AWHONN's clinical issues in perinatal and women's health nursing最新文献

Social stigma impedes the delivery of quality health care to women who identify as lesbians. Nurses who are aware of and sensitive to women who are lesbians in their practice are able to increase the caliber of the health care they provide. This article provides examples in which a lesbian sociosexual orientation has an impact on the medical history, differential diagnosis, physical examination, and treatment.

Women face criticism regarding their bodies from childhood to old age. Overt and covert messages demand that all women seek the ever-changing "ideal" body through a variety of costly, ineffective, and often dangerous means. As these demands are internalized, healthy women may develop a negative body image and a damaged sense of self. Nurses can promote peace between mind and body through the nursing process, role modeling, and community involvement. Body image should be assessed, particularly during vulnerable periods, such as adolescence, pregnancy, postpartum, and menopause. Planning, intervention, and evaluation should focus on self-acceptance and emotional and physical well-being, rather than on changing one's appearance.

Interstitial cystitis (IC) is a form of painful bladder disease, characterized by chronic urinary urgency, frequency, and pain without evidence of bacterial infection. Ninety percent of patients with IC are women. Somatization disorder is a psychiatric diagnosis, given most often to women who report a variety of symptoms, such as dysmenorrhea, burning in sex organs, dyspareunia, irregular menstrual periods, and painful urination. Because diagnosis of interstitial cystitis may take many years, health care providers must be alert to the risks of the overdiagnosis of psychiatric problems and the underdiagnosis of interstitial cystitis.

It is well known that regular, moderate-intensity exercise is beneficial in promoting good health and preventing disease and disability in women; however, high levels of sedentary behavior are observed in women of all races, incomes, and age groups. The determinants of exercise participation in women are poorly understood. Exercise intervention programs should be designed to increase women's general physical activity habits and enhance physical fitness. Exercise programs should include physical activities that are safe and increase gradually in the frequency, intensity, and duration of effort expended over time.

Creating an ethical work environment in a health care organization is both necessary and difficult. In the process of providing care, nurses often make decisions with ethical implications. This decision making is enhanced when the work environment supports an ethical approach. Nursing can implement strategies to support ethical decision making.

Resolution of ethical issues requires critical thinking and problem solving skills. This article reviews the professional code of ethics for nurses and decision-making frameworks as guides to assist nurses in becoming active participants in the process of ethical reflection.

This article outlines clinical approaches with women in abusive relationships or those who recently have left such situations. A model, the process of entrapment in and recovering from an abusive relationship, describes the experience of women in abusive relationships with a male partner and the cumulative influence of these experiences on women's views of self. This model has served as the basis for the development of specific interventions designed to assist women at different points in time while they experience abuse in a relationship or are recovering from the experience of being abused.

Women who are leaving abusive relationships rely on social support. However, their descriptions of the process of leaving, their reasons for leaving, and what helped them most in leaving relate to issues about the self as much as the availability of support. Clinicians who consider both of these resources can better support the decision making of women who are living in and leaving abusive male partners.

Nurses working with migrant farm worker women face serious challenges. Poverty, language, and cultural differences between farm worker women and health care providers present substantial barriers to women obtaining access to the health care system. These differences are especially important in instances of domestic violence. The transient life style of migrant farm workers, combined with geographic and social isolation, make it especially difficult for health care providers to meet the needs of migrant battered women. Strategies for working with migrant battered women are offered.

This article discusses the perinatal health issue of abuse directed at pregnant women by their intimate partners. The incidence, prevalence, and severity of intimate violence during pregnancy are presented, as is a discussion of the possible health disruptions that can occur as a result of violence and abuse. Nursing interventions for abused pregnant women are presented within a framework of advocacy and empowerment. Strategies for primary prevention are outlined, and methods of secondary and tertiary intervention are discussed. The article concludes with a discussion of culturally relevant practice for abused women.