Examining the Reproductive Health Behaviors of Women with Chronic Disease

Yıl 2019, Cilt: 6 Sayı: 2, 83 - 91, 30.07.2019

Mesude Duman , Sermin Timur Taşhan Emine Kaplan Serin

Öz

Aim: This study was conducted to examine the reproductive health behaviors of women with chronic disease. Material and Methods: This descriptive study was conducted between 15 October 2016-15 October 2017 with 160 married women who applied to internal medicine outpatient clinics or were hospitalized in internal diseases clinics of a private hospital in Adıyaman and were diagnosed with at least one chronic disease. During the study period, the total number of women with chronic disease in reproductive age who was applied to the internal medicine outpatient clinics and admitted to the internal clinics was 297. In the study, no sampling was performed and all women who met the sample selection criteria and accepted the study were included in the study. The data were collected using “Participant Information Form”. Percentage, arithmetic mean and standard deviation were used in statistical analysis. The necessary permission was received from the institution where the study was conducted and ethical approval was received from the Non-interventional Clinical Studies Ethics Committee. Results: 88.1% of the women who participated in the study reported that having a disease did not affect their decision of having a child in the future, 40% of them had pregnancy after being diagnosed with the illness, 63.8% of them had shortened the duration of breastfeeding due to their disease, 13.8% of them had a perinatal loss after the diagnosis and 10% of them reported that their sexual life was affected because of their illness. In addition, it was determined that 71.9% of women currently use a modern contraceptive method and 26.5% of women who use modern methods prefer condom. Conclusion: The study results showed that having a chronic disease did not affect the desire of having children, shortening the duration of breastfeeding and the high rate of contraceptive use in women with chronic disease. It is recommended that nurses should be more susceptible to possible reproductive health problems in women with chronic diseases, consider reproductive health problems more carefully and provide the necessary additional health care. 

Anahtar Kelimeler

Chronic illness, nursing, reproductive health, woman

Kronik Hastalığı Olan Kadınların Üreme Sağlığı Davranışlarının İncelenmesi

Öz

Amaç: Araştırma kronik hastalığı olan kadınların üreme sağlığı davranışlarını incelemek amacıyla yapılmıştır.
Gereç ve Yöntem: Araştırma tanımlayıcı türdedir. 15 Ekim 2016- 15 Ekim 2017 tarihleri arasında Adıyaman’da özel bir hastanenin dâhili polikliniklerine başvuran veya dahili kliniklerinde yatan ve en az bir kronik hastalık tanısı konulmuş 160 evli kadın ile yürütülmüştür. Araştırmanın yapıldığı tarihlerde polikliniğe başvuran veya klinikte yatan, kronik bir hastalığı bulunan ve üreme çağında olan toplam kadın sayısı 297’dir. Araştırmada herhangi bir örneklem hesabına gidilmemiş olup örneklem seçim kriterlerine uyan ve araştırmaya kabul eden kadınların tamamı örnekleme alınmıştır. Verilerin toplanmasında “Katılımcı Bilgi Formu” kullanılmıştır. İstatistiksel analizde yüzdelik, aritmetik ortalama ve standart sapma kullanılmıştır. Araştırmanın yapılabilmesi için gerekli kurum izni ve etik kurul onayı alınmıştır.
Bulgular: Araştırmaya katılan kadınların %88.1’i hastalıklarının gelecekte çocuk sahibi olma kararını etkilemediğini, %40’ı hastalık tanısı konulduktan sonra gebelik geçirdiğini, %63.8’i hastalıklarından ve kullandıkları ilaçlardan dolayı emzirme sürelerinin kısaldığını, %13.8’i hastalık tanısı konulduktan sonra perinatal kayıp yaşadığını ve %10’u cinsel yaşamının hastalıktan etkilendiğini belirtmiştir. Ayrıca kadınların %71.9’unun şu an modern bir korunma yöntemi kullandığı ve modern korunma yöntemleri kullanan kadınların %26.5’inin kondomu tercih ettiği belirlenmiştir.
Sonuç: Araştırma kronik hastalığın çocuk sahibi olma düşüncesini etkilemediğini ancak, emzirme sürelerini kısalttığını göstermiştir. Kronik hastalığı olan kadınlar yüksek oranda kontraseptif kullanmaktadır. Hemşirelerin kronik hastalığa sahip kadınlarda olası üreme sağlığı sorunlarına ilişkin daha duyarlı olması, üreme sağlığı sorunlarını daha dikkatli ele alması ve gerekli ek sağlık bakımı sunması önerilmektedir.

Anahtar Kelimeler

kadın, kronik hastalık, hemşirelik, üreme sağlığı

Kaynakça

• 1. Yurdakul M, Akçınar M, Akan N. Kronik hastalığı olan doğurgan çağdaki kadın hastaların aile planlaması danışmanlık gereksinimleri. İ.Ü.F.N. Hem. Der. 2008; 62:97-110.
• 2. Beaglehole R, Epping-Jordan J, Patel V, Chopra M, Ebrahim S, Kidd M, et al. Improving the prevention and management of chronic disease in low-income and middle-income countries: A priority for primary health care. Lancet. 2008;(372):940–949.
• 3. Drake JK. The growing chronic disease burden: implications for reproductive health. Outlook. 2009; 26(1):8.
• 4. Manaf RA, Ismail IZ, Latiff LA. Contraceptive use among women with chronic medical conditions and factors associated with its non-use in Malaysia. Global Journal of Health Science. 2012; 4(5):91-99.
• 5. Reddy SM, Ramachandran A, Cabral H, Kazis L. Provision of family planning to women with cardiovascular risk factors. The Journal of the American Board of Family Medicine. 2015 Jan 1;28(1):105-114.
• 6. Nojomi M, Morrovatdar N, Davoudi F, Hosseini S. Contraceptive use by Iranian women with hypertension, diabetes or obesity. Eastern Mediterranean Health Journal. 2013; 19 (7):638-643.
• 7. Pirkle CM, de Albuquerque Sousa AC, Alvarado B, Zunzunegui MV. Early maternal age at first birth is associated with chronic diseases and poor physical performance in older age: cross-sectional analysis from the international mobility in aging study. BMC Public Health. 2014 Dec;14(1):293.
• 8. Mittal P, Dandekar A, Hessler D. Use of a modified reproductive life plan to improve awareness of preconception health in women with chronic disease. The Permanente Journal. 2014;18(2):28-32.
• 9. Ünal B, Ergör G, Horasan GD, Kalaça S, Sözmen K. Türkiye kronik hastalıklar ve risk faktörleri sıklığı çalışması. Ankara: Sağlık Bakanlığı. 2013.
• 10. Erci B. Halk sağlığı hemşireliği. 2.bs. Elazığ: Anadolu Nobel Tıp Kitapevleri; 2016.
• 11. Akın A. Aile planlamasından üreme sağlığına geçiş, Aktüel Tıp Dergisi, 2001, 6(1):4-8.
• 12. Bonnema RA, McNamara MC, Spencer AL. Contraception choices in women with underlying medical conditions. American Family Physician. 2010 Sep 15;82(6):621-628.
• 13. Chuang CH, Velott DL, Weisman CS. Exploring knowledge and attitudes related to pregnancy and preconception health in women with chronic medical conditions. Maternal and Child Health Journal. 2010 Sep 1;14(5):713-719.
• 14. Rich-Edwards JW. Reproductive health as a sentinel of chronic disease in women. Women's Health. 2009; 5(2):101-105.
• 15. Thompson D, Thomas H, Solomon J, Nashef L, Kendall S. Chronic illness, reproductive health and moral work: women's experiences of epilepsy. Chronic Illness. 2008 Mar;4(1):54-64.
• 16. Watnick S. Pregnancy and contraceptive counseling of women with chronic kidney disease and kidney transplants. Advances in Chronic Kidney Disease. 2007 Apr 1;14(2):126-131.
• 17. Aksu H, Yurtsev E. Gebelik, Diyabet ve hemşirelik bakımı. Hacettepe Üniversitesi Hemşirelik Fakültesi Dergisi. 2009; 16(3):50-58.
• 18. Chor J, Oswald L, Briller J, Cowett A, Peacock N, Harwood B. Reproductive health experiences of women with cardiovascular disease. Contraception. 2012 Nov 1;86(5):464-469.
• 19. Hanson BM, Dorais JA. Reproductive considerations in the setting of chronic viral illness. American Journal of Obstetrics & Gynecology. 2017 Jul 1;217(1):4-10.
• 20. Chor J, Rankin K, Harwood B, Handler A. Unintended pregnancy and postpartum contraceptive use in women with and without chronic medical disease who experienced a live birth. Contraception. 2011; 84:57-63.
• 21. Holing EV, Beyer CS, Brown ZA, Connell FA. Why don't women with diabetes plan their pregnancies? Diabetes Care. 1998 Jun 1;21(6):889-895.
• 22. DeNoble AE, Hall KS, Xu X, Zochowski MK, Piehl K, Dalton VK. Receipt of prescription contraception by commercially insured women with chronic medical conditions. Obstetrics and Gynecology. 2014 Jun;123(6):1213.
• 23. Millar SL, Cameron ST. Contraception in women with medical conditions. Obstetrics, Gynaecology and Reproductive Medicine. 2016 Nov 1;26(11):324-331.
• 24. Schwarz EB, Postlethwaite D, Hung YY, Lantzman E, Armstrong MA, Horberg MA. Provision of contraceptive services to women with diabetes mellitus. J Gen Intern Med. 2012; 27:196-201.
• 25. Perritt JB, Burke A, Jamshidli R, Wang J, Fox M. Contraception counseling, pregnancy intention and contraception use in women with medical problems: an analysis of data from the Maryland pregnancy risk assessment monitoring system (PRAMS). Contraception. 2013;88:263-268.
• 26. Mansour D. Implications of the growing obesity epidemic on contraception and reproductive health. Journal of Family Planning and Reproductive Health Care. 2004; 30(4):209-211.
• 27. Lewis M, Heinemann L, MacRae K, Bruppacher R, Spitzer W. The increased risk of venous thromboembolism and the use of third generation progestagens: role of bias in observational research. The transnational research group on oral contraceptives and the health of young women. Contraception. 1996;54:5-13.
• 28. Neinstein L. Contraception in women with special medical needs. Comp Ther. 1998; 24:229-250.
• 29. World Health Organization. Medical eligibility criteria for contraceptive use. 4th ed. Geneva: WHO; 2009. Available from: http://apps.who.int/rhl/guidelines/Executive_summary_guideline_WHO_medical_eligibility_criteria/en/
• 30. Dunlop AL, Jack BW, Bottalico JN, Lu MC, James A, Shellhaas CS, Hallstrom LH, Solomon BD, Feero WG, Menard MK, Prasad MR. The clinical content of preconception care: women with chronic medical conditions. American Journal of Obstetrics & Gynecology. 2008 Dec 1;199(6):310-327.
• 31. Nikolov A, Dimitrov A, Kolarov G, Todarova K, Mekhandzhiev T. Contraception in women with diabetes mellitus. Akush Ginekol. 2005; 44(5):47-52.
• 32. Cynthia H, Chuang A, Bensyl DM, Weisman CS. Contraceptiveuse by diabetic and obese women. Women’s Health Issue. 2005;15(4):167-173.
• 33. Mazaheri E, Mostafazadeh F, Karimollahi M. Pattern of contraceptive use in diabetic women. Maturitas. 2009;63(1):128-150.
• 34. Janz N. Contraception in diabetic women: an Italian study. Diabetes Res Clin Pract. 2005; 67(3):267-272.
• 35. Mekonnen TT, Woldeyohannes SM, Yigzaw T. Contraceptive use in women with hypertension and diabetes: cross-sectional study in Northwest Ethiopia. International Journal of Women's Health. 2015;7:957.
• 36. Lakasing L, Khamashta M. Contraceptive practices in women with systemic lupus erythematosus and/or antiphospholipid syndrome: what advice should we be giving? BMJ Sexual & Reproductive Health. 2001 Jan 1;27(1):7-12.
• 37. Rogers P, Mansour D, Mattinson A, O'sullivan JJ. A collaborative clinic between contraception and sexual health services and an adult congenital heart disease clinic. BMJ Sexual & Reproductive Health. 2007 Jan 1;33(1):17-21.
• 38. Vahratian A, Barber J, Lawrence J. Family planning practice among diabetes, over weight and obese women in 2002 national survey for family growth. Diabetes Care. 2009; 32(6):1026-1031.
• 39. Durmuşoğlu F, Tomruk DG, Yıldırım, A. Özel dönem ve durumlarda kontrasepsiyon, aile planlamasında temel bilgiler. İnsan Kaynağını Geliştirme Vakfı, İstanbul.2002; 195-212.
• 40. Yıldırım A. Üreme sistemi ve cinsellik, aile planlamasında temel bilgiler. İnsan Kaynağını Geliştirme Vakfı, İstanbul. (2002);93-105.
• 41. Holton S, Thananjeyan A, Rowe H, Kirkman M, Jordan L, McNamee K, Bayly C, McBain J, Sinnott V, Fisher J. The fertility management experiences of Australian women with a non-communicable chronic disease: findings from the understanding fertility management in contemporary Australia survey. Maternal and Child Health Journal. 2018 Feb 6:1-11.
• 42. Veloz-Martínez MG, Hinojosa-Cruz JC, Vital-Reyes VS, Becerra-Alcántara GI, Delgadillo-Plascencia J. Contraception in women with chronic diseases. Ginecologia y Obstetricia de Mexico. 2015 Jul 15;83(07):393-399.
• 43. Soltani H, Dickinson FM, Kalk J, Payne K. Breast feeding practices and views among diabetic women: a retrospective cohort study. Midwifery. 2008 Dec 1;24(4):471-479.
• 44. Ocaktan C. İnsüline bağımlı diyabeti olan ve diyabeti olmayan kadınların emzirmeye ilişkin görüş ve uygulamalarının karşılaştırılması. Adnan Menderes Üniversitesi Sağlık Bilimleri Enstitüsü, Yüksek Lisans Tezi. 2017.
• 45. Josephson MA, McKay DB. Women and transplantation: fertility, sexuality, pregnancy, contraception. Advances in Chronic Kidney Disease. 2013 Sep 1;20(5):433-440.
• 46. Klemetti MM, Laivuori H, Tikkanen M, Nuutila M, Hiilesmaa V, Teramo K. Obstetric and perinatal outcome in type 1 diabetes patients with diabetic nephropathy during 1988–2011. Diabetologia. 2015;58(4):678-686.
• 47. Çayan S, Akbay E, Bozlu M, Canpolat B, Acar D, Ulusoy E. The prevalence of female sexual dysfunction and potential risk factors that may impair sexual function in Turkish women. Urologia Internationalis. 2004;72(1):52-57