Women’s Cultural Health Problems
Consider the need to perform a vaginal examination on a woman who practices Muslim religion. What should you consider? How would you car for Hispanic with sexually transmitted infection? Finally, an adolescent African American female presents with a grey white discharge that has a positive whiff test. What is your treatment plan?
Vaginal Examination on Muslim Women
Healthcare providers should have ample knowledge and an in-depth understanding of the beliefs and backgrounds of their patients to offer culturally sensitive care. The religion and culture of Muslims can considerably influence their perceptions about medical care. A growing number of peer reviewed journals acknowledge the impact of culture and religion on healthcare utilization, sexual and productive behavior. It is presently hypothesized that some religious influences including Islam can partially elucidate differences in health outcomes of s health (Arousell, & Carlbom, 2016). The delivery of high-quality care to Muslim patients necessitates an in-depth understanding of the variances in spiritual and cultural ideals.
Several factors need to be considered when performing a vaginal examination of women who practice Islam. They include ideas of modesty, touch restriction, privacy concerns, religious implications, influence of traditional medicine and perspectives on health, family, illness, unacceptable medicine. During a vaginal exam, it is appropriate to have female healthcare professionals. If a male physician performs the vaginal exam, the rule of thumb is to notify the female patient that her apparel should be removed for the exam, but will be dressed up instantly. This reduces exposure and notifies her the rationale for the removal of attire. Also, physical and eye contact should be minimized between the male healthcare professional and female patient. The male clinician might have to communicate through the spouse since the patient is female. In most scenarios, it is advisable to have a third person, preferably female, to comfort the patient in the examination room. Understanding these Islamic beliefs will aid the healthcare professional in the delivery of culturally competent healthcare.
Hispanic Female: Sexually Transmitted Infection
One of Healthy People 2020 goals is promoting healthy behavior, strengthening capacity in the local community, and increasing access to high quality care services to prevent STI and other related complications. One of the social, behavioral factors that have an impact on spreading STDs is the ethnic and racial disparities as African Americans, Hispanics, and American Native populations tend to have a higher rate of STDs, in comparison with whites. Prevention studies accentuate tailoring health interventions aimed at addressing the needs, cultural beliefs, norms, and values of explicit target populations. There are some critical considerations in delivering healthcare for a Hispanic female with a sexually transmitted infection. Cultural beliefs have an effect on communication, prevention strategies, attitude concerning contraception, and fidelity (Gindi, et al., 2010). Another cultural orientation is most patients are less open to discussions about sexuality, which discourages safe sex practices amongst Hispanics (CDC, 2014). For instance, Hispanic teenagers have a lesser likelihood than teenagers of other races for reporting consistent use of condoms. Moreover, the Hispanic customs recommend a submissive role for women and dominant role for the men. They explain why females are cognizant of their risks of STIs but are reluctant to demand safe sex as they fear physical and emotional abuse and maintain financial sustenance. Thus, an understanding of the diverging and shared values and cultural beliefs amongst Hispanics is critical in developing strategies and interventions for the reduction of sexual risks for Hispanic women.
African American Female: Bacterial Vaginosis
Bacterial vaginosis is more prevalent among African American women, who are three times the possibility of experiencing bacterial vaginosis than white women (Coleman & Gaydos, 2018). Despite the prevalence and accessibility of treatment, treatment failure and recurrence are prevalent among African American women. The 2015, the CDC Prevention STD guidelines recommends a treatment plan for bacterial vaginosis. This consists of oral metronidazole, 500 milligrams twice every day for one week, metronidazole, 0.750 percent gel intravaginally at night for five days, or clindamycin, 2 percent intravaginally at night for one week. The Center for Disease Control and Prevention endorses nucleic acid amplification tests to diagnose trichomoniasis in high-risk women. Also, sexual activity is a risk factor for bacterial vaginosis, including multiple sexual partners, new sexual partners, female sexual partners, and unprotected sexual intercourse. Past research has assessed the benefits of the simultaneous treating of sexual partners of the patient. The trichomoniasis can be treated with either oral metronidazole or tinidazole, and sex partners should be treated (Jones, 2019). Decreasing the amount of partners, the use of condoms and ample cleaning of mutual erotic accessories can help prevent the BV recurrence. Finally, abstinence and vaginal cleanliness practices, like douching, are suggested as techniques to prevent recurrence of BV.
References
Arousell, J., & Carlbom, A. (April 01, 2016). Culture and religious beliefs in relation to reproductive health. Best Practice & Research Clinical Obstetrics & Gynaecology, 32, 77-87. https://doi.org/10.1016/j.bpobgyn.2015.08.011
Attum B., Hafiz S., Malik A., & Shamoon, Z. (2020) Cultural Competence in the Care of Muslim Patients and Their Families. Stat Pearls. Treasure Island (FL): StatPearls Publishing. Available from: https://www.ncbi.nlm.nih.gov/books/NBK499933/
Bickley, L. S., Szilagyi, P. G., In Hoffman, R. M., & Bates, B. (2017). Bates’ pocket guide to physical examination and history taking. Philadelphia: Lippincott Williams & Wilkins.
Centers for Disease Control and Prevention (2014) Health Disparities in HIV/AIDS, Viral Hepatitis, STDs, and TB. National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention, https://www.cdc.gov/nchhstp/healthdisparities/hispanics.html
Coleman, J. S., & Gaydos, C. A. (September 01, 2018). Molecular diagnosis of bacterial vaginosis: An update. Journal of Clinical Microbiology, 56, 9.)
Dunphy, L. M. H., In Winland-Brown, J. E., In Porter, B. O., & In Thomas, D. J. (2019). Primary care: The art and science of advanced practice nursing – an interprofessional approach. Philadelphia, PA: F.A. Davis Company.
Gindi, R. M., Erbelding, E. J., & Page, K. R. (2010). Sexually transmitted infection prevalence and behavioral risk factors among Latino and non-Latino patients attending the Baltimore City STD clinics. Sexually transmitted diseases, 37(3), 191–196. https://doi.org/10.1097/OLQ.0b013e3181bf55a0
Healthy People. (2010) Healthy 2020 Topics and Objectives: Sexually Transmitted Diseases
U.S. Department of Health and Human Services, Washington. Retrieved from https://www.healthypeople.gov/2020/topics-objectives/topic/sexually-transmitted-diseases#nine
Jones, A. (June 01, 2019). Bacterial Vaginosis: A Review of Treatment, Recurrence, and Disparities. The Journal for Nurse Practitioners, 15, 6, 420-423.
Paladine, H. L., & Desai, U. A. (January 01, 2018). Vaginitis: Diagnosis and Treatment. American Family Physician, 97, 5, 321-321.
Seller, R. H., & Symons, A. B. (2017). Differential Diagnosis of Common Complaints. Philadelphia, Pa, Elsevier/Saunders.