Utilizing Community Health Nursing for Women

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Utilizing Community Health Nursing for Womens
Health Promotion and Health Protection

• Lily Hsu,RN., MSNShanghai Jiao Tong University
  School of Nursing

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Learning Objectives for Community Health
Nursing-Womens Health

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Dimension of Womens Health

• Consider
• Womens Role(stress?role function)
• Health care for womens health needs
• Health needs and change across lifespan

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What are the womens Health?

• Maternal-child health?
• Reproductive health?
• Menarche Health?
• Mental Health?
• Gynecological Health ?
• General Health Well-being?
• Gender difference in health ?

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Factors impacts on womens Health

• Accessibility in health care
• Role equality
• Womens work and income
• Career women and family life
• Family member and marital relationship
• Unexpected accident or injury
• Disability women
• Family and sexual violence
• Occupational Health

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Overview for Community Health Challenge in
Womens Health Issues
Duty and Responsibility of Community Health
Practice in Nursing
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Womens Health Challenge

• Reduce the maternal mortality rate every year,
  in the world, 520,000 maternal death (20
  ?????),98 death occurred in developing
  countries, due to unable to provide proper
  antenatal care during delivery
• ??2015 ?????(1994)?????-?????75,???

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The Top Five Cause of Death in China among Urban
Women(2004)

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Chronic Disease among Women

• Cardiac Disease
• Hypertension
• DM
• Arthritis
• Cancer

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Chinese Womens Mental Health

• Among 15-34y/o females, suicide is the leading
  cause of death
• Rural and farm areas, women has the highest
  suicide rate (WHO)
• Women is 25 more likely to committed suicide
  than men
• 50of women in rural area committed suicide by
  pesticide.
• 
  (WHO, 2004)

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Womens Health Data in China

• ??????????? 48.3 (2004)
• ?????????? 97 (2003)
• ????????????? 11,??????? 0.92 (2002)
• ??????? 95.8 (2002)
• 15-25?????? 98 (2004)
• ?????????????? 30 (2003)
• ???????????? 37 (2003)
• ????????20 (2004)

UN-2005
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Womens Disease Data in China

• ???????40??,????11.30
• ????????????????10???3540?
• ??????????13.15?
• 2007?????????3000???WHO??????,?2010?????????????4?
  ?
• ????????,??????????????880??

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Womens Health Data in Shanghai

• ???????????1.4 (2005)
• ??????????2.5
• ???3.16 (2004)
• ?????????????15.11
• ??????9.15
• ??????68.55(2003)

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Womens Health Indicators in China

• Incidence of breast cancer
• Incidence of Cervical cancer
• Lung Cancer
• Maternal mortality rate

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Health Challenges in Womens Lifespan

• Teenagestress from school, Body image, anoxia,
  depression, drug abuse, STD, suicide
• Childbearing age Maternal role change, fatigue
  postpartum, new mother role,
• Elderly age adopt to physical and psychological
  change, empty nest, depression, suicide

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Challenges of Teenage Mothers

• Health Problem STD?unexpected pregnancy,
  maternal and infant nutritional status, pregnancy
  care
• Social Support pregnancy and child care
• Social economic challenges
• Violence and drug abuse
• Lack of self-protection and prevention

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Violence and Maternal Health

• Homicide is the second most common cause of
  injury-related death among pregnant women and new
  mothers
• CDC,2005,
• American Journal of Public Health

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??????????(2005)

• 5 ??????????????????
• ????(44)???(37)???????(34)?,????????????
• ???????????????????????,
• ???????????????????????????,????????????????

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??????????

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• Healthy
  People 2010
• USA

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20
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• Healthy People 2010, USA

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Womens Health Problem that Require Community
Health Nursing Intervention
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Home Birth-prevention of postpartum hemorrhage

• Post Delivery
• 1.Prophylaxis Oxytocin for uterus contraction
• 2. Clip the umbilicus cord
• 3. Avoiding inadequate umbilicus tracking

Safe Motherhood How Community Nursing Can Help?
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??HIV??????

• ????????,HIV/AIDS ??????,???10?HIV??????13?????
  HIV,????????(??,??????)???15-25?????,75??HIV??
• ??4-5?,??????HIV?????????-PMTCT Prevention of
  Mother-To-Child-Transmission ?????????
• ????????????
• 2002???????-MTCT-Plus ?????????????

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????HIV??????

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• ???????1997??5.5???2002?4??11
• ?????????

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????????????

• ????????,?????????????1??????????????,??????????
• ?????(Mozambique),57???18????,?30??????,?80?????
  ??????????HIV?????
• ??gt71????????????, 30??????????????
• ??????????????????????????-HIV????????   

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Impact of Chronic Illness

• ??????????????????????30?,????????????????????40/
  10????????1978??0.93???2.33?10??,????????????4
  .42,??????10.385?
• 
  (2007)
•   

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??????????(2006)

• ??5
• ??7.8

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????????-????

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• ??HIV??
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???????

• ????,????????,?????????????????? 10-15
  (WHO,2004)
• ????????????,?????????????????

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?????HIV/AIDS ??

• 2004 ??? Glion Call to Action by UN
  ????????????????????????????,????????????

??HIV ?? ???????
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????????????

• ??? (40?????)
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???????? (2002 US)

1. ??
2. ???
3. ???(??)
4. ??
5. ??????
6. ??
7. ????

600????????,2003?,¼ ??????,2004 ??????????????
35
?????

• ???10?????????????
• ?????????10????2?
• 20???????????????????????,????????

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?????

• Among all women with TB, 81 of TB cases affect
  minority women. Of these cases, 26 are among
  Asian American/Pacific Islander women (second
  only to African American women, who make up 30
  of TB cases among minority women).
• (2005
  NWHIC, USA)

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?????????

• As many as 90 of Asian Americans are lactose
  intolerant or cannot easily digest dairy products
• ????????
• ?????
• ?????
• ??????

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UN ??????-2015?????????

• Millennium Development Goals ????????????
• 1? ???? Gender Equality,?????
• ?????
• 2????? Womens Empowerment
• 3?????????????????
• 4???????? Sexual and Reproductive
  Right/Health??75 ??????

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Community Projects Initiated by Community Nurses

• Elderly safety program, preventing falls.
• Womens Heart Program to prevent heart attack
• Mental health program for stress reduction and
  suicide prevention
• High risk pregnant home visit
• Health Promotion for smoking ceasing, life style
  modification, diet control, weight control
• Asthma prevention program
• Post-Stroke rehabilitation

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