/10.3389/fgwh.2026.1734365 |
| Rights: |
info:eu-repo/semantics/openAccess |
| Accession Number: |
edsbas.11503A17 |
| Database: |
BASE |