Needs Assessment Research: Women’s Health

Deaf women: experiences and perceptions of healthcare system access.

Steinberg AG, Wiggins EA, Barmada CH, Sullivan VJ.
Department of Psychiatry, University of Pennsylvania School of Medicine, Philadelphia, Pennsylvania, USA. J Womens Health (Larchmt) 2002 Oct;11(8):729-41

Background: The authors investigated the knowledge, attitudes, and healthcare experiences of Deaf women.
p. Methods: Interviews with 45 deaf women who participated in focus groups in American Sign Language were translated, transcribed, and analyzed. Deaf women’s understanding of women’s health issues, knowledge of health vocabulary in both English and American Sign Language, common health concerns among Deaf women, and issues of access to information, including pathways and barriers, were examined. As a qualitative study, the results of this investigation are limited and should be viewed as exploratory.
p. Results: A lack of health knowledge was evident, including little understanding of the meaning or value of cancer screening, mammography, or Pap smears; purposes of prescribed medications, such as hormone replacement therapy (HRT); or necessity for other medical or surgical interventions. Negative experiences and avoidance or nonuse of health services were reported, largely due to the lack of a common language with healthcare providers. Insensitive behaviors were also described. Positive experiences and increased access to health information were reported with practitioners who used qualified interpreters. Providers who demonstrated minimal signing skills, a willingness to use paper and pen, and sensitivity to improving communication were appreciated.
p. Conclusion: Deaf women have unique cultural and linguistic issues that affect healthcare experiences. Improved access to health information may be achieved with specialized resource materials, improved prevention and targeted intervention strategies, and self-advocacy skills development. Healthcare providers must be trained to become more effective communicators with Deaf patients and to use qualified interpreters to assure access to healthcare for Deaf women.

Double jeopardy. The health care system slights women with disabilities.

Smeltzer SC.
Villanova University College of Nursing, PA, USA. Am J Nurs 2000 Aug;100(8):11

Excerpts of an Executive Summary of Research and Evaluation of the International Leadership Forum for Women with Disabilities (ILFWD), Bethesda, MA, USA, 1997.

Doe T.
Int J Rehabil Res 2000 Dec;23(4):333-4

Family planning for women with learning disabilities.

Taylor G, Pearson J, Cook H.
Merton and Sutton Community NHS Trust. Nurs Times 1998 Oct 7-13;94(40):60-1

Gynecologic and reproductive services for women with developmental disabilities.

Kopac CA, Fritz J, Holt RA.
Georgetown University School of Nursing, Washington, DC 20007, USA. Clin Excell Nurse Pract 1998 Mar;2(2):88-95

A two-phase study using mail-out questionnaires examined the availability and accessibility of gynecologic and reproductive services for women with developmental disabilities. First, 127 women with developmental disabilities responded to queries about the accessibility and type of available services, the providers of necessary care, and satisfaction with the services. The age range of the women was 18-80 years, with a mean age of 40 years. Of the women queried, 40% indicated that they had not received health education regarding gynecologic and reproductive needs, and 27% indicated that they disliked health education about such matters. In the second phase of the study, agencies that provide services to these women were queried about patterns of the providers, available services, and identified barriers, including financial problems, difficulty in finding a provider, family perceptions, and fear of and distaste for examinations. A surprising finding was that more than one-third of the reporting agencies indicated that questions about the identification and treatment of sexual abuse were not applicable to their agencies. The findings are discussed with an emphasis on identified barriers to care, available services, and the implications for nurse practitioner practice.

Women with spinal cord injury and the impact of aging.

Pentland W, Walker J, Minnes P, Tremblay M, Brouwer B, Gould M.
School of Rehabilitation Therapy, Queen’s University, Kingston, Ontario, K7L 3N6, Canada.
Spinal Cord 2002 Aug;40(8):374-87

Objective: The objectives of this study were to describe what women with longstanding spinal cord injury (SCI) feel they are experiencing as they age, how they are coping and what they require in order to ensure their continued social and economic participation in society.

Study Design, Methods, and Setting: A naturalistic approach was taken, incorporating three focus groups (n=10) and key informant interviews (n=19) of women with SCI ranging in age from 31 to 70 years and living in rural and urban communities in Ontario, Canada.

Results: The women feel isolated and sense many of their key concerns are ignored or dismissed by health care and service providers. The common physical changes and concerns were gynecological/sexual and bowel and bladder issues. Socio-emotional changes with age included impact of their age-related changes on important relationships and re-evaluation of personal priorities. They articulated worries including declining health, increasing dependency and financial stresses. Additional resources they need to age successfully include improved environmental accessibility, assistive devices, more flexible and responsive attendant and household support, access to recreation and fitness opportunities and peer and psychological support.

Conclusion: Many of the issues raised by the women were consistent with the authors’ previous examination of aging in men with SCI and women with disabilities. The most striking difference was their profound sense of isolation and perceptions that health care and service providers were unprepared or unwilling to address the unique issues they face as women living and now aging with SCI.