Regina Cardaci

Abstract

Gynecologic cancer survivors report sexual health among their highest concerns. The aim of this study was to identify the prevalence of sexual dysfunction (SD) in survivors of gynecologic malignancies and to evaluate the association of sexual function with race, ethnicity and treatment modality. In this study, survivors of endometrial, cervical, vaginal, and vulvar cancer who presented to the gynecologic oncology practice were asked to self-administer the Female Sexual Function Index (FSFI) survey to evaluate their sexual function. The prevalence of SD was estimated and its association with demographic and clinical co-variates was analyzed. Of the 155 participants, the prevalence of SD was 44.5% (95%CI: 36.7–52.7). Patients were significantly more likely to report SD if they did not currently have a partner (69% vs 22% p < .01). Abstinence within six months of their cancer diagnosis was also associated with SD (72% vs 26% p < .01). Patients who self-identified as black race compared to white race were three times more likely to have SD (OR = 3.9, 95% CI 1.1–14.3). Patients who received adjuvant chemotherapy and radiation therapy compared to those who did not among the entire cohort had an increased risk of SD (OR = 3.4, 95% CI 1.2–9.6). In our diverse population, almost half of our patients were identified to have SD. Black as compared to white race reported significantly higher sexual dysfunction. An increased risk for sexual dysfunction was observed among those women who received chemotherapy and radiation with or without surgery. Precis: Survivorship is an important issue for women with gynecologic malignancies. This study addresses the high rates of sexual dysfunction in a racially diverse patient population.

Abstract

Pregnancy and childbirth for most women are typically positive experiences, a time where they are granted extra courtesy and assistance. For women in the criminal justice system in the United States, this is not the case as they are subject to treatment that is inadequate, and at times dangerous and inhumane. An example of such treatment is the practice of shackling pregnant women at various points in their pregnancies, including during labour. Shackling refers to the practice of restraining women with metal or plastic handcuffs, ankle restraints or ‘belly chains.’ This practice places women and their unborn babies at undue risk. Recently, some states in the United States have passed legislation banning this practice, although the majority of states have no restrictions on this practice. Many providers and caregivers, as well as the general public, are not aware that such laws are in effect, while others are not aware of the practice of shackling. Caring for women requiring reproductive health care, including complete obstetric and gynaecologic health services are recognised and supported by the World Health Organisation. No longer can the health of childbearing women be denied or placed at risk within the criminal justice system. This paper will discuss the recent changes in these laws, the rights of incarcerated childbearing women, and implications for practice, policy, and research.

Abstract

The Baby-Friendly Hospital Initiative (BFHI) is a program developed by the World Health Organization (WHO) and the United Nations Children's Fund (UNICEF) to promote breastfeeding in hospitals and birthing facilities worldwide. Since the program was launched in 1991, breastfeeding initiation, duration, and exclusivity have increased globally, a trend largely attributed to changes in hospital policies and practices brought about by the BFHI. This article provides an overview of these practices and policies, the institutional benefits of achieving BFHI certification, and the process through which health care facilities can do so. All nurses - whether they work in maternity care or another nursing specialty in a hospital, ambulatory, or community setting - can play a role in promoting societal health through their support of long-term breastfeeding as recommended by the WHO and UNICEF.

Abstract

Overview: Current practices in the treatment and transfer of pregnant inmates in this country may negatively affect maternal and fetal health or well-being. Some violate federal or state laws; others conflict with standards of obstetric care and are widely considered unethical or inhumane. This article discusses these practices; their legal status; and implications for nursing practice, policy, and research.

Abstract

Purpose: The purpose of this case study is to demonstrate how the use of the standard nursing languages of NANDA International (NANDA-I), the Nursing Interventions Classification (NIC), and the Nursing Outcomes Classification (NOC) help a teen mother provide safe care for her newborn. In addition, this study aims to demonstrate how important standardized nursing languages are in documenting the care provided. Data Sources: The data sources for this article are clinical nursing practice, research evidence in the form of care directives from the American Academy of Pediatrics regarding newborn safety and feeding, and the books that provide directions for the use of NANDA-I, NIC, and NOC. Data Synthesis: This case demonstrates the use of the nursing process in providing care for a teen mother and a newborn. Conclusions: Many new mothers, especially teens, are poorly informed regarding normal newborn care and safety upon hospital discharge. For this reason, teen mothers should be referred for nursing assessments in the home environment after discharge. Implications For Nursing: This case demonstrates the need for education of all parents prior to hospital discharge and supports the need for home-based evaluations to ensure the safety of the infant. This case also supports the use of standardized nursing language to document the care provided.