Adolescents experience barriers in access to sexual and reproductive health care, leading to a disproportionately high burden of disease and morbidity. Teens and young adults may avoid or delay accessing care due to perceived or experienced bias or judgement from healthcare providers or perceived or experienced inability to access care independently. Establishing positive, trusting relationships with adolescents is key to promotion of life-long health. Confidentiality plays a critical role in developing strong client-provider relationships, particularly for adolescent clients. Perception of confidentiality impacts an adolescent’s decision to seek care, disclose behaviors and concerns, as well as return for follow-up care. This chapter addresses the specific sexual and reproductive health needs of adolescents including care for common gynecologic conditions in adolescence as well as pregnancy. There is also information about mental health, suicide prevention, bullying, sexting, and age specific vaccination recommendations.
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Telehealth is a term that has been used interchangeably with telemedicine. It is defined as the use of medical information exchanged from one site to another through electronic communication to improve a patient’s health. Goals of telehealth include the following: Enhance overall patient outcomes; Make health care accessible to individuals in rural or isolated communities; Allow services to be more readily available for people with limited mobility, time, or transportation options; Lower healthcare costs. This chapter explores the basics of telehealth in women’s healthcare. Telehealth in women’s health is essential to providing accessible, innovative, and equitable health care services to the women’s health gender-related population. In an ever-evolving healthcare landscape, understanding the key components of telehealth service in women’s health is critical to ensuring patients receive optimal care and health outcomes. Telehealth services can be delivered in the following four ways: synchronously, asynchronously, mHealth, and remote patient monitoring.
- Go to chapter: Lesbian Health (Don’t Ask…Won’t Tell: Lesbian Women and Women Who Have Sex With Women)
Lesbian women, or women who have sex with women, experience health disparities in terms of prevention screening and desired health outcomes as compared to heterosexual women. Lesbian women are less likely to seek out care due to: stigma associated with being identified as lesbian, and previously experienced negative encounters with healthcare providers. This chapter discusses screening recommendations for sexual-minority women (lesbian, bisexual, and women who have sex with women). The screening includes breast cancer screening, cervical cancer screening and human papillomavirus, and screening for sexually transmitted infections. It explains the importance of using inclusive language, and presents sexual history questions. The chapter describes the approach to patient and provider communication. It also presents terminology used among lesbian women to describe their sexual practices. The chapter also discusses risk assessment and reduction.
Intimate partner violence (
IPV) is a global public health problem, linked to long-term health, social, and economic consequences. IPV, domestic violence, and family violence are terms that have been used to refer to physical, sexual, and psychological violence, and stalking, within intimate partner relationships. The overwhelming majority of violence and abuse is perpetrated by men against women, however, IPVdoes occur in same-sex relationships. There are four main forms of IPV. They are physical violence, sexual violence, stalking, and psychological aggression. The United States Preventive Services Task Force ( USPSTF) recommends IPVscreening for all women of reproductive age. IPVis the most common cause of injury among women of child-bearing age and their children. Health care professionals should screen for IPVand learn the abuse indicators, supportive care, safety planning, and community resources available to support women victims of IPV.
Polyps are the most common benign tumors of cervix and are found most often during the menstruating years. They are soft, pear-shaped (finger-like), red to purple lesions, and are usually pedunculated growths from the surface of the cervical canal. They are very friable and contain a large number of blood vessels, particularly near the surface. Typically, polyps are not cancerous (benign) and are easy to remove. Polyps do not usually grow back. However, women who have polyps once are at risk of growing more polyps. Pelvic examination will reveal smooth, red, or purple finger-like growths on the cervix. They are often removed during a routine pelvic examination. A cervical biopsy will most often show cells that are consistent with a benign polyp. Rarely, there may be abnormal, precancerous, or cancer cells in a polyp.
Women veterans deserve high-quality compassionate care in a safe, secure environment. Since the recent military reduction in force, there are more military men and women exiting the armed forces and transitioning to civilian life. The fastest growing sub-population of veterans is women veterans. Women comprise 15% of the armed forces. The military experiences of women veterans can and often do impact the remainder of their lives, physically and mentally. Many women veterans access health care through the Veterans Health Administration (
VHA) via their local Veterans Affairs ( VA) health care systems. However, most women veterans are seen in civilian medical care facilities. Health care providers need to recognize that the woman they are seeing today may have been in the military and is a former woman warrior. This chapter discusses specific areas of concern for female veterans in primary care, mental health care, trauma-informed care, VHA/ VAservices, and reproductive health care.
Cancers of the breast and ovary impose a significant burden on women’s health. Most cancers are sporadic and there is limited ability to predict who will be affected. Family history of cancer is common, but specific features in the family pedigree can suggest a hereditary pattern and increased cancer risk for family members. Approximately 5% to 10% of breast and ovarian cancers are hereditary, due to a single gene germline mutation. Identification and screening of high-risk women are essential skills for healthcare practitioners.
BRCA1 and BRCA2 gene mutations are responsible for hereditary breast and ovarian cancer syndrome, accounting for a large percentage of heritable cancers of the breast and ovary. A mutation in one of these genes has a profound impact on cancer risk. This chapter discusses the genetic testing for hereditary breast and ovarian cancer and details the management options for the unaffected woman who tests BRCApositive.
Human trafficking, also known as trafficking in persons or modern-day slavery, is a crime that involves compelling or coercing a person to provide labor or services or to engage in commercial sex acts. The coercion can be subtle or overt, physical, or psychological. The exploitation of a minor for commercial sex is human trafficking, regardless of whether any form of force, fraud, or coercion was used. Sex trafficking is the recruitment, harboring, transportation, provision, obtaining, patronizing, soliciting, or advertising of a person for a commercial sex act. Sex trafficking is divided into two distinct subcategories: adult sex trafficking and child sex trafficking. This chapter discusses etiology and incidence, and risk factors of human trafficking, and guidelines for primary care providers responding to suspicion or disclosures of human trafficking. It also discusses trauma-informed care, treatment and management, definition and types of female genital mutilation.
This book serves as a clinical guide to assist clinicians in prescribing psychotropic medications to address mental health conditions. It is used to assist clinicians to understand the key aspects of psychopharmacology. This is the first practical guide for novice and experienced nurse practitioners for explaining and choosing appropriate psychiatric medications. This clinical reference is ideal for students and all clinically oriented healthcare professionals since it provides concise, bulleted-style text for easy access to pertinent information. The book offers readers a broad understanding of the key aspects of psychotropic medications used in general psychiatry and primary-care settings and includes strategies to ease medication decision-making and evidence-based best practices to select and manage psychotropic medications. It is organized into two parts. Part I begins with an overview of general pharmacological principles and a brief overview of neurotransmitters, and covers the rationale for medication use and the risks and benefits of the major classes of psychotropic medications. Part II includes medications across drug classes that are divided by age population and includes practice management strategies, safety considerations, drug interactions, identification of side effects and adverse reactions, basic laboratory test recommendations, treatment options, and self-management strategies. The book ends with important concepts for patient and/or caregiver education and advocacy. It is intended for clinical healthcare providers, including physicians, nurses,
APRNs, and other healthcare clinicians who need a practice guide, test review, or clinical resource guide that is easy to access and use.
As humans navigate the different ages of life, they pass through different stages of development. Mental health professionals rely on various theories, treatment modalities, and ongoing research to inform their best practice; this book supports the reader to do so in a culturally responsive, humble, self-reflective way, in order that the clients will be ethically and effectively served across the lifespan. It is organized in a way that makes it interesting, entertaining, and relevant. The book is organized in two parts. Part one uses three chapters to provide an overview of lifespan development, theories of human and lifespan development, and theories of intersectionality and identity development. These chapters provide the foundation from which to explore relevant developmental concepts as they apply to people at various ages and stages of development. Part two cover different ages and stages of development. It presents each age and stage in a two-chapter sequence. The first chapter in each sequence will introduce a case study of a client belonging to a particular age group. The second chapter in each age and stage will anchor specific theories, models, and presents clinical interventions to working with the identified case. New and relevant research will be included to further contextualize the application of the theory. The book inspires the lifelong learners as scientist-practitioners, with ongoing openness to revising what one “know”, even as one become more clear about what appears to be self-evident.