Week 10-12 Flashcards
Setting the Stage Sexual Health
- Part of overall history
- Explain you will ask 3 questions
- Ensure confidentiality
Screening Questions Sexual Health
- Have you been sexual active in the past year
- Do you have sex with men, women, or both
- How many sexual partners in the past year
Multiple Partners
- STD/HIV Protection
- Substance use
- History of STDs
- Trauma/violence
- Pregnancy/protection
- Sexual function & satisfaction
Long-Term Monogamous Partners
- Pregnancy/protection
- Trauma/violence
- Sexual function & satisfaction
Non-Sexually Active
- Past Partners
Sexual Risk Assessment
- Partners
- Practices
- Past history of STDs
- Protection against STDs
- Pregnancy plans
Orientation & Gender Identity Considerations
- Client self-identification
- Preferred pronouns
- Changes overtime
- Use same verbiage as client
Children & Adolescent Considerations
- Tanner staging
- Puberty
- Menarche
Tanner Staging
- Sexual maturity stages
- Secondary sex characteristics
- Pubic hair
- Breast development
- External genitalia
Menarche
- First menstrual cycle
- Ages 10-16
Physical Assessment Considerations
- Intimate nature
- Maximize privacy
- Right to a chaperone
- Matter of fact approach
- Be aware of language ‘relax’
Abuse Screening Considerations
- Question specific behaviours
- Allow sharing
- Past is as important as present
- Easily misunderstood
Health Promotion Sexual Health
- Safer sex guidelines
- Immunizations (HPV)
- Breast self examination
- Testicular self examination
- Pap smears
- PSA testing (prostate)
Fear & Stress Origin
- Amygdala
- Hippocampus
Neurological Effects of Trauma & Violence
- High stress levels effect brain development
- Difficulty identifying, expressing, managing emotions
- Mistrust in healthcare professionals
Delayed Trauma Response Signs
- Persistent fatigue
- Sleep disorders
- Nightmares
- Fear of recurrence
- Anxiety (flashbacks)
- Depression
- Avoidance of emotions, sensations, activities
Impact of Violence
- Death
- Severe injuries
- Brain/nervous system development
- Negative coping & health risk behaviors
- Unintended pregnancies
- Non-communicable disease
- Impact opportunities & future generations
Impairment of Brain & NS
- Exposure at early age
- Impair brain & damage NS components
- Affect cognitive development
- Educational & vocational under-achievement
NS Damage Effects
- Endocrine
- Circulatory
- Musculoskeletal
- Reproductive
- Respiratory
- Immune
Negative Coping/High Risk Behaviours
- More likely to smoke, misuse alcohol, drugs
- High-risk sexual behaviors
- Higher rates of anxiety, depression, suicide
Unintended Pregnancy Risks
- Induced abortions
- Gynaecological problems
- STIs
Non-Communicable Disease
- Risk of CV disease, cancer, diabetes
- Due to negative coping & health risk behaviors
Impact on Opportunities
- More likely to drop out of school
- Difficulty finding & maintaining employment
- Risk for later victimization
- Perpetration of interpersonal & self-direct violence
- Affects on next generation
Types of Violence
- Sexual
- Physical
- Verbal
- Psychosocial
Child Violence
- Physical/emotional abuse
- Neglect
- Maltreatment (younger ages)
- Sexual abuse (girls higher risk)
- Peer violence & intimate partner violence (adolescence)
Signs of Child Abuse
- Low self-worth
- Antisocial
- Injuries/marks on posterior side
- Bullying
- Self-isolating by choice
- Sexualized behaviors
Parent Factors of Child Abuse
- Low socio-economic status
- < 19 years old
- Single parent
- Non-biological parents
- Abuse as child
- Substance abuse
- Lack of social support
- Unplanned pregnancy
- Negative parental attitude
Family Factors of Child Abuse
- Spousal violence
- Poor martial relations
- Poor child-parent relationship
- Unhappy family life
Child Factors Contributing to Abuse
- Behavioral problems
- Disability
Legal Obligations of Child Abuse
- Law to report suspected child abuse/neglect
- Reasonable grounds
- Report to CAS/CFS
LIVES Screening
- Listen closely, no judgement
- Inquire about needs/concerns
- Validate experiences
- Enhance safety
- Support connection with additional services
Intimate Partner Violence
- Use screening tool (LIVES)
- No obligation to report
Elder Abuse
- Neglect
- Financial
- Physical
- Emotional
- Sexual
Reporting Elder Abuse
- Improper/incompetent treatment
- Abuse
- Neglect
- Illegal conduct
- Misuse/fraud involving money or public funding
- Only mandatory to report LTC
Abuse Prevention
- Public & professional awareness campaigns
- Screening
- School-based intergenerational programs
- Caregiver support interventions
- Residential care policies
- Caregiver training on dementia
Responding to Abuse
- Mandatory reporting to authorities
- Self-help groups
- Safe-houses & emergency shelters
- Psychological programmes for abusers
- Helplines (information & referrals)
- Caregiver support interventions
Health Equity
- User accessibility
Marginalized by Inequity
- Likelihood of developing health problems as a result of excessive risk
Vulnerability
- Dependant on others for care/safety
Barriers to Health Care
- Location
- Language
- Transport
- Discrimination (race, sexuality)
- Health card
- Time off work
- Financial
- Low health literacy
Marginalized People
- Poverty/homelessness
- Chronic conditions
- Disability
- Stigmatized risk behaviours
- Indigenous
- Rural
- Elderly (LTC)
- Children
Poverty
- Inquire about income, employment
- Most people 3 problematic paychecks from poverty
- Shelters potentially unsafe (unmanaged mental illness, violence)
Health Risks of Poverty
- Poorer health outcomes
- Incidence of acute & chronic disease conditions mental illness
- Higher morbidity & mortality rates
- Cumulative risk factors, adverse events
- Less access to preventive screening
- Violence exposure
- Stigma
Stigma Result
- Restricting factor to access services
Inequity Screening
- Making ends meet?
- Needs to get by?
- Difficulty stretching paycheck?
Harm Reduction
- Practical strategies
- Lessen negative consequences
Caring for Marginalized Populations
- Impact on brain of violence/trauma
- Impact of multigenerational trauma/violence
- Principles of TVIC
- Truth & reconciliation commission
- Equity oriented health acre
- Reflect on personal views & biases
- Show leadership