Ortopedik Engelli Kadınlarda Üreme Sağlığı Sorunları ve Çözüm Yolları

Yıl 2021, Cilt: 3 Sayı: 2, 134 - 144, 19.08.2021

Dilek Kaloğlu Binici

https://doi.org/10.46413/boneyusbad.932845

Öz

Ortopedik engelli kadınların üreme sağlığı ihtiyaçlarının ve haklarının bilinmesi, sunulması gereken üreme sağlığı hizmetlerine anahtardır. Fakat ortopedik engelli kadınların üreme sağlığı ihtiyaçları, sağlık profesyonelleri, aile üyeleri, bakıcıları ve araştırmacılar tarafından gereken ilgiyi görmemektedir. Bu durum onların aile planlaması, toplumsal cinsiyete dayalı şiddet, cinsel sağlık, jinekolojik muayene, gebelik, doğum ve doğum sonrası süreçlerde sorunlar yaşamasına neden olmaktadır. Bu sorunlara yönelik ortopedik engelli kadına dair sağlık, şiddet ve temel bilgilerini içeren ulusal ve uluslararası düzeyde veri tabanı oluşturulması önerilmektedir. Hizmet veren sağlık profesyonellerine de ortopedik engellilik, üreme sağlığı, şiddet, istismar, travma, etik, empati, sempati, iletişim ve değerler gibi konularda teknolojinin de desteğiyle gerekli eğitimler verilmelidir. Bu derlemenin cinsiyete ve engelliliğe özgü bir çalışma olarak literatüre katkı sağlayacağı düşünülmektedir.

Anahtar Kelimeler

Cinsel sağlık, Çözüm, Kadın, Ortopedik engel, Üreme sağlığı

Reproductive Health Problems and Solutions in Orthopedically Disabled Women

Öz

Knowing the reproductive health needs and rights of orthopedically disabled women is the key to reproductive health services that need to be provided. However, the reproductive health needs of orthopedically disabled women do not receive the necessary attention from health professionals, family members, caregivers and researchers. This situation causes their to experience problems in family planning, gender-based violence, sexual health, gynecological examination, pregnancy, birth and postpartum processes. It is recommended to create a national and international database containing health, violence and basic information on orthopedically disabled women for these problems. Necessary training should be given to healthcare professionals, with the support of technology, on issues such as orthopedic disability, reproductive health, violence, abuse, trauma, ethics, empathy, sympathy, communication and values. It is thought that this review will contribute to the literature as a gender and disability specific study.

Anahtar Kelimeler

Sexual health, Solution, Woman, Orthopedic disability, Reproductive health.

Kaynakça

• Abdul Karimu, A.T.F. (2018). Disabled persons in ghanaian health strategies: Reflections on the 2016 adolescent reproductive health policy. Reproductive health matters 26(54), 20-24. doi:10.1080/09688080.2018.1527158
• AÇSHB (2020). Engelli ve yaşlı istatistik bülteni. Erişim tarihi 02.02.2021, https://ailevecalisma.gov.tr/media/37313/istatistik-bulteni-ocak-2020-1.pdf
• Agaronnik, N., Campbell, E. G., Ressalam, J., Iezzoni, L.I. (2019). Exploring issues relating to disability cultural competence among practicing physicians. Disability and health journal 12 (3), 403-410. doi:10.1016/j.dhjo.2019.01.010.
• Akwasi, A. G., Naomi, G., Reindolf, A., Prince, P., Enoch, A., Emmanuel, A., ... Tsiboe, A. K. (2020). Knowledge on and attitude towards sexually transmitted infections: A qualitative study of people with physical disabilities in a peri-urban district of Ghana. Cogent Medicine, 7 (1736249), 1-10.
• Altuntaş, Nezahat ve Doğanay, Gülmelek (2016). Trabzon’da engelli kadın profili. KTÜ Sosyal Bilimler Enstitüsü Sosyal Bilimler Dergisi, 6 (12), 315-339.
• Aslan, M., Şeker, S. (2013). Engellilere yönelik toplumsal algı ve dışlanmışlık (Siirt Örneği). Sosyal Haklar Uluslararası Sempozyumu, 449-463.
• Ayiga, N., Kigozi, S. (2016). Access to and uptake of contraception by women with disabilities. Journal of Social Sciences, 12 (4), 171-181. doi:10.3844/jssp.2016.171.181.
• Bae, J. (2006). The impact of marriage on unmet needs of korean women with physical disabilities: Reanalyzing the Results of a Regional Survey of Cheonan-Si, South Korea. (The Master of Science Degree). Southern Illinois University at Carbondale.
• Bayrak Çebitürk, N. (2019). Ebe ve Hemşirelerin Engelli Kadınların Gebelik, Doğum ve Doğum Sonrası Dönemlerine Yönelik Düşünce ve Deneyimleri. (Yüksek Lisans Tezi). Aydın Adnan Menderes Üniversitesi Sağlık Bilimleri Enstitüsü, Aydın.
• Beyene, G. A., Munea, A. M., Fekadu, G. A. (2019). Modern contraceptive use and associated factors among women with disabilities in Gondar City, Amhara Region, North West Ethiopia: A cross sectional study". African journal of reproductive health, 23 (2), 101-109. doi:10.29063/ajrh2019/v23i2.10
• Bremer, K., Cockburn, L., Ruth, A. (2010). Reproductive health experiences among women with physical disabilities in the Northwest Region of Cameroon". International journal of gynecology & obstetrics, 108 (3), 211-213.
• Buz, S., Karabulut, A. (2015). Ortopedik engelli kadınlar: toplumsal cinsiyet çerçevesinde bir çalışma. Igdır university journal of social sciences (7).
• Carrillo González, G. M., Sánchez Herrera, B., & Chaparro Díaz, L. (2013). Chronic disease and sexuality. Investigación Y Educación En Enfermería, 31 (2), 295-304.
• Egelioglu Cetisli, N., Isık, G., Ardahan Akgul, E., Topaloglu Oren, D. E., Ozguven Oztornacı, B. ve Yıldırım Sarı, H. (2018). Experiences of infant and child care of mothers with disabilities in Turkey: A qualitative study. African Journal of Reproductive Health, 22 (4), 81-91.
• Chakravarty, E. F., Nelson, L., Krishnan, E. (2006). Obstetric Hospitalizations in the United States for women with systemic Lupus Erythematosus and Rheumatoid Arthritis. Arthritis & rheumatism, 54 (3), 899-907. doi:10.1002/art.21663
• Clements, K. M., Mitra, M., Zhang, J., Iezzoni, L. I. (2016). Pregnancy characteristics and outcomes among women at risk for disability from health conditions identified in medical claims. Women's health issues, 26 (5), 504-510.
• Cowley, K. C. (2005). Psychogenic and pharmacologic induction of the let-down reflex can facilitate breastfeeding by tetraplegic women: A report of 3 cases. Archives of physical medicine and rehabilitation, 86 (6), 1261-1264. doi:10.1016/j.apmr.2004.10.039
• Cumurcu, B. E., Karlıdağ, R., Han Almış, B. (2012). Fiziksel engellilerde cinsellik. Psikiyatride güncel yaklaşımlar, 4(1): 84-98. doi:10.5455/cap.20120406
• Çitil Canbay, F. (2020). Babalara Verilen Web Tabanli Eğitimin Doğum Sonrasi Fonksiyonel Durumlarina Etkisi. Doktora Tezi. Aydın Aydın Adnan Menderes Üniversitesi Sağlık Bilimleri Enstitüsü Ebelik Doktora Programı, Aydın.
• Dean, L., Tolhurst, R., Khanna, R., Jehan, K. (2017). You’re disabled, why did you have sex in the first place?’An intersectional analysis of experiences of disabled women with regard to their sexual and reproductive health and rights in Gujarat State, India. Global Health Action, 10 (1290316), 1-9. doi:10.1080/16549716.2017.1290316
• DSÖ, Dünya Sağlik Örgütü ve Dünya Bankası, (2011). Dünya Engellilik Raporu. Ankara: Anıl Group Matbaa.
• Duman, M. (2018). Engelli Bireylerin Üreme Sağlığı Sorunları. B. Erci ve S. Timur Taşhan (Eds.), Her yönüyle engellilik. Elazığ: Anadolu Nobel Tıp Kitabevleri Tic.Ltd.Şti.
• Durevall, D., Lindskog, A. (2015). Intimate partner violence and hiv in ten Sub-Saharan African Countries: What do the demographic and health surveys tell us?. The Lancet global health 3 (1), e34-e43. doi:10.1016/S2214-109X(14)70343-2
• Engkad, Engelli Kadın Derneği (2014). Türkiye'de Engelli Kadınlara Yönelik Şiddet Raporu 2013-2014. Erişim tarihi 2.12.2020, https://www.siginaksizbirdunya.org/images/files/turkiyede-engelli-kadina-yonelik-siddet-raporu-2013-2014.pdf
• Esatbeyoğlu, F., Güven Karahan, B. (2014). Engelli bireylerin fiziksel aktiviteye katılımlarının önündeki engeller. Hacettepe Spor Bilimleri Dergisi, 25, 43-55.
• Foundation, Liliane (2019). Sexual and reproductive health and rights. Erişim tarihi 04.11.2020 https://www.lilianefonds.org/uploads/media/5d91c46cd43c0/sexual-reproductive-health-rights.pdf?token=/uploads/media/5d91c46cd43c0/sexual-reproductive-health-rights.pdf
• Ganle, J. K., Baatiema, L., Quansah, R., Danso-Appiah, A. (2020). Barriers facing persons with disability in accessing sexual and reproductive health services in Sub-Saharan Africa: A systematic review. Available at SSRN 3544815, 31. doi:10.2139/ssrn.3544815.
• Grabois, E. (2001). Guide to getting reproductive health care services for women with disabilities under the Americans with disabilities act of 1990. Sexuality and disability, 19 (3), 191-208.
• Gül, S., Koruk, F. (2019). Fertility problem characteristics experienced by women with physical disability and distressing factors. Sexuality and disability, 37 (1), 63-75.
• Gümüş, S, S., Altınsoy, M. (2015). Hatay okullarında engellilerin cinsel eğitimi durum değerlendirmesi. Adnan Menderes Üniversitesi Eğitim Fakültesi Eğitim Bilimleri Dergisi, 6 (2), 63-72.
• Güngör, İ. (2016). Engelli Kadınlarda Üreme Sağlığı.. N. Kızılkaya Beji (Ed). Hemşire ve Ebelere Yönelik Kadın Sağlığı ve Hastalıkları 2. Baskı.(pp. 171-201). İstanbul: Nobel Tıp Kitabevleri Tic. Ltd. Şti.
• Gürel, R., Yılmaz, D. V. (2018). examining the attitude towards family planning of women with disability in Turkey. Sexuality and disability, 36 (3), 265-275. doi:10.1007/s11195-018-9518-z
• Hacettepe Üniversitesi Nüfus Etütleri Enstitüsü. (2019). 2018 Türkiye Nüfus ve Sağlık Araştırması Hacettepe Üniversitesi Nüfus Etütleri Enstitüsü, T.C. Cumhurbaşkanlığı Strateji ve Bütçe Başkanlığı ve TÜBİTAK, Ankara, Türkiye.
• Haynes, R. M., Boulet, S. L., Fox, M. H., Carroll, D. D., Courtney-Long, E., Warner, L. (2018). Contraceptive use at last intercourse among reproductive-aged women with disabilities: An analysis of population-based data from seven states. Contraception, 97 (6), 538-545. doi:10.1016/j.contraception.2017.12.008
• Hayward, K., Chen, A. Y., Forbes, E., Byrne, R., Greenberg, M. B., Fowler, E. G. (2017). Reproductive healthcare experiences of women with cerebral palsy. Disability and Health Journal, 10 (3), 413-418.
• Hess, M. J., & Hough, S. (2012). Impact of spinal cord injury on sexuality: Broad-based clinical practice intervention and practical application. The Journal of Spinal Cord Medicine, 35 (4), 211-218. doi:10.1179/2045772312Y.0000000025
• Holdsworth, E., Trifonova, V., Tanton, C., Kuper, H., Datta, J., Macdowall, W., Mercer, C. H. (2018). Sexual behaviours and sexual health outcomes among young adults with limiting disabilities: Findings from third british national survey of sexual attitudes and lifestyles (Natsal-3)". BMJ open, 8 (7), 1-12. doi:10.1136
• Hunt, X., Carew, M. T., Braathen, S. H., Swartz, L., Chiwaula, M., Rohleder, P. (2017). The sexual and reproductive rights and benefit derived from sexual and reproductive health services of people with physical disabilities in South Africa: Beliefs of non-disabled people. Reproductive Health Matters, 25 (50), 66-79. doi:10.1080/09688080.2017.1332949
• Iezzoni, L. I., Wint, A. J., Smeltzer, S. C., Ecker, J. L. (2015). How did that happen? Public responses to women with mobility disability during pregnancy. Disability and Health Journal, 8 (3), 380-387. doi:10.1016/j.dhjo.2015.02.002
• Ji, Y., Rana, C., Shi, C., Zhong, Y. (2019). Self-esteem mediates the relationships between social support, subjective well-being, and perceived discrimination in Chinese people with physical disability. Frontiers in Psychology, 10.
• Kapan, B. K., Boyacıoğlu, N. E. (2019). Engelli gebelerin karşılaştıkları zorluklar ve ebelik yaklaşımı. Ankara Sağlık Bilimleri Dergisi (ASBD),64-71.
• Karataş, K., Gökçearslan Çifci, E. (2010). Türkiye’de engelli kadın olmak: Deneyimler ve çözüm önerileri. Uluslararası Sosyal Araştırmalar Dergisi, 3 (13), 147-153.
• Kokanalı, D., Karaca, M., Özel, Ş., Üstün, Y. E. (2018). Engelli kadınlarda üreme sağlığı. Jinekoloji Obstetrik ve Neonatoloji Tıp Dergisi, 15 (1), 28-30.
• Lee, E. K.O., Oh, H. (2005). A wise wife and good mother: Reproductive Health and maternity among women with disability in South Korea. Sexuality and Disability, 23 (3), 121-144. doi:10.1007/s11195-005-6728-y.
• McCabe, J., Holmes, D. (2014). Nursing, sexual health and youth with disabilities: A critical ethnography. Journal of Advanced Nursing, 70 (1), 77-86. doi:10.1111/jan.12167
• Mitra, M., Clements, K. M., Zhang, J., Iezzoni, L. I., Smeltzer, S. C., Long-Bellil, L. M. (2015). Maternal characteristics, pregnancy complications and adverse birth outcomes among women with disabilities. Medical Care, 53 (12), 1027.
• Mosher, W., Hughes, R. B., Bloom, T., Horton, L., Mojtabai, R., Alhusen, J. L. (2018). Contraceptive use by disability status: New National Estimates from the National Survey of family growth. Contraception, 97 (6), 552-558. doi:10.1016/j.contraception.2018.03.031
• Nosek, M. A., Hughes, R. B. (2003). Psychosocial issues of women with physical disabilities: The continuing gender debate. Rehabilitation Counseling Bulletin, 46 (4), 224-233.
• Nosek, M. A., Simmons, D. K. (2007). People with disabilities as a health disparities population: The case of sexual and reproductive health disparities. Californian Journal of Health Promotion 5 (special issue), 68-81.
• Osmaniye RAM, Rehberlik ve Araştırma Merkezi Özel Eğitim Hizmetleri Bölümü (2018). Bedensel (Fiziksel /Ortopedik) Yetersizlik. Erişim tarihi 06.05.2020, https://osmaniyeram.meb.k12.tr/meb_iys_dosyalar/80/01/396162/dosyalar/2018_07/30101411_2-_BEDENSEL_YETERSYZLYK_VE_EYYTYMLERY.pdf
• Özata, M., Karip, S. (2017). Engelli bireylerin sağlık hizmetleri kullanımında yaşadıkları sorunlar: Konya Örneği. Hacettepe Sağlık İdaresi Dergisi, 20 (4), 409-427.
• Palermo, T., Bleck, J., Peterman, A. (2014). Tip of the Iceberg: Reporting and gender-based violence in developing countries. American Journal of Epidemiology, 179 (5), 602-612. doi:10.1093/aje/kwt295
• Powell, R. M., Mitra, M., Smeltzer, S. C., Long-Bellil, L. M., Smith, L. D., Rosenthal, E., Iezzoni, L. I. (2018). Breastfeeding among women with physical disabilities in the United States. Journal of Human Lactation, 34 (2), 253-261. doi:10.1177/0890334417739836
• Ramos, A., Samso, J. (2004). Specific aspects of erectile dysfunction in spinal cord injury. International Journal of Impotence Research, 16 (2), S42-S45. doi:10.1038/sj.ijir.3901242
• Rugoho, T., Maphosa, F. (2017). Challenges Faced by women with disabilities in accessing sexual and reproductive health in Zimbabwe: The case of Chitungwiza Town. African Journal of Disability (online), 6, 1-8.
• Sabharwal, S., Sebastian, J. L., Lanouette, M. (2000). An educational intervention to teach medical students about examining disabled patients. Jama, 284 (9), 1080-1081.
• SB (2009). TC Sağlık Bakanlığı Ana Çocuk Müdürlüğü, Aile Planlaması Genel Üreme Sağlığına Giriş Katılımcı Rehberi, Ankara.
• Shandra, C. L., Hogan, D. P., Short, S. E. (2014). Planning for motherhood: fertility attitudes, desires and intentions among women with disabilities. Perspectives on Sexual and Reproductive Health, 46 (4), 203-210.
• Sonalkar, S., Chavez, V., McClusky, J., Hunter, T. A., Mollen, C. J. (2020). Gynecologic care for women with physical disabilities: A qualitative study of patients and providers. Women's Health Issues, 30(2), 136-141.
• Şenyurt Akdağ, A., Tanay Aksaç, G., Temur Şİmşekcan, N., Kara, Ö. (2016). (2016). Toplumsal cinsiyet eşitliği ve engelli kadın el Kitabı. Ankara.
• Tejeji, M. Y., Assefa, B., Kebede, T., McDowell, M., Tenaw, E. (2017). Assessment on family planning needs of people living with disabilities: Case of Addis Ababa, Ethiopia.
• Tom, S., Lezzoni, L., Grace, N. (2009). The art of medicine: Disability and the training of health professionals. Lancet, 374, 1815-1816.
• Walsh-Gallagher, D., Sinclair, M., Mc Conkey, R. (2012). The ambiguity of disabled women's experiences of pregnancy, childbirth and motherhood: A phenomenological understanding. Midwifery, 28 (2), 156-162. doi:10.1016/j.midw.2011.01.003
• Walter, L. J., Nosek, M. A., Langdon, K. (2001). Understanding of sexuality and reproductive health among women with and without physical disabilities. Sexuality and Disability, 19 (3), 167-176.
• WHO, World Health Organization (2011). World Report on Disability 2011. World Report on Disability 2011, Erişim tarihi 01.04.2021, https://bit.ly/3sXS4lh
• WHO, World Health Organization (2021). Reproductive Health., Erişim tarihi 13.06.2021, https://www.who.int/westernpacific/health-topics/reproductive-health
• Wiegerink, D. J., Stam, H. J., Ketelaar, M., Cohen-Kettenis, P. T., Roebroeck, M. E., Netherlands, T. R. G. S. W. (2012). Personal and environmental factors contributing to participation in romantic relationships and sexual activity of young adults with Cerebral Palsy. Disability and Rehabilitation, 34 (17), 1481-1487. doi:10.3109/09638288.2011.648002
• Disabled World, (2021). Disability Statistics: Information, Charts, Graphs and Tables, Erişim tarihi 28.03.2021, https://bit.ly/3sVVrsT.
• Wu, J. P., McKee, K. S., McKee, M. M., Meade, M. A., Plegue, M. A., Sen, A. (2017). Use of reversible contraceptive methods among us women with physical or sensory disabilities. Perspectives on Sexual and Reproductive Health, 49 (3): 141-147.
• Xibillé-Friedmann, D., Álvarez-Fuentes, M., Flores-Flores, G., Gudiño-Quiroz, J., Cruz-Valdez, A. (2005). percepción de la sexualidad en pacientes con enfermedades reumáticas: estudio piloto de casos y controles. Reumatología Clínica, 1 (1), 20-24. doi:10.1016/S1699-258X(05)72708-X