ISSN:0091-2182    

DOI:10.1016/0091-2182(91)90013-F

出版商:Blackwell Publishing Ltd    

年代:1991

数据来源: WILEY

ISSN:0091-2182    

DOI:10.1016/0091-2182(91)90014-G

出版商:Blackwell Publishing Ltd    

年代:1991

数据来源: WILEY

ISSN:0091-2182    

DOI:10.1016/0091-2182(91)90015-H

出版商:Blackwell Publishing Ltd    

年代:1991

数据来源: WILEY

摘要:

ABSTRACTAs more women move into their 40s, it can be anticipated that nurse‐midwives will be sought to continue to provide care and anticipatory guidance in the perimenopausal period. This article reviews definitions, demographics, physiology, and clinical manifestations of the perimenopausal period. In addition, management strategies other than hormone replacement therapy for the common discomforts of menopause are identified and discusse

ISSN:0091-2182    

DOI:10.1016/0091-2182(91)90016-I

出版商:Blackwell Publishing Ltd    

年代:1991

数据来源: WILEY

摘要:

ABSTRACTThe perimenopausal period is often a frustrating time for the woman who is experiencing it and for the health care professional who provides care for her. Although menopause is a universal experience for women, how it is experienced is not universal. Physiology, anatomy, social support systems, culture, expectations, and the woman's attitudes (especially her self‐image) all have an influence on how easy or difficult the perimenopausal transition period is for an individual. This paper discusses psycho‐sexual aspects of the perimenopausal period and suggests how nurse‐midwives or other health professionals can make this often difficult period e

ISSN:0091-2182    

DOI:10.1016/0091-2182(91)90017-J

出版商:Blackwell Publishing Ltd    

年代:1991

数据来源: WILEY

摘要:

ABSTRACTThe purpose of this qualitative investigation was to generate theory grounded in the responses of perimenopausal women about the process of menopause. A purposive sample of 12 perimenopausal women was interviewed to discover the menopausal process. Data were generated from interviews, two‐month daily logs, and field notes. A substantive theory of integrating a Changing Me identified the perimenopausal process, which included four categories: Tuning Into Me, My Body and Moods, which described the awareness of physical and emotional changes that initiated the beginnings of menopause; Facing a Paradox of Feelings, which reflected the thoughts, perceptions, and feelings experienced by perimenopausal women; Contrasting impressions, which described the assimilation of information and the formulation of the woman's own personal meaning; and Making Adjustments, which included changes made by the women in response to this process. Implications for health care and education of perimenopausal women are discusse

ISSN:0091-2182    

DOI:10.1016/0091-2182(91)90018-K

出版商:Blackwell Publishing Ltd    

年代:1991

数据来源: WILEY

摘要:

ABSTRACTHormonal replacement therapy—usually involving estrogen with or without an added progestin—has been proposed as a treatment for a variety of changes associated with the perimenopausal years, including hot flushes, vaginal and urinary tract atrophy, sexual problems, aging skin, and a number of affective symptoms. It has also been Studied as a preventive measure against osteoporosis and cardiovascular disease, with some researchers claiming a protective effect against breast cancer, although others cite it as a risk factor for breast cancer. This article reviews the literature in each of these areas, suggesting an individualized approach to hormone replacement therapy, determined by patient and practitioner, based on symptomatology and risk factors. Alternative therapies are briefly outli

ISSN:0091-2182    

DOI:10.1016/0091-2182(91)90019-L

出版商:Blackwell Publishing Ltd    

年代:1991

数据来源: WILEY

摘要:

ABSTRACTThe differential diagnosis and clinical management of abnormal uterine bleeding and of amenorrhea present complex challenges to the provider of well woman gynecologic care. The physiologic origins of these problems are detailed and related to historical information, possible physical findings, and laboratory tests results. In particular, dysfunctional uterine bleeding is distinguished from other causes of bleeding such as infections, carcinoma, ectopic pregnancy, side effects of contraception, and benign disorders such as myomas. The differential diagnosis of amenorrhea is also presented with attention to medical and exogenous causes, as well as amenorrhea due to alterations of hypothalamic function; pituitary, ovarian, thyroid, and adrenal dysfunction; and abnormalities of the outflow tract. Strategies are presented for initiating the clinical investigation of these problems, when to comanage with a gynecologist, and when to refer.

ISSN:0091-2182    

DOI:10.1016/0091-2182(91)90020-P

出版商:Blackwell Publishing Ltd    

年代:1991

数据来源: WILEY

摘要:

ABSTRACTCertified nurse‐midwives provide primary care for women. An essential part of a physical examination is a complete assessment of the breasts. Normal breasts and their variations and deviations are discussed, with particular attention paid to breast pain, masses, and nipple discharge, and the clinical implications of each. In addition, the demographics, risk factors, staging criteria, and treatment modalities of breast cancer are presente

ISSN:0091-2182    

DOI:10.1016/0091-2182(91)90021-G

出版商:Blackwell Publishing Ltd    

年代:1991

数据来源: WILEY

摘要:

ABSTRACTThis article notes that liability claims of failure to diagnose breast cancer are increasing in number and seventy, at least in part because women understand that early diagnosis improves survival. Legal cases are presented that illustrate particular liability risks, and risk management recommendations are made.

ISSN:0091-2182    

DOI:10.1016/0091-2182(91)90022-H

出版商:Blackwell Publishing Ltd    

年代:1991

数据来源: WILEY