Showing papers in "Journal of Womens Health in 2008"
TL;DR: Improving the frequency and scope of mammography recommendation by primary care providers is the single most important direct contribution the medical community can make toward increasing mammography use.
Abstract: Objective: A significant segment of women remains underscreened with mammography. We sought to summarize literature related to factors associated with receipt of mammography. For data sources, we used English language papers published between 1988 and 2007, including 221 studies describing 4,957,347 women. Methods: We calculated odds ratios (ORs) associated with receipt of mammography. Random effects modeling was used to assess trends in mammography utilization and to calculate summary multivariate point estimates. Results were stratified by age, race/ethnicity, and study year. We summarized results between 1988 and 2004 and compared recent years with these results. Results: Physician access barriers, such as not having a physician-recommend mammography (adjusted OR 0.16, 95% CI 0.08-0.33) and having no primary care provider (OR 0.41, 95% CI 0.32-0.53), were highly predictive of not obtaining mammography. Past screening behavior correlated strongly with receipt of mammography (clinical breast exa...
359 citations
TL;DR: The case is made that deeply embedded unconscious gender-based biases and assumptions underpin the stalled advancement of women on both fronts and the need to move beyond "fixing the women" to a systemic, institutional approach that acknowledges and addresses the impact of unconscious, gender-linked biases.
Abstract: The term “glass ceiling” refers to women's lack of advancement into leadership positions despite no visible barriers. The term has been applied to academic medicine for over a decade but has not previously been applied to the advancement of women's health. This paper discusses (1) the historical linking of the advances in women's health with women's leadership in academic medicine, (2) the slow progress of women into leadership in academic medicine, and (3) indicators that the advancement of women's health has stalled. We make the case that deeply embedded unconscious gender-based biases and assumptions underpin the stalled advancement of women on both fronts. We conclude with recommendations to promote progress beyond the apparent glass ceiling that is preventing further advancement of women's health and women leaders. We emphasize the need to move beyond “fixing the women” to a systemic, institutional approach that acknowledges and addresses the impact of unconscious, gender-linked biases that ...
256 citations
TL;DR: Pregnant women overall reported low rates of formal treatment use but frequently sought help from informal sources, such as friends, family, and printed materials, with African American women expressing greater confidence in religious settings than white women.
Abstract: Background and methods: Little is understood about why few women during the perinatal period will use depression treatment. In particular, beliefs and barriers related to depression treatment use have not been studied. In this study, African American and white pregnant women (n = 108) who screened ≥10 on the Edinburgh Postnatal Depression Scale (EPDS) were asked about recent formal and informal treatment use in prenatal care settings. Confidence in the helpfulness of treatment, providers, and settings and perceived barriers to treatment were assessed and compared between African American and white women. Results: Pregnant women overall reported low rates of formal treatment use but frequently sought help from informal sources, such as friends, family, and printed materials. All women expressed greatest confidence in psychosocial treatments and lowest confidence in antidepressants. African American women reported less confidence in advice from family and friends and in antidepressants than did whi...
237 citations
TL;DR: This paper summarized the literature on grief subsequent to an early miscarriage to elucidate the nature, incidence, intensity, and duration of grief at this time and to identify potential moderators, concluding that a sizable percentage of women seem to experience a grief reaction, with the actual incidence of grief unclear.
Abstract: Objective: The literature exploring the relationship between miscarriage and grief is sparse. This paper summarizes the literature on grief subsequent to an early miscarriage to elucidate the nature, incidence, intensity, and duration of grief at this time and to identify potential moderators. Methods: An electronic search of the Medline and Psych Info databases was conducted. Studies were selected for inclusion if they related to early miscarriage, used a standardized measure to assess perinatal grief, and specified the assessment intervals employed. Qualitative studies were included when helpful to develop hypotheses. Results: Descriptions of grief following miscarriage are highly variable but tend to match descriptions of grief used to characterize other types of significant losses. A sizable percentage of women seem to experience a grief reaction, with the actual incidence of grief unclear. Suggestively, grief, when present, seems to be similar in intensity to grief after other types of major...
236 citations
Indiana University1, University of Bristol2, Moi University3, University of Cape Town4, Columbia University5, University of Bern6, University of Bordeaux7, French Institute of Health and Medical Research8, Institut de recherche pour le développement9, Federal University of Rio de Janeiro10, Universidade Federal do Rio Grande do Sul11, University of North Carolina at Chapel Hill12, University of California, San Francisco13, National Institutes of Health14
TL;DR: Women in resource-constrained settings are not necessarily disadvantaged in their access to HAART, and more attention needs to be paid to ensuring that HIV-infected men are seeking care and starting HAART.
Abstract: Aims: To compare the gender distribution of HIV-infected adults receiving highly active antiretroviral treatment (HAART) in resource-constrained settings with estimates of the gender distribution of HIV infection; to describe the clinical characteristics of women and men receiving HAART. Methods: The Antiretroviral Therapy in Lower-Income Countries, ART-LINC Collaboration is a network of clinics providing HAART in Africa, Latin America, and Asia. We compared UNAIDS data on the gender distribution of HIV infection with the proportions of women and men receiving HAART in the ART-LINC Collaboration. Results: Twenty-nine centers in 13 countries participated. Among 33,164 individuals, 19,989 (60.3%) were women. Proportions of women receiving HAART in ART-LINC centers were similar to, or higher than, UNAIDS estimates of the proportions of HIV-infected women in all but two centers. There were fewer women receiving HAART than expected from UNAIDS data in one center in Uganda and one center in India. Taki...
217 citations
TL;DR: The majority of reasons for faculty attrition are amenable to change, and retaining high-quality faculty in medical settings may justify the costs of faculty development and retention efforts.
Abstract: Purpose: Faculty attrition, particularly among female and minority faculty, is a serious problem in academic medical settings. The reasons why faculty in academic medical settings choose to leave their employment are not well understood. Further, it is not clear if the reasons why women and minority faculty leave differ from those of other groups. Methods: One hundred sixty-six medical school faculty who left the School of Medicine (SOM) between July 1, 2001, and June 30, 2005, completed a survey about their reasons for leaving. Results: The three most common overall reasons for leaving the institution included career/professional advancement (29.8%), low salary (25.5%), and chairman/departmental leadership issues (22.4%). The ranking of these reasons varied slightly across racial and gender groups, with women and minority faculty also citing personal reasons for leaving. Women and minority faculty were at lower academic ranks at the time they left the SOM compared with male and majority groups. ...
197 citations
TL;DR: Evidence of elevated frequency, severity, and persistence of abuse experienced by lesbian and bisexual women in childhood and adolescence is shown.
Abstract: Background: A growing body of research documents multiple health disparities by sexual orientation among women, yet little is known about the possible causes of these disparities. One underlying factor may be heightened risk for abuse victimization in childhood in lesbian and bisexual women. Methods: Using survey data from 63,028 women participating in the Nurses' Health Study II, we investigated sexual orientation group differences in emotional, physical, and sexual abuse in childhood and adolescence. Multivariable log-binomial and linear regression models were used to examine orientation group differences in prevalence and severity of abuse, with heterosexual as the referent and controlling for sociodemographics. Results: Results showed strong evidence of elevated frequency, severity, and persistence of abuse experienced by lesbian and bisexual women. Comparing physical abuse victimization occurring in both childhood and adolescence, lesbian (30%, prevalence ratio [PR] 1.61, 95% confidence interval [CI] 1.40, 1.84) and bisexual (24%, PR 1.26, 95% CI 1.00, 1.60) women were more likely to report victimization than were heterosexual women (19%). Similarly, comparing sexual abuse victimization occurring in both age periods, lesbian (19%, PR 2.16, 95% CI 1.80, 2.60) and bisexual (20%, PR 2.29, 95% CI 1.76, 2.98) women were more likely to report victimization than were heterosexual women (9%). Conclusions: This study documents prevalent and persistent abuse disproportionately experienced by lesbian and bisexual women. Language: en
151 citations
TL;DR: HPV vaccine acceptability for an adolescent daughter was associated with women's beliefs about their own healthcare needs and insights can inform future health communication activities intended to increase vaccination uptake in other high-risk populations of rural Southern women.
Abstract: Background: Although cervical cancer rates in the United States are highest in Southern and rural areas, research on human papillomavirus (HPV) vaccine acceptability has focused on other geographic areas. Methods: To address this gap, we surveyed women from a rural area in North Carolina with elevated rates of cervical cancer to identify predictors of HPV vaccine acceptability for themselves and their daughters. Results: One hundred forty-six women completed questionnaires about HPV infection, cervical cancer, and HPV vaccination. The majority (62%) of respondents were African American. Most respondents intended to vaccinate an adolescent daughter against HPV. Older and African American women reported lower vaccination intentions. Higher intentions to vaccinate an adolescent daughter against HPV were associated with knowing more about HPV, believing that HPV infection and cervical cancer are both likely and have negative consequences, and believing that the HPV vaccine is effective against cervic...
150 citations
TL;DR: After an abnormal mammogram, African American and Hispanic women had longer times to diagnostic follow-up compared with non-Hispanic white women and racial/ethnic disparities remained significant in a multivariable model.
Abstract: Background: Although non-Hispanic white women have an increased risk of developing breast cancer, the disease-specific survival is lower for African American and Hispanic women. Little is known about disparities in follow-up after an abnormal mammogram. The goal of this study was to investigate potential disparities in follow-up after an abnormal mammogram. Methods: A retrospective cohort study of 6722 women with an abnormal mammogram and documented follow-up from January 2000 through December 2002 was performed at an academic medical center in New York City. The outcome was the number of days between the abnormal mammogram and follow-up imaging or biopsy. Cox proportional hazards models were used to assess the effect of race/ethnicity and other potential covariates. Results: The median number of days to diagnostic follow-up after an abnormal mammogram was greater for African American (20 days) and Hispanic (21 days) women compared with non-Hispanic white (14 days) women (p < 0.001). Racial/ethni...
144 citations
TL;DR: The results of the present study indicate that Native American postmenopausal women benefit from regular consumption of flaxseed by reducing their risk of cardiovascular disease as seen from lowered LDL-C and total cholesterol levels.
Abstract: Objective: The objective of the study was to investigate the extent to which the daily incorporation of approximately 30 g of flaxseed, a rich source of lignans, omega-3 fatty acids, and f...
143 citations
TL;DR: Comparing the effectiveness of three screening instruments--Edinburgh Postnatal Depression Scale (EPDS), Patient Health Questionnaire (PHQ-9), and the 7-item screen of the Postpartum Depression Screening Scale (PDSS)--for identifying women with postpartum depression in the first 6 months after delivery found the EPDS was significantly more accurate than the PDSS_SF and PHQ- 9 with the cutoff points used.
Abstract: Objectives: Postpartum depression, the most prevalent complication of childbirth, is often unrecognized. Our objective was to compare the effectiveness of three screening instruments—Edinburgh Postnatal Depression Scale (EPDS), Patient Health Questionnaire (PHQ-9), and the 7-item screen of the Postpartum Depression Screening Scale (PDSS)—for identifying women with postpartum depression in the first 6 months after delivery. Methods: We administered the three instruments via telephone to women who were ≥18 years and had delivered infants 6–8 weeks earlier. We arranged home interviews to confirm DSM-IV criteria current major depressive disorder (MDD) in women who had an above-threshold score on any of the instruments. For women who screened negative on the 6–8 week call, we repeated the screening at 3 months and 6 months to identify emergent symptoms. The primary outcome measures were the screening scores and DSM-IV diagnoses. Results: Of 135 women reached, 123 (91%) were screened, 29 (24%) had home...
TL;DR: Gender disparity in grant funding is largely explained by gender disparities in academic rank, however, gender differences in grant application behavior at lower academic ranks also contribute to gender disparity inGrant funding for medical science.
Abstract: Purpose: To evaluate whether there were differences in acquisition of research grant support between male and female faculty at eight Harvard Medical School-affiliated institutions. Methods: Data were obtained from the participating institutions on all research grant applications submitted by full-time faculty from 2001 through 2003. Data were analyzed by gender and faculty rank of applicant, source of support (federal or nonfederal), funding outcome, amount of funding requested, and amount of funding awarded. Results: Data on 6319 grant applications submitted by 2480 faculty applicants were analyzed. Women represented 29% of investigators and submitted 26% of all grant requests. There were significant gender differences in the mean number of submissions per applicant (women 2.3, men 2.7), success rate (women 41%, men 45%), number of years requested (women 3.1, men 3.4), median annual amount requested (women $115,325, men $150,000), mean number of years awarded (women 2.9, men 3.2), and median an...
TL;DR: A facilitated peer mentorship pilot program that was developed to meet the unique needs of women faculty demonstrated success in a small-scale pilot program and may result in greater numbers of women achieving academic advancement.
Abstract: Background: In the United States, female physicians working in academic medical practices are less likely to achieve the academic rank of associate professor or professor than are male physicians of comparable seniority. Lack of mentoring has been suggested as a possible contributor to this difference. Methods: In this paper, we describe a facilitated peer mentorship pilot program that was developed to meet the unique needs of women faculty. Experienced female physicians acted as facilitators to a group of junior women who served as their own peer mentors. Outcome measures for the program included comparison of a pretest and a posttest completed by the peer mentor participants, a skills acquisition survey, published papers, and academic advancement of participants. Results: All the peer participants realized increased academic activity in the form of published papers and promotion in academic rank, skills acquisition, and enthusiasm for continuance of the program. Conclusions: This new model of f...
TL;DR: To effectively treat MDD in women and to prevent the recurrence of illness in vulnerable women, clinicians must understand the sex-specific aspects of mood disorders over the longitudinal course of women's reproductive lives.
Abstract: Background and aims: Epidemiological data on the prevalence of mood disorders demonstrate that major depressive disorder (MDD) is approximately twice as common in women as in men and that
TL;DR: The central hypothesis presented is that dysregulation in either system individually or in their bidirectional interaction is associated with the development of PPD.
Abstract: Postpartum depression (PPD) is a potentially debilitating disorder that develops in a significant percentage of women during the first year after giving birth. Women afflicted with PPD experience long-term consequences, including sadness, guilt, and despair. Offspring may be affected as well. Several investigators have tested psychosocial risk factors for the development of PPD; however, substantial amounts of variance in PPD have gone unexplained with regression on psychosocial variables alone. Likewise, interventions for PPD that have focused on psychosocial risk factors alone have been largely unsuccessful. The unexplained variance and disappointing treatment success could well be due to investigators' failure to address relevant biological changes occurring during the postpartum period. Two biological systems that are affected significantly and remain in flux during the postpartum period are the innate immune system and the hypothalamic-pituitary-adrenal (HPA) axis. Bidirectional interactions...
TL;DR: These findings suggest that cervical cancer survivors generally have a positive attitude toward sexuality and engage in satisfying sexual activity.
Abstract: Objectives: The study reported here assesses sexuality and sexual functioning among women treated for invasive cervical cancer over broad portions of the life cycle. Hysterectomy and oophorectomy, two widespread interventions in invasive cervical cancer, have potentially important effects on a woman's self-image and sexuality. Methods: The investigation focused on women aged 29–69 with histories of invasive cervical cancer (n = 179) from the Connecticut Tumor Registry, 6–29 years postdiagnosis. Logistic regression analysis was used to assess the relative impact of time since cervical cancer diagnosis and treatment received, adjusting for age and social and economic background. Sexuality, sexual function, and potential correlates were assessed using the Sexual Adjustment Scale, the MOS-36, and the Center for Epidemiological Studies—Depression Scale (CES-D). Results: Strong majorities of women in the study indicated that they were sexually active (81.1%) and both desired (81.4%) and enjoyed (90.9%)...
TL;DR: Abused women who sought formal help were more likely to be exposed to physical or sexual IPV, severe psychological IPV (physical, sexual, and psychological), severity, and duration and rates of legal help seeking increased with abuse severity.
Abstract: Objective: To examine the relationship between intimate partner violence (IPV) type, severity, and duration and abused women's use of medical and legal services. Methods: Participants were 1509 randomly sampled women from a large health plan who were interviewed by telephone to assess (1) self-reported lifetime exposure to IPV type (physical, sexual, and psychological), severity, and duration and (2) women's use of medical and legal services (civil protection orders). Results: Compared with women who experienced psychological abuse only, sexually abused women were 1.3 times as likely to seek medical care, and women exposed to physical IPV or sexual IPV were 3.2 times and 1.6 times as likely, respectively, to seek legal services. Rates of medical and legal help seeking increased with increasing abuse severity among physically abused women, and rates of legal help seeking increased with abuse severity among sexually and psychologically abused women. Longer duration of physical and sexual IPV was al...
TL;DR: In this article, the authors examined the effect of gender on smoking behaviors in Taiwan and found that men smoke significantly more cigarettes per day than women, while women smoke less than men.
Abstract: Background: Gender-sensitive tobacco control policies are being challenged, and new directions are being sought because public health efforts have reduced cigarette consumption more substantially among men than among women. To better target women, it would help to identify the protective cultural factors that promote resiliency in women and discourage them from smoking. Whereas western cultures have generated a great deal of gender-specific research and programs on the prevention of smoking in women, Asian cultures have not. Taking a personal and sociocultural perspective, this study examines the effect of gender on smoking behaviors in Taiwan. Methods: In a 2004 cross-sectional random-sampled interview survey, 827 adult men and 90 adult women smokers in Taiwan were queried about the time they began smoking, maintenance of their habits, and their readiness to change. Results: The male/female smoking rate ratio was 9.5 (45.7% vs. 4.8%). Men smoked significantly more cigarettes per day than women (...
TL;DR: Women who reported that they did not know how to cope or had just tried to forget about their experiences reported more frequent domestic violence exposure during the conflict and had higher negative mental health outcomes associated with the conflict than did those who reported using active strategies.
Abstract: Objectives: To investigate how Lebanese women were affected by the July 2006 conflict that erupted between the Hezbollah and the State of Israel, with a specific focus on their personal vi...
TL;DR: Pregnancy in older women is of great relevance, particularly in developed countries where many women experience pregnancy late in the childbearing age, according to a hospital-based data analysis of delivery records from 1998 to 2003.
Abstract: Background: Pregnancy in older women is of great relevance, particularly in developed countries where many women experience pregnancy late in the childbearing age. Methods: A hospital-based data analysis of 9506 delivery records from 1998 to 2003 at the Liverpool Women's Hospital was undertaken to assess pregnancy outcomes in older women of reproductive age. Results: Overall, 2.4 % of mothers were >40 years of age (advanced), 5.6% were 40 years were at higher risk for delivering a LBW (9.4% vs. 5.3%, p = 0.005) or a very preterm baby (8.9% vs. 4.4%, p = 0.001) than were multiparous mothers of the same age. There was an association between matern...
TL;DR: The burden of premenstrual dysphoric disorder was greater on mental/emotional HRQoL domains than on physical HRZoL, and PMDD is associated with substantial burden on both physical and mental aspects of HRqoL.
Abstract: Objective: The purpose of this study was to document the burden of premenstrual dysphoric disorder (PMDD) on health-related quality of life (HRQoL) in comparison to the U.S. general popula...
TL;DR: The supposition that better treatment outcomes can be achieved by scheduling quit dates to coincide with the follicular phase of the MC in female smokers is supported.
Abstract: Background and Objective: The deleterious health consequences of smoking are even more severe for women, yet ironically, they have more difficulty quitting than men. Identifying relapse predictors for women and implementing strategies to increase their chances of successfully quitting and remaining abstinent are important goals. Clinicians and researchers suggest that women could achieve greater success in smoking cessation interventions if the initial quit attempt coincided with the follicular phase (i.e., preovulatory phase) of their menstrual cycle (MC) rather than the luteal phase (i.e., premenstrual). However, no experimental data have been published to support this claim. Our objective was to determine whether MC phase affected smoking status in premenopausal female smokers participating in a smoking cessation treatment trial. Methods: Data from 102 treatment-seeking smokers who participated in an 8-week nicotine replacement therapy (NRT) plus behavioral intervention smoking cessation study...
TL;DR: It is concluded that no consensus about the relationship between breastfeeding and breast cancer is emerging and expanded consideration of possible confounders for this relationship is required to determine if breastfeeding is protective and how protection might be conferred.
Abstract: Breastfeeding is hypothesized to reduce the risk of breast cancer primarily through two mechanisms, differentiation of breast tissue and reduction of the lifetime number of ovulatory cycles, but previous reviews of the association between breastfeeding and breast cancer have not consistently found that breastfeeding reduces risk of breast cancer. Our systematic review yielded 30 case-control studies and 1 cohort study published between 1999 and 2007. Of the 27 studies that assessed the effect of ever breastfeeding compared with never breastfeeding, only 11 found significant protection against breast cancer. Of the 24 studies of the effect of breastfeeding duration, only 13 found a reduced risk of breast cancer with extended lactation. We conclude that no consensus about the relationship between breastfeeding and breast cancer is emerging. Expanded consideration of possible confounders for this relationship is required to determine if breastfeeding is protective and how protection might be conferred.
TL;DR: There are prevention behaviors that have the potential of substantially reducing the occurrence ofCMV-related permanent disability in children, however, the results suggest that few women are aware of CMV or these prevention behaviors.
Abstract: Background: Congenital cytomegalovirus (CMV) is as common a cause of serious disability as Down syndrome and neural tube defects. When acquired prior to or during pregnancy, CMV can be transmitted transplacentally to the fetus, sometimes causing serious temporary symptoms, permanent disabilities, or both to the child. One way to prevent infection before and during pregnancy is through simple hygienic practices, such as handwashing. Methods: This study used the 2005 annual HealthStyles™ survey, a mail survey of the U.S. population aged <18 years, to assess knowledge of congenital CMV. Self-reports by female respondents measured willingness to adopt particular hygienic behaviors to prevent CMV transmission. Results: Only 14% of female respondents had heard of CMV. Among women who reported they had heard of CMV, the largest proportion said they had heard about it from a doctor, hospital, clinic, or other health professional (29%). The accuracy of women's knowledge of what conditions congenital CMV c...
TL;DR: Findings in this Hispanic population, although based on small numbers of cases, are consistent with prior research among predominantly non-Hispanic white populations.
Abstract: Objective: Studies in predominantly non-Hispanic white populations have suggested that physical activity during pregnancy is associated with a reduced risk of gestational diabetes mellitus...
TL;DR: Quantitative results indicate that tenofovir vaginal gel was acceptable to almost all users, while qualitative findings indicate that acceptability is complex, varies among users, and is likely shaped by a variety of contextual factors that manufacturers will need to consider to optimize use-effectiveness.
Abstract: Objectives: In this phase I safety trial of tenofovir gel, a candidate vaginal microbicide for human immunodeficiency virus (HIV) prevention, a mixed-methods design was used to gather acceptability data among women participants. The impact of acceptability factors on use of the gel and the relationship between qualitative and quantitative acceptability data are explored. Methods: Participants included low-risk, HIV-uninfected, and clinically stable HIV-infected women. Participants were enrolled into cohorts stratified by HIV serostatus, sexual activity, gel concentration, and frequency of use. Quantitative data were collected via interviewer-administered structured questionnaires. Qualitative data were collected via semistructured small group discussions. Results: Although 94% of participants stated they would “probably” or “definitely” use tenofovir gel, a range of responses emerged on multiple domains relevant to microbicide acceptability during the qualitative discussions. Lubrication, leakage...
TL;DR: In clinical practice, overlapping treatment regimens may be advantageous in treating the coexisting menstrual-related pain conditions of dysmenorrhea and migraine.
Abstract: Menstrual disorders affect millions of women in the United States and represent an important health burden. The most common menstrual disorders are dysmenorrhea and headache; these conditions are leading causes of work or school absenteeism and substantially impact quality of life. Headache associated with menses is often migraine and referred to as menstrual migraine. Although the pathogenesis of menstrual-related pain conditions is not fully understood, menstrual-related overproduction of prostaglandins is implicated in the pathophysiology of both menstrual migraine and dysmenorrhea. In clinical practice, nonsteroidal anti-inflammatory drugs (NSAIDs) are considered the first-line therapeutic option for managing pain associated with dysmenorrhea. NSAIDs also play a role in the acute treatment and intermittent prophylaxis of migraine. Triptans, a class of highly selective serotonin receptor agonists, represent the gold standard for acute treatment of migraine. In addition, hormone therapy is effective in many cases for treating dysmenorrhea and may be beneficial in the management of menstrual migraine. Thus, overlapping treatment regimens may be advantageous in treating the coexisting menstrual-related pain conditions of dysmenorrhea and migraine.
TL;DR: College students' perceptions regarding emergency contraception provision in light of the then pending U.S. Food and Drug Administration (FDA) decision about the over-the-counter (OTC) status of EC are examined.
Abstract: Background and objective: The authors examined college students' perceptions regarding emergency contraception (EC) provision in light of the then pending U.S. Food and Drug Administration...
TL;DR: A nurse-directed cardiac rehabilitation program tailored to the needs of women following an acute cardiac event to address their psychological and social needs appears to be feasible and acceptable.
Abstract: Background and aims: Heart disease in women is characterised by greater disability and a higher rate of morbidity and early death after an acute coronary event compared with men. Women also have lower participation rates than men in cardiac rehabilitation. This study sought to describe development of a nurse-directed cardiac rehabilitation program tailored to the needs of women following an acute cardiac event to address their psychological and social needs. Methods: The Heart Awareness for Women program (HAFW) commenced in 2003 with phase I involving development of program elements and seeking validation through consumers and clinical experts. The program was then trialed in an 8-week program in a convenience sample of 6 women. Phase II applied the revised program using action research principles focusing on enabling clinical staff to implement the ongoing program. A total of 54 women participated in this phase, 48 of whom completed baseline questionnaires. A mixed-method evaluation, using quest...
TL;DR: Although disclosure rates of CAM use to conventional providers were higher than in previous population-based studies, disclosure should be increased, especially for women who are pregnant and those with heart disease and cancer.
Abstract: Background: Medical pluralism can be defined as the employment of more than one medical system or the use of both conventional and complementary and alternative medicine (CAM) for health and illness. American women use a variety of health services and practices for women's health conditions, yet no national study has specifically characterized women's medical pluralism. Our objective was to describe medical pluralism among American women. Methods: A nationally representative telephone survey of 808 women ≥18 years of age was conducted in 2001. Cross-sectional observations of the use of 11 CAM domains and the use of an additional domain—spirituality, religion, or prayer for health—during the past year are reported. Women's health conditions, treatments used, reasons for use, and disclosure to conventional physicians are described, along with predictors of CAM use. Results: Over half (53%) of respondents used CAM for health conditions, especially for those involving chronic pain. The majority of wo...