İncinebilir Bireylerde İhmal Edilen Bir Sağlık Hizmeti: Prekonsepsiyonel Bakıma Multidisipliner Holistik Yaklaşım

Year 2021, Volume: 15 Issue: 3, 622 - 632, 10.09.2021

Dilek Bilgiç Mükerrem Başli Melih Başoğlu Merlinda Aluş Tokat Figen Yanık

https://doi.org/10.21763/tjfmpc.899903

Abstract

Kadın sağlığı ve gebelik süreci ile doğrudan ilişkili olan prekonsepsiyonel bakımın, yakın zamanda gebelik planlayan çiftler için öncelikli olmakla birlikte üreme çağındaki tüm bireylere ulaştırılması önerilmektedir. İncinebilir bireyler prekonsepsiyonel bakım kapsamında ihmal edilmemesi gereken önemli bir grup olarak karşımıza çıkmaktadır. İncinebilir bireyler birçok açıdan toplum geneline göre daha fazla risk taşımaktadır. Bu bireyler çeşitli nedenlerden dolayı sağlık bakımına ve prekonsepsiyonel bakıma yeterince ulaşamamaktadır. İncinebilir bireylere de prekonsepsiyonel bakımın ulaştırılması, gelecek nesillerin daha sağlıklı bireylerden oluşmasına katkı sağlayabilir. Sağlık profesyonelleri, incinebilir bireylerin sağlığını geliştirme sürecinde yaşanan sorunların farkında olmalı, kültürel farklılıkları dikkate almalı, ön yargılarından uzak olmalıdır. İncinebilir bireylerin de üreme sağlığı ihtiyaçları olduğu, sağlıklı bir gebelik yaşayabilmek için sağlık bakımına ihtiyaçları olduğu unutulmamalıdır. Bu derlemede incinebilir bireylerde prekonsepsiyonel bakımın önemi ve multidisipliner holistik yaklaşımın literatür doğrultusunda incelenmesi amaçlanmıştır. Derleme kapsamında engelli, göçmen, madde kullanımı olan, Human Immunodeficiency Virus (HIV) enfekte olan ve lezbiyen, biseksüel ve transseksüel (LBT) bireylere yönelik prekonsepsiyonel bakımdan bahsedilecektir.

Keywords

incinebilir gruplar, prekonsepsiyonel bakım, multidisipliner, holistik bakım, hemşirelik

A Healthcare Service That is Neglected in Vulnerable Individuals: Multidisciplinary Holistic Approach to Preconception Care

Abstract

Preconception care, which is directly related to women's health and pregnancy process, is a priority for couples who are planning pregnancy in the near future, but it is recommended to reach all individuals of reproductive age. Vulnerable individuals also emerge as an important group that should not be neglected within the scope of preconception care. Vulnerable individuals carry more risks than the general population in many respects. These individuals can not access health care and preconception care adequately due to various reasons. Providing preconception care to vulnerable individuals may contribute to the formation of healthier individuals for future generations. Health professionals should be aware of the problems experienced in the process of improving the health of vulnerable individuals, take into account cultural differences and be free from prejudices. It should not be forgotten that vulnerable individuals also have reproductive health needs and need health care in order to have a healthy pregnancy. In this review, it is aimed to investigate the importance of preconception care and multidisciplinary holistic approach in vulnerable individuals in line with the literature. Within the scope of the review, preconception care for disabled, immigrant, substance user, Human Immunodeficiency Virus (HIV) infected and lesbian, bisexual and transsexual (LBT) individuals will be discussed.

Keywords

vulnerable groups, preconception care, multidisiplinary, holistic care, nursing

References

• 1. WHO, World Health Organization. ''Meeting to develop a global consensus on preconception care to reduce maternal and childhood mortality and morbidity'', 2013. https://apps.who.int/iris/handle/10665/78067 (Erişim Tarihi: 03.01.2021)
• 2. Mechanic D, Tanner J. Vulnerable people, groups, and populations: societal view. Health Aff (Millwood), 2007; 26(5): 1220-1230.
• 3. Directive 2013/33/EU of the European Parliament and of the Council of 26 June 2013 laying down standards for the reception of applicants for international protection OJL 180, 29.6.2013, p. 96–116 Special edition in Croatian: Chapter 19 Volume: 137 – 157.
• 4. Tezel A. Toplumda risk grupları (incinebilir gruplar). https://acikders.ankara.edu.tr (Erişim Tarihi: 27.12.2020)
• 5. McEvoy L, Duffy A. Holistic practice-a concept analysis. Nurse Education in Practice 2008; 8:412-419.
• 6. Korkut Bayındır S. Biçer S. Holistik hemşirelik bakımı. İzmir Kâtip Çelebi Üniversitesi Sağlık Bilimleri Fakültesi Dergisi 2019; 4(1): 25-29
• 7. Finocchario-Kessler S, Bastos FI, Malta M, Anderson J, Goggin K, Sweat M, et al. Discussing childbearing with HIV-infected women of reproductive age in clinical care: a comparison of Brazil and the US. AIDS Behav 2012; 16 (1): 99-107.
• 8. Finocchario-Kessler S, Dariotis JK, Sweat MD, Trent ME, Keller JM, Hafeez Q, et al. Do HIV-infected women want to discuss reproductive plans with providers, and are those conversations occurring? AIDS Patient Care STDS. 2010; 24 (5): 317-323.
• 9. Mitra M, Clements KM, Zhang J, Smith LD. Disparities in adverse preconception risk factors between women with and without disabilities. Matern Child Health J 2016; 20 (3): 507–515.
• 10. Nilsen RM, Daltveit AK, Iversen MM, Sandberg MG, Schytt E, Small R, et al. Preconception folic acid supplement use in immigrant women (1999-2016). Nutrients 2019; 11 (10): 2300.
• 11. Lang AY, Barlett R, Robinson T, Boyle JA. Perspectives on preconception health among migrant women in Australia: a qualitative study. Women and Birth 2020; 33 (4): 334-342.
• 12. 5378 sayılı Engelliler Kanunu. https://www.mevzuat.gov.tr/MevzuatMetin/1.5.5378.pdf
• 13. Signore C, Spong CY, Krotoski D, Shinowara NL, Blackwell SC. Pregnancy in women with physical disabilities. Obstetrics & Gynecology 2011; 117 (4): 935.
• 14. T.C. Aile, Çalışma ve Sosyal Hizmetler Bakanlığı, Engelli ve Yaşlı Hizmetleri Genel Müdürlüğü, Engelli ve yaşlı istatistik bülteni, 2020. Erişim Tarihi: 22.01.2021 https://www.ailevecalisma.gov.tr/media/42250/istatistik-bulteni-2020-mart.pdf
• 15. Şentürk Erenel A, Uzun Aksoy M. İncinebilir bir grup; engelli kadınlar ve cinsellik. Turkiye Klinikleri J Gyneacol Obst 2018; 4 (1): 27-31.
• 16. Ruhl C, Moran B. The clinical content of preconception care: preconception care for special populations. American Journal of Obstetrics & Gynecology 2008; 199(6 Suppl 2): 384-388.
• 17. Sumilo D, Kurinczuk JJ, Redshaw ME, Gray R. Prevalence and impact of disability in women who had recently given birth in the UK. BMC Pregnancy Childbirth 2012; 12:31.
• 18. Iezzoni LI, Yu J, Wint AJ, Smeltzer SC, Ecker JL. General health, health conditions, and current pregnancy among U.S. women with and without chronic physical disabilities. Disabil Health J 2014; 7 (2): 181–188.
• 19. Thierry JM. The Importance of preconception care for women with disabilities. Matern Child Health J 2006; 10: 175–176.
• 20. Mitra M, Parish SL, Clements KM, Cui X, Diop H. Pregnancy outcomes among women with intellectual and developmental disabilities. American Journal of Preventive Medicine 2015;48 (3): 300-308.
• 21. Güngör İ. (2017). Engelli kadınlarda üreme sağlığı. İçinde Beji NK (editör). Kadın Sağlığı ve Hastalıkları. İstanbul: Nobel Tıp Kitapevleri. s.171-201.
• 22. United Nations. International migration report 2015. Department of Social and Economic Affairs Population Division, New York, 2016, s1-s22.
• 23. Başli M, Bekar M, Civelek İ. Kültürlerarası hemşirelikte kullanılan modeller ve ‘‘kültürel yeterlilik süreci modeli’’ni anlamak. Necmettin Erbakan Üniversitesi Sağlık Bilimleri Dergisi 2018; 1(1).
• 24. Göç İdaresi Genel Müdürlüğü. Türkiye göç raporu 2016. T.C. İçişleri Bakanlığı Göç İdaresi Genel Müdürlüğü Yayınları, Ankara, 2017, s29-s84.
• 25. Türk Kızılayı, Göç ve Mülteci Hizmetleri Müdürlüğü. 2017 yılı göç istatistik raporu. Türk Kızılayı Genel Müdürlüğü, Ankara, 2017, s1-s21.
• 26. Kurtuldu K, Şahin E, Göçün kadın yaşamı ve sağlığı üzerine etkileri, Ordu Üniversitesi Hemşirelik Çalışmaları Dergisi, Aralık 2018; 1(1):37-46
• 27. Tortumluoğlu G. Transkültürel hemşirelik ve kültürel bakım modeli örnekleri. C.Ü.Hemşirelik Yüksekokulu Dergisi 2004; 8 (2): 47-57.
• 28. Center for Disease Control (CDC). HIV surveillance reports 2018. Erişim Adresi: https://www.cdc.gov/hiv/pdf/library/reports/surveillance/cdc-hiv-surveillance-report-2018-updated-vol-31.pdf (Erişim Tarihi: 16.11.2020)
• 29. Bhatt SJ, Douglas N. Undetectable equals untransmittable (U=U): implications for preconception counseling for human immunodeficiency virus serodiscordant couples. American Journal of Obstetrics & Gynecology 2020; 222 (1): 53.e1-53.e4.
• 30. Loutfy MR, Blitz S, Zang Y, Hart TA, Walmsley SL, Smaill FM, et al. Self-reported preconception care of hıv-positive women of reproductive potential: a retrospective study. Journal of the International Association of Providers of AIDS Care 2014; 13 (5): 424–433.
• 31. Lampe MA. Human immunodeficiency virus-1 and preconception care. Matern Child Health J 2006; 10: 193–195.
• 32. Aaron E, Criniti SM. Preconception health care for HIV-infected women. International AIDS Society USA Topics in HIV Medicine 2007; 15(4): 137-141.
• 33. Thompson MA, Horberg MA, Agwu AL, Colasanti JA, Jain MK, Short WR, et al. Primary care guidance for persons with human immunodeficiency virus: 2020 update by the HIV Medicine Association of the Infectious Diseases Society of America. Clinical Infectious Diseases 2020, XX.
• 34. A Working Group of the Office of AIDS Research Advisory Council (OARAC). Panel on treatment of pregnant women with hıv ınfection and prevention of perinatal transmission. recommendations for use of antiretroviral drugs in transmission in the United States- April 14, 2020. Available at: http://aidsinfo.nih.gov/contentfiles/lvguidelines/ PerinatalGL.pdf
• 35. Floyd LR, Jack BW, Cefalo R, Atrash H, Mahoney J, Herron A, et al. The clinical content of preconception care: alcohol, tobacco, and illicit drug exposures. American Journal of Obstetrics & Gynecology 2008; 199(6 Suppl 2): 333-339.
• 36. Lassi ZS, Imam AM, Dean SV, Bhutta ZA. Preconception care: caffeine, smoking, alcohol, drugs and other environmental chemical/radiation exposure. Reproductive Health 2014; 11 (Suppl 3): 6
• 37. Ögel K. Sigara, alkol ve madde kullanım bozuklukları: tanı, tedavi ve önleme. Yeniden Yayınları. İstanbul, 2010, s3-s61.
• 38. Witt WP, Mandell KC, Wisk LE, Cheng ER, Chatterjee D, Wakeel F, et al. Infant birthweight in the US: the role of preconception stressful life events and substance use. Arch Womens Ment Health 2016; 19 (3): 529–542.
• 39. Bushe-Ribero S, Romero IL. Lesbian pregnancy: care and considerations. Seminars in Reproductive Medicine 2017; 35 (5): 420-425.
• 40. American College of Obstetricinas and Gyneocologists (ACOG). Prepregnancy counselling-ACOG Committee Opinion. American Society of Reproductive Medicine 2019; 133 (1): 78-89.
• 41. Bilgiç D, Hotun Şahin N. Lezbiyenlerde üreme sağlığı. Turkiye Klinikleri J Health Sci 2017; 2(1): 30-39.
• 42. Cipres D, Seidman D, Cloniger C, Nova C, O’Shea A, Obedin-Maliver J. Contraceptive use and pregnancy intentions among transgender men presenting to a clinic for sex workers and their families in San Francisco. Contraception 2017; 95 (2): 186-189.
• 43. Peel E. Pregnancy loss in lesbian and bisexual women: an online survey of experiences. Human Reproduction 2010; 26 (3): 721–727.
• 44. Everett BG, Kominlarek MA, Mollborn S, Adkins DE, Hughes TL. Sexual orientation disparities in pregnancy and infant outcomes, Matern Child Health J. 2019; 23(1): 72-81.
• 45. Gonzalez-Comadran M, Avila JU, Tascon AS, Jimenez R, Sola I, Brassesco M, et al.. The impact of donor insemination on the risk of preeclampsia: a systematic review and meta-analysis, European Journal of Obstetrics & Gynecoloy and Reproductive Biology 2014; 182: 160-166
• 46. Tracy JK, Understanding and reducing risks via ınfection in LBT women, In: Boehmer U, Elk R (Editors), Cancer and the LGBT Community Unique Perspectives from Risk to Survivorship, Switzerland, Springer International Publishing 2015; 23-36.
• 47. Marrazzo JM, Gorgos LM. Emerging sexual health issues among women who have sex with women. Curr Infect Dis Rep 2012;14(2): 204–211.
• 48. Fredriksen-Goldsen KI, Kim HJ, Barkan SE, Balsam KF, Mincer SL. Disparities in health-related quality of life: a comparison of lesbians and bisexual women. Am J Public Health. 2010; 100 (11): 2255–2261.
• 49. Trocki KF, Drabble LA, Midanik LT, Tobacco, marijuana, and sensation seeking: comparisons across gay, lesbian, bisexual, and heterosexual groups. Psychology of Addictive Behaviors. 2009; 23(4): 620-631.
• 50. McNair R, The ALICE study: “alcohol and lesbian/bisexual women: ınsights into culture and emotions”, The Department of General Practice, The University of Melbourne, Beyondblue, 2014 https://www.glhv.org.au Erişim Tarihi: 23.04.2020
• 51. Steele LS, Stratmann H. Counseling lesbian patients about getting pregnant. Canadian Family Physician 2006; 52: 605-611.