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Temane AM, Magagula FN, Nolte AGW. Midwives' lived experiences of caring for women with mobility disabilities during pregnancy, labour and puerperium in Eswatini: a qualitative study. BMC Womens Health 2024; 24:207. [PMID: 38561691 PMCID: PMC10986101 DOI: 10.1186/s12905-024-03032-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2023] [Accepted: 03/18/2024] [Indexed: 04/04/2024] Open
Abstract
BACKGROUND Midwives encounter various difficulties while aiming to achieve excellence in providing maternity care to women with mobility disabilities. The study aimed to explore and describe midwives' experiences of caring for women with mobility disabilities during pregnancy, labour and puerperium in Eswatini. METHODS A qualitative, exploratory, descriptive, contextual research design with a phenomenological approach was followed. Twelve midwives working in maternal health facilities in the Hhohho and Manzini regions in Eswatini were interviewed. Purposive sampling was used to select midwives to participate in the research. In-depth phenomenological interviews were conducted, and Giorgi's descriptive phenomenological method was used for data analysis. RESULTS Three themes emerged from the data analysis: midwives experienced physical and emotional strain in providing maternity care to women with mobility disabilities, they experienced frustration due to the lack of equipment to meet the needs of women with mobility disabilities, and they faced challenges in providing support and holistic care to women with mobility disabilities during pregnancy, labour and puerperium. CONCLUSIONS Midwives experienced challenges caring for women with mobility disabilities during pregnancy, labour and the puerperium in Eswatini. There is a need to develop and empower midwives with the knowledge and skill to implement guidelines and enact protocols. Moreover, equipment and infrastructure are required to facilitate support and holistic maternity care for women with mobility disabilities.
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Affiliation(s)
- Annie M Temane
- Health Sciences, University of Johannesburg, Johannesburg, South Africa.
| | | | - Anna G W Nolte
- Health Sciences, University of Johannesburg, Johannesburg, South Africa
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2
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O'Brien KE, Rosen MW, Ernst SD. Obstetric and Gynecologic Care for Individuals with Disabilities. Obstet Gynecol Clin North Am 2024; 51:43-56. [PMID: 38267130 DOI: 10.1016/j.ogc.2023.10.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/26/2024]
Abstract
This article explores the inequities experienced by individuals with disabilities when accessing obstetric and gynecologic care. The unique needs, abilities, and barriers to care are reviewed, as well as recommendations for provision of care to people with disabilities.
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Affiliation(s)
- Kathleen E O'Brien
- Michigan Medicine, 1500 East Medical Center Drive, Ann Arbor, MI 48104, USA.
| | - Monica Woll Rosen
- Michigan Medicine, 1500 East Medical Center Drive, Ann Arbor, MI 48104, USA
| | - Susan Dwyer Ernst
- Michigan Medicine, 1500 East Medical Center Drive, Ann Arbor, MI 48104, USA
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Saito T, Imahashi K, Yamaki C. Use of General Health Examination and Cancer Screening among People with Disability Who Need Support from Others: Analysis of the 2016 Comprehensive Survey of Living Conditions in Japan. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2024; 21:219. [PMID: 38397708 PMCID: PMC10888656 DOI: 10.3390/ijerph21020219] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/04/2024] [Revised: 02/07/2024] [Accepted: 02/07/2024] [Indexed: 02/25/2024]
Abstract
Research on preventive healthcare services among people with disability in Japan is scarce. This study aimed to (1) examine the relationship between disability and the use of general health examination (GHE) and cancer screening (lung, gastric, colorectal, breast and cervical cancer) and (2) explore the reasons for not using GHE. This cross-sectional study used secondary data from individuals aged 20-74 years (n = 15,294) from the Comprehensive Survey of Living Conditions of 2016. Binomial logistic regression analysis was conducted to examine the relationship between disability and non-participation in preventive services. In addition, a descriptive analysis was conducted to explore the reasons for non-participation in GHE. Consequently, disability was identified as an independently associated factor for non-participation in GHE (odds ratios (OR): 1.73; 95% confidence interval (95%CI): 1.14-2.62) and screening for colorectal (OR: 1.78; 95%CI: 1.08-2.94), gastric (OR: 2.27; 95%CI: 1.27-4.05), cervical (OR: 2.12; 95%CI: 1.04-4.32) and breast cancer (OR: 2.22; 95%CI: 1.04-4.72), controlling for confounding factors. The most dominant reason for non-participation was "I can go to see the doctor anytime, if I am worried (25/54, 46.3%)." Our findings imply the existence of disability-based disparity in preventive healthcare service use in Japan.
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Affiliation(s)
- Takashi Saito
- Department of Social Rehabilitation, Research Institute of National Rehabilitation Center for Persons with Disabilities, 4-1 Namiki, Tokorozawa 359-8555, Japan;
| | - Kumiko Imahashi
- Department of Social Rehabilitation, Research Institute of National Rehabilitation Center for Persons with Disabilities, 4-1 Namiki, Tokorozawa 359-8555, Japan;
| | - Chikako Yamaki
- Institute for Cancer Control, National Cancer Center, 5-1-1 Tsukiji, Chuou 104-0045, Japan;
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Ramer S, Nguyen AT, Nelson JM, Whiteman MK, Warner L, Thierry JM, Folger S, von Essen BS, Kortsmit K. Breastfeeding by Disability Status in the United States: Pregnancy Risk Assessment Monitoring System, 2018-2020. Am J Public Health 2024; 114:108-117. [PMID: 38091565 PMCID: PMC10726937 DOI: 10.2105/ajph.2023.307438] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2023]
Abstract
Objectives. To describe breastfeeding initiation and breastfeeding at 1, 2, and 3 months, and information sources on breastfeeding among women with a recent live birth by disability status. Methods. We analyzed October 2018 to December 2020 data from the Pregnancy Risk Assessment Monitoring System for 24 sites in the United States that included the Washington Group Short Set of Questions on Disability (seeing, hearing, walking or climbing stairs, remembering or concentrating, self-care, communicating). We defined disability as reporting "a lot of difficulty" or "cannot do this at all" on any of these questions. Results. Among 39 673 respondents, 6.0% reported disability. In adjusted analyses, breastfeeding was lower among respondents with disability at 2 (62.6% vs 66.6%; adjusted prevalence ratio [APR] = 0.94; 95% confidence interval [CI] = 0.89, 0.99) and 3 months (54.7% vs 59.6%; APR = 0.92; 95% CI = 0.86, 0.98) than those without disability. Respondents with disability were less likely to receive information from health care providers or support professionals (89.3% vs 92.3%), but as likely from breastfeeding or lactation specialists (78.1% vs 75.3%). Conclusions. Strategies to ensure women with disability, receive breastfeeding support, including breastfeeding information, could improve breastfeeding outcomes. (Am J Public Health. 2024;114(1):108-117. https://doi.org/10.2105/AJPH.2023.307438).
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Affiliation(s)
- Stephanie Ramer
- Stephanie Ramer, Antoinette T. Nguyen, Maura K. Whiteman, Lee Warner, Suzanne Folger, Beatriz Salvesen von Essen, and Katherine Kortsmit are with the Division of Reproductive Health, National Center for Chronic Disease Prevention and Health Promotion, Centers of Disease Control and Prevention (CDC), Atlanta, GA. At the time of the study, Jennifer M. Nelson was is with the Division of Nutrition, Physical Activity and Obesity, National Center for Chronic Disease Prevention and Health Promotion, CDC, Atlanta. JoAnn M. Thierry is with the Division of Human Development and Disability, National Center on Birth Defects and Developmental Disabilities, CDC, Atlanta
| | - Antoinette T Nguyen
- Stephanie Ramer, Antoinette T. Nguyen, Maura K. Whiteman, Lee Warner, Suzanne Folger, Beatriz Salvesen von Essen, and Katherine Kortsmit are with the Division of Reproductive Health, National Center for Chronic Disease Prevention and Health Promotion, Centers of Disease Control and Prevention (CDC), Atlanta, GA. At the time of the study, Jennifer M. Nelson was is with the Division of Nutrition, Physical Activity and Obesity, National Center for Chronic Disease Prevention and Health Promotion, CDC, Atlanta. JoAnn M. Thierry is with the Division of Human Development and Disability, National Center on Birth Defects and Developmental Disabilities, CDC, Atlanta
| | - Jennifer M Nelson
- Stephanie Ramer, Antoinette T. Nguyen, Maura K. Whiteman, Lee Warner, Suzanne Folger, Beatriz Salvesen von Essen, and Katherine Kortsmit are with the Division of Reproductive Health, National Center for Chronic Disease Prevention and Health Promotion, Centers of Disease Control and Prevention (CDC), Atlanta, GA. At the time of the study, Jennifer M. Nelson was is with the Division of Nutrition, Physical Activity and Obesity, National Center for Chronic Disease Prevention and Health Promotion, CDC, Atlanta. JoAnn M. Thierry is with the Division of Human Development and Disability, National Center on Birth Defects and Developmental Disabilities, CDC, Atlanta
| | - Maura K Whiteman
- Stephanie Ramer, Antoinette T. Nguyen, Maura K. Whiteman, Lee Warner, Suzanne Folger, Beatriz Salvesen von Essen, and Katherine Kortsmit are with the Division of Reproductive Health, National Center for Chronic Disease Prevention and Health Promotion, Centers of Disease Control and Prevention (CDC), Atlanta, GA. At the time of the study, Jennifer M. Nelson was is with the Division of Nutrition, Physical Activity and Obesity, National Center for Chronic Disease Prevention and Health Promotion, CDC, Atlanta. JoAnn M. Thierry is with the Division of Human Development and Disability, National Center on Birth Defects and Developmental Disabilities, CDC, Atlanta
| | - Lee Warner
- Stephanie Ramer, Antoinette T. Nguyen, Maura K. Whiteman, Lee Warner, Suzanne Folger, Beatriz Salvesen von Essen, and Katherine Kortsmit are with the Division of Reproductive Health, National Center for Chronic Disease Prevention and Health Promotion, Centers of Disease Control and Prevention (CDC), Atlanta, GA. At the time of the study, Jennifer M. Nelson was is with the Division of Nutrition, Physical Activity and Obesity, National Center for Chronic Disease Prevention and Health Promotion, CDC, Atlanta. JoAnn M. Thierry is with the Division of Human Development and Disability, National Center on Birth Defects and Developmental Disabilities, CDC, Atlanta
| | - JoAnn M Thierry
- Stephanie Ramer, Antoinette T. Nguyen, Maura K. Whiteman, Lee Warner, Suzanne Folger, Beatriz Salvesen von Essen, and Katherine Kortsmit are with the Division of Reproductive Health, National Center for Chronic Disease Prevention and Health Promotion, Centers of Disease Control and Prevention (CDC), Atlanta, GA. At the time of the study, Jennifer M. Nelson was is with the Division of Nutrition, Physical Activity and Obesity, National Center for Chronic Disease Prevention and Health Promotion, CDC, Atlanta. JoAnn M. Thierry is with the Division of Human Development and Disability, National Center on Birth Defects and Developmental Disabilities, CDC, Atlanta
| | - Suzanne Folger
- Stephanie Ramer, Antoinette T. Nguyen, Maura K. Whiteman, Lee Warner, Suzanne Folger, Beatriz Salvesen von Essen, and Katherine Kortsmit are with the Division of Reproductive Health, National Center for Chronic Disease Prevention and Health Promotion, Centers of Disease Control and Prevention (CDC), Atlanta, GA. At the time of the study, Jennifer M. Nelson was is with the Division of Nutrition, Physical Activity and Obesity, National Center for Chronic Disease Prevention and Health Promotion, CDC, Atlanta. JoAnn M. Thierry is with the Division of Human Development and Disability, National Center on Birth Defects and Developmental Disabilities, CDC, Atlanta
| | - Beatriz Salvesen von Essen
- Stephanie Ramer, Antoinette T. Nguyen, Maura K. Whiteman, Lee Warner, Suzanne Folger, Beatriz Salvesen von Essen, and Katherine Kortsmit are with the Division of Reproductive Health, National Center for Chronic Disease Prevention and Health Promotion, Centers of Disease Control and Prevention (CDC), Atlanta, GA. At the time of the study, Jennifer M. Nelson was is with the Division of Nutrition, Physical Activity and Obesity, National Center for Chronic Disease Prevention and Health Promotion, CDC, Atlanta. JoAnn M. Thierry is with the Division of Human Development and Disability, National Center on Birth Defects and Developmental Disabilities, CDC, Atlanta
| | - Katherine Kortsmit
- Stephanie Ramer, Antoinette T. Nguyen, Maura K. Whiteman, Lee Warner, Suzanne Folger, Beatriz Salvesen von Essen, and Katherine Kortsmit are with the Division of Reproductive Health, National Center for Chronic Disease Prevention and Health Promotion, Centers of Disease Control and Prevention (CDC), Atlanta, GA. At the time of the study, Jennifer M. Nelson was is with the Division of Nutrition, Physical Activity and Obesity, National Center for Chronic Disease Prevention and Health Promotion, CDC, Atlanta. JoAnn M. Thierry is with the Division of Human Development and Disability, National Center on Birth Defects and Developmental Disabilities, CDC, Atlanta
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Wu W, He X, Li S, Jin M, Ni Y. Pain nursing for gynecologic cancer patients. Front Oncol 2023; 13:1205553. [PMID: 37564934 PMCID: PMC10410261 DOI: 10.3389/fonc.2023.1205553] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2023] [Accepted: 07/11/2023] [Indexed: 08/12/2023] Open
Abstract
Gynecological malignancy remains a prevalent cause of mortality among women. Chronic cancer pain, as a severe complication of malignancy and its therapies, accounts for a substantial burden of physical and psychological distress in affected patients. Accordingly, early identification, assessment, and standardized management of such pain are crucial in the prevention or delay of its progression. In the present review, we provide a comprehensive overview of the pathological factors that contribute to pain in patients with gynecological malignancy while highlighting the underlying mechanisms of pain in this population. In addition, we summarize several treatment modalities targeting pain management in gynecologic cancer patients, including surgery, radiotherapy, and chemotherapy. These interventions are crucial for tumor elimination and patient survival. Chronic cancer pain exerts a significant impact on wellbeing and quality of life for patients with gynecologic cancer. Therefore, our review emphasizes the importance of addressing this pain and its psychological sequelae and advocates for a multidisciplinary approach that encompasses nursing and psychological support. In summary, this review offers valuable insights into the pathological factors underlying pain, reviews pain management modalities, and stresses the critical role of early intervention and comprehensive care in enhancing the quality of life of these patients.
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Affiliation(s)
| | - Xiaodan He
- Department of Gynecology, Cancer Hospital of China Medical University, Liaoning Cancer Hospital and Institute, Shenyang, Liaoning, China
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Trip K, Wilson J, Ahuja A, Johnston S, Verkuyl M, Innis JA. Student Engagement With an Open Educational Resource on Gynecological Assessment. J Nurse Pract 2023. [DOI: 10.1016/j.nurpra.2022.104529] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
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Magagula F, Temane A, Nolte AG. Women with mobility disabilities’ experiences of maternity care during pregnancy, labour and puerperium in Eswatini. Health SA 2022; 27:1861. [DOI: 10.4102/hsag.v27i0.1861] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2021] [Accepted: 08/25/2022] [Indexed: 11/10/2022] Open
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Del Rosario E, Bodden A, Sala DA, Goodman A, Lam C, Karamitopoulos M. Transition program: Initial implementation with adults with neuromuscular conditions. J Pediatr Nurs 2022; 67:52-56. [PMID: 35939953 DOI: 10.1016/j.pedn.2022.06.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/04/2021] [Revised: 06/20/2022] [Accepted: 06/22/2022] [Indexed: 11/27/2022]
Abstract
PURPOSE To identify current medical and psychosocial needs and to examine the effectiveness of healthcare transition program for adult-aged patients with neuromuscular conditions transitioning from pediatric to adult services. DESIGN AND METHODS At Neuromuscular Transition Clinic visit, 46 patients were evaluated and referred to adult-based providers, if did not currently have one, from an acquired list of interested clinicians. At mean follow-up of 22 months, 42 were interviewed by phone regarding referrals for Core Services (primary care, physiatry, dental care and gynecology), Medical Specialties and Rehabilitation Services. Mean age was 30 years with 62% males. Majority (74%) had cerebral palsy. Sixty percent were non-ambulatory. RESULTS As per protocol, all were indicated to need Core Services. Eighty-three percent already had adult primary care provider. Most referrals were given for physiatry (62%), vocational training (100%), and occupational therapy (88%). At follow-up, visits were completed most frequently with adult provider for primary care (100%), occupational therapy (78%), and neurology (75%). Referred provider was seen 100% for physiatry, neurology, physical therapy, occupational therapy and vocational training. Of the total 125 referrals given across all services, 73 (58%) participants had completed a visit with an adult provider. CONCLUSIONS As only about 60% transitioned to adult-based services after referral, healthcare transition remains challenging and requires tailoring of services according to patients' needs, staff and willing-and-available adult-based providers. PRACTICE IMPLICATIONS Transitioning healthcare of patients with neuromuscular conditions from pediatric- to adult-based providers remains challenging. This clinical specialty requires tailoring of services based on patient's needs, and availability of adult-based providers and resources.
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Affiliation(s)
- Eduardo Del Rosario
- Hassenfeld Children's Hospital of New York at NYU Langone Health, NYU Langone Orthopedic Hospital, New York, NY, USA.
| | - Adella Bodden
- Hassenfeld Children's Hospital of New York at NYU Langone Health, NYU Langone Orthopedic Hospital, New York, NY, USA
| | - Debra A Sala
- Hassenfeld Children's Hospital of New York at NYU Langone Health, NYU Langone Orthopedic Hospital, New York, NY, USA
| | - Aline Goodman
- Hassenfeld Children's Hospital of New York at NYU Langone Health, NYU Langone Orthopedic Hospital, New York, NY, USA
| | - Connie Lam
- Initiative for Women with Disabilities, NYU Langone Health, New York, NY, USA
| | - Mara Karamitopoulos
- Hassenfeld Children's Hospital of New York at NYU Langone Health, NYU Langone Orthopedic Hospital, New York, NY, USA
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Ho IK, Sheldon TA, Botelho E. Medical mistrust among women with intersecting marginalized identities: a scoping review. ETHNICITY & HEALTH 2022; 27:1733-1751. [PMID: 34647832 DOI: 10.1080/13557858.2021.1990220] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/17/2021] [Accepted: 10/01/2021] [Indexed: 06/13/2023]
Abstract
The purpose of this scoping review is to synthesize knowledge about medical mistrust and health among women who occupy other marginalized identities; namely women who also belong to one or more of the following social groups: people of color, people of low socioeconomic status, people with disabilities, lesbian and bisexual women, and/or women who have sex with women. This scoping review is based on the methodological framework by Arksey and O'Malley (2005. "Scoping Studies: Towards a Methodological Framework." International Journal of Social Research Methodology 8: 19-32. doi:10.1080/1364557032000119616). Specific search terms were entered into selected databases. Based on a set of inclusion criteria, articles were screened and assessed for eligibility. Data from the selected articles were extracted and summarized. Forty studies were included. Thirty-one studies used quantitative methodology, of which more than half used the Group-Based Medical Mistrust Scale. The majority of studies (84%) investigated the intersection of gender with race and ethnicity. Breast cancer and HIV combined accounted for more than half of the included studies. Of those studies that examined the relationship between medical mistrust and a health outcome or health behavior, almost all reported that medical mistrust had a deleterious impact. Medical mistrust among women with intersecting marginalized identities is worthy of further study, and there is still a dearth of knowledge in the role of medical mistrust among a wide range of subgroups of women and health domains.
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Affiliation(s)
- Ivy K Ho
- Department of Psychology, University of Massachusetts Lowell, Lowell, MA, USA
| | - Taylor A Sheldon
- Department of Psychology, University of Massachusetts Lowell, Lowell, MA, USA
| | - Elliott Botelho
- Department of Psychology, University of Massachusetts Lowell, Lowell, MA, USA
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Su CJ, Cyr PEP. Accessible Medical Education & TIC: Increasing Equitable Care for Disabled Patients. HARVARD PUBLIC HEALTH REVIEW (CAMBRIDGE, MASS.) 2022; 44:https://hphr.org/edition-44-su/. [PMID: 36176338 PMCID: PMC9518008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Subscribe] [Scholar Register] [Indexed: 06/16/2023]
Abstract
An estimated 1 in 4 U.S. adults has a disability, and this number continues to increase. Disabled individuals face significant healthcare inequities, including but not limited to inaccessibility and mistreatment. Our current healthcare system is ill-equipped to provide equitable care to this population. There is a lack of accessibility in healthcare environments, lack of accessible medical training to enable disabled people to become healthcare providers serving their own community, and lack of thorough medical education that encompasses care for disabled patients. Furthermore, the increased risk of trauma, as well as increased risk of medical trauma specifically, endured by disabled people puts them at greater risk of long-lasting adverse effects. In this commentary, we analyze three key areas: 1) the current state of healthcare for disabled patients, 2) disability in medical education & physician workforce, and 3) the relationship between trauma and disability. We argue that the road to more equitable care for disabled patients involves changes to medical education that address all three of these areas. Medical training should expose trainees to disability early and throughout their training, should be made more accessible to support disabled physicians, and finally, should be trauma-informed in a manner that explicitly includes caring for disabled patients and their other intersecting identities.
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Implicit biases in healthcare: implications and future directions for gynecologic oncology. Am J Obstet Gynecol 2022; 227:1-9. [PMID: 35026128 DOI: 10.1016/j.ajog.2021.12.267] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2021] [Revised: 12/09/2021] [Accepted: 12/24/2021] [Indexed: 11/21/2022]
Abstract
Health disparities have been found among patients with gynecologic cancers, with the greatest differences arising among groups based on racial, ethnic, and socioeconomic factors. Although there may be multiple social barriers that can influence health disparities, another potential influence may stem from healthcare system factors that unconsciously perpetuate bias toward patients who are racially and socioeconomically disadvantaged. More recent research suggested that providers hold these implicit biases (automatic and unconscious attitudes) for stigmatized populations with cancer, with emerging evidence for patients with gynecologic cancer. These implicit biases may guide providers' communication and medical judgments, which, in turn, may influence the patient's satisfaction with and trust in the provider. This narrative review consolidated the current research on implicit bias in healthcare, with a specific emphasis on oncology professionals, and identified future areas of research for examining and changing implicit biases in the field of gynecologic oncology.
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Holt L, Carney MH, Duncanson L, Hazen C, Kumar A, McKeon BA, Woodard L. Perceived Barriers to Gynecologic Care by Women Who Use Wheelchairs. Cureus 2021; 13:e15647. [PMID: 34306857 PMCID: PMC8279694 DOI: 10.7759/cureus.15647] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/14/2021] [Indexed: 11/29/2022] Open
Abstract
Objective The aim of this study was to evaluate the current barriers associated with gynecologic care as perceived by women who use wheelchairs. Methods This qualitative study evaluated the barriers to gynecologic healthcare as described by female wheelchair users. We recruited English-speaking female participants aged 18 years and older who primarily used a wheelchair for mobility through flyer and email distribution. Interviews were conducted by three investigators using a semi-structured interview guide and recorded for transcription. Two investigators reviewed all transcriptions for accuracy which were then coded to identify emergent themes. Results The thematic saturation was achieved with 16 interviews. The most common barrier cited was transferring to the exam table (n=16). Women reported that their providers lacked knowledge and experience with women who use wheelchairs (n= 11). Conclusion There are many barriers to gynecologic care for women who use wheelchairs. Interventions are needed to improve accessibility to care for women who use wheelchairs.
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Affiliation(s)
- Lauren Holt
- Family and Community Medicine, University of South Florida Morsani College of Medicine, Tampa, USA
| | - Madeline H Carney
- Family Medicine, University of South Florida Morsani College of Medicine, Tampa, USA
| | - Lauren Duncanson
- Family and Community Medicine, University of South Florida Morsani College of Medicine, Tampa, USA
| | - Christopher Hazen
- School of Health Sciences, University of South Florida Morsani College of Medicine, Tampa, USA
| | - Ambuj Kumar
- Biostatistics and Epidemiology, University of South Florida Morsani College of Medicine, Tampa, USA
| | - Bri Anne McKeon
- Obstetrics and Gynecology, University of South Florida Morsani College of Medicine, Tampa, USA
| | - Laurie Woodard
- Family Medicine, University of South Florida Morsani College of Medicine, Tampa, USA
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Becker H, Andrews E, Walker LO, Phillips CS. Health and Well-Being among Women with Physical Disabilities After Childbirth: An Exploratory Study. Womens Health Issues 2020; 31:140-147. [PMID: 33272777 DOI: 10.1016/j.whi.2020.10.007] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2020] [Revised: 10/23/2020] [Accepted: 10/27/2020] [Indexed: 11/27/2022]
Abstract
PURPOSE Although research about pregnancy for women with disabilities has increased, their postpartum experience has received little attention. Studies generally focus on parenting, not on the health of the mothers themselves, despite recent studies underscoring the health risks they may face. Thus, our purpose was to examine postpartum health among women with physical disabilities, including how they maintain or improve their health. METHODS Semistructured interviews were conducted with eleven new mothers with physically disabling conditions. A qualitative descriptive approach was used to analyze the transcribed interviews and identify themes. RESULTS Nine women had delivered via cesarean section, and most had mobility impairments. Their average age was 35 years; 91% were college educated and 82% had a partner. Six overarching themes were identified: paying a price to have the baby, focus on the baby, supports-or a lack thereof, feelings of isolation, getting challenges under control/overcoming barriers, and not quite there yet/getting back to health promotion. CONCLUSIONS Despite their resilience in dealing with the challenges of caring for their babies within the context of their disabling conditions (including recovery from complications from the birth experience), these women clearly identified the need for additional resources and supports. They also recognized limitations to their own health that came along with their parenting responsibilities. Health care providers should be more attuned to the postpartum needs of women with physical disabilities, and policies should provide additional supports such as insurance coverage for home visits to help maximize women's health and well-being during this important life transition.
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Affiliation(s)
- Heather Becker
- The University of Texas at Austin, School of Nursing, Austin, Texas.
| | - Erin Andrews
- VA Texas Valley Coastal Bend HealthCare System, Austin, Texas
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