Variations in hysterectomy rates have been associated with assorted physician and patient characteristics, and the disproportionate rate of hysterectomies in African American women has been attributed to a higher prevalence of leiomyomas. The role of women's beliefs and attitudes toward hysterectomy and participation in decision making for medical treatment has not been explored as a source of variance. The purposes of this qualitative study were to explore these constructs in a triethnic sample of women to understand beliefs, attitudes, and decision-making preferences among underserved women; to facilitate development of a quantitative survey; and to inform development of interventions to assist women with such medical decisions. Twenty-three focus groups were conducted with 148 women from community sites and public health clinics. Thirteen self-identified lesbians participated in three groups. Analysis of audiotaped transcripts yielded four main themes: perceived outcomes of hysterectomy, perceived views of men/partners, opinions about healthcare providers, decision-making process. Across groups, the women expressed similar expectations from hysterectomy, differing only in the degree to which dimensions were emphasized. The women thought men perceived women with hysterectomy as less desirable for reasons unrelated to childbearing. Attitudes toward physicians were negative except among Hispanic women. All women expressed a strong desire to be involved in elective treatment decisions and would discuss their choice with important others. Implications for intervention development include enhancing women's skills and confidence to evaluate treatment options and to interact with physicians around treatment choices and creation of portable educational components for important others.
Scar hydration is an important factor in wound healing and can be achieved with topical petrolatum-based ointment. Topical onion gel extract was ineffective in improving scar erythema and pruritus in our patients.
Health care professionals do not always screen patients for domestic abuse. In the absence of screening, the likelihood of misdiagnoses and prescriptions contraindicated for symptoms of abuse survivors is increased. Several factors may contribute to the lack of routine and uniform screening, including a lack of educational preparedness. The qualitative findings presented here are part of a larger quantitative study investigating the skills, beliefs, and expectations about screening for domestic abuse among physicians, dentists, and nurse practitioners from a border community in southwest Texas. Practitioners requested specific information to enhance educational preparedness and improve clinical practice for their abused patients.
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