1. Meeting the Health Needs of Women Copyright ©2008 by Pearson Education, Inc. Upper Saddle River, New Jersey 07458 All rights reserved. Community Health Nursing, 5/e Mary Jo Clark 17 CHAPTER

2. Community Health Nursing, 5/e Mary Jo Clark Copyright ©2008 by Pearson Education, Inc. Women’s Health Definition –Health and illness issues unique to, more prevalent or serious in women

3. Community Health Nursing, 5/e Mary Jo Clark Copyright ©2008 by Pearson Education, Inc. Women’s Health (continued) Demographics Areas needing greater emphasis –Health consequences of trauma –Differences in development, manifestation, and treatment of specific conditions –Lesbian/gay health issues –Health issues specific to disabled women

4. Community Health Nursing, 5/e Mary Jo Clark Copyright ©2008 by Pearson Education, Inc. Biophysical Considerations Genetic inheritance Maturation and aging Physiologic functions –Physical illness and disability Chronic illness

5. Community Health Nursing, 5/e Mary Jo Clark Copyright ©2008 by Pearson Education, Inc. Biophysical Considerations (continued) –Reproductive issues Contraception and infertility Pregnancy –Immunity

6. Community Health Nursing, 5/e Mary Jo Clark Copyright ©2008 by Pearson Education, Inc. Psychological Considerations Stress and coping Sexuality Mental health and illness

7. Community Health Nursing, 5/e Mary Jo Clark Copyright ©2008 by Pearson Education, Inc. Physical Environmental Considerations Exposure to household chemicals Accident and injury rates in home and workplace Vitamin D deficiencies

8. Community Health Nursing, 5/e Mary Jo Clark Copyright ©2008 by Pearson Education, Inc. Sociocultural Considerations Roles and relationships Occupational and economic issues Violence and abuse

9. Community Health Nursing, 5/e Mary Jo Clark Copyright ©2008 by Pearson Education, Inc. Behavioral Considerations Dietary consumption patterns –Fad diets –Obesity –Eating disorders –Nutrient deficiencies

10. Community Health Nursing, 5/e Mary Jo Clark Copyright ©2008 by Pearson Education, Inc. Behavioral Considerations (continued) Tobacco, alcohol, and drug use Physical activity and exercise Sexual activity

11. Community Health Nursing, 5/e Mary Jo Clark Copyright ©2008 by Pearson Education, Inc. Health System Considerations Lack of attention to women’s health needs –Focus primarily on reproductive issues Lack of illness prevention and health promotion resources Health insurance discrimination Lack of support for informal caregivers Failure of providers to recognize signs of abuse

12. Community Health Nursing, 5/e Mary Jo Clark Copyright ©2008 by Pearson Education, Inc. Women’s Health Problems Genetic predisposition to certain diseases –Thyroid diseases –Diabetes –Asthma –Dermatitis –Allergies

13. Community Health Nursing, 5/e Mary Jo Clark Copyright ©2008 by Pearson Education, Inc. Menarche and Reproductive Concerns Cultural considerations Premenstrual dysphoric disorder (PMDD) Physiologic responses to menopause

14. Community Health Nursing, 5/e Mary Jo Clark Copyright ©2008 by Pearson Education, Inc. Physiologic Functions Influencing Women’s Health Incidence and prevalence of specific illnesses –Increased risk for multiple chronic diseases and disability Examples: heart disease, cancer, stroke, Alzheimer’s disease, diabetes, rheumatoid arthritis, osteoporosis Increased incidence of disabilities and reported symptoms that affect self-care, self-image, and coping abilities

15. Community Health Nursing, 5/e Mary Jo Clark Copyright ©2008 by Pearson Education, Inc. Pregnancy and Childbearing Pregnancy-related mortality Perinatal transmission of HIV Advanced maternal age at conception Pregnancy-related fatalities –Increased risk to become a victim of homicide Postpartum depression

16. Community Health Nursing, 5/e Mary Jo Clark Copyright ©2008 by Pearson Education, Inc. Infertility and Contraception Access to and education about contraceptives Cultural implications of infertility Assistive reproductive technology and concomitant risks

17. Community Health Nursing, 5/e Mary Jo Clark Copyright ©2008 by Pearson Education, Inc. Immunizations Levels Low immunization rates –Rubella –Tetanus –Influenza

18. Community Health Nursing, 5/e Mary Jo Clark Copyright ©2008 by Pearson Education, Inc. Health Needs of Lesbian Client Biophysical considerations –STD risks vary –Reproductive issues Psychological considerations –Feelings of isolation –Coming out issues –Lack of understanding about relationship loss issues

19. Community Health Nursing, 5/e Mary Jo Clark Copyright ©2008 by Pearson Education, Inc. Health Needs of Lesbian Client (continued) Sociocultural considerations –Societal fears and misunderstandings –Discrimination –Loss of social support –Legal issues

20. Community Health Nursing, 5/e Mary Jo Clark Copyright ©2008 by Pearson Education, Inc. Health Needs of Lesbian Client (continued) Behavioral considerations –Varying patterns of drug, alcohol, and tobacco use Health System considerations –Barriers to health care

21. Community Health Nursing, 5/e Mary Jo Clark Copyright ©2008 by Pearson Education, Inc. Primary Prevention for Women Maintaining balance, perspective, and priorities in life Developing and maintaining health relationships Developing and maintaining a healthy sense of self Developing and maintaining a physically healthy body and preventing acute and chronic illness

22. Community Health Nursing, 5/e Mary Jo Clark Copyright ©2008 by Pearson Education, Inc. Secondary Prevention for Women Refer to Table 17-5 Existing health problems Screening –Breast and cervical cancer –Mammogram screening

23. Community Health Nursing, 5/e Mary Jo Clark Copyright ©2008 by Pearson Education, Inc. Secondary Prevention for Women (continued) Diagnosis –Referral for medical or social assistance Infertility/fertility control Menopause Physical abuse Treatment for existing problems

24. Community Health Nursing, 5/e Mary Jo Clark Copyright ©2008 by Pearson Education, Inc. Role of Community Health Nurse Counsel, teach, and refer for all aspects of fertility control or pregnancy plans Referral to fertility specialist Provide case finding, referral, and support services

25. Community Health Nursing, 5/e Mary Jo Clark Copyright ©2008 by Pearson Education, Inc. Physical Abuse of Women: First Dimension Physical and psychological effects of abuse –Recognition of problem –Education in the signs and symptoms of abuse

26. Community Health Nursing, 5/e Mary Jo Clark Copyright ©2008 by Pearson Education, Inc. Physical Abuse of Women: Second dimension Dealing with source of problem –Supportive counseling –Reassurance –Establishing feelings of control and empowerment –Referrals for medical care and counseling

27. Community Health Nursing, 5/e Mary Jo Clark Copyright ©2008 by Pearson Education, Inc. Lesbian, Bisexual, and Transgender Clients: Community Health Nurse’s Role Gain understanding/insight into similarities and differences between subgroups and heterosexual population Identify support systems available Assist with availability of legal issues

28. Community Health Nursing, 5/e Mary Jo Clark Copyright ©2008 by Pearson Education, Inc. Lesbian, Bisexual, and Transgender Clients: Community Health Nurse’s Role Gather data on their perceptions and use of health care services Advocate for available screening services Advocate for equitable treatment (e.g., inheritance laws, etc)

29. Community Health Nursing, 5/e Mary Jo Clark Copyright ©2008 by Pearson Education, Inc. Resources Family Centered Maternity Care The Institute for Family-Centered Care promotes collaboration between care provider and family, offering educational material and other professional resources for family-centered care at home and in the hospital.Family Centered Maternity Care CDC Women’s Health HIV Factsheet Women account for more than one quarter of all new HIV/AIDS diagnoses. Women of color are especially affected by HIV infection and AIDS. Includes other statistics, charts, links.CDC Women’s Health HIV Factsheet

30. Community Health Nursing, 5/e Mary Jo Clark Copyright ©2008 by Pearson Education, Inc. Resources March of Dimes The March of Dimes website offers fact sheets for pregnancy including teenage pregnancy.March of Dimes Sexuality Information and Education Council The Sexuality Information and Education Council of the U.S. is a national, nonprofit organization, which affirms that sexuality is a natural and healthy part of living. SIECUS develops, collects, and disseminates information, promotes comprehensive education about sexuality, and advocates the right of individuals to make responsible sexual choices.Sexuality Information and Education Council

31. Community Health Nursing, 5/e Mary Jo Clark Copyright ©2008 by Pearson Education, Inc. Resources Alan Guttmacher Institute The Alan Guttmacher Institute (AGI) is a nonprofit organization focused on sexual and reproductive health research, policy analysis and public education. The site offers US teenage pregnancy statistics, information on sexual education and statistics on birth rates from each state.Alan Guttmacher Institute

32. Community Health Nursing, 5/e Mary Jo Clark Copyright ©2008 by Pearson Education, Inc. Resources National Center for Health Statistics This article from CDC, National Center for Health Statistics, and National Vital Statistics System presents detailed information about birth rates, including the adolescent pregnant patient.National Center for Health Statistics Lesbian Health US Department of Health & Human Services website discusses unique challenges lesbians within the health care system in relation to both physical and mental health.Lesbian Health