April 2009

SEMINAR TRAINING FOR CONTRACEPTIVE CARE – THE PHYSICAL EXAMINATION (INTRODUCTION)

Doctors, nurses and some other health professionals such as physiotherapists are in the unique position of having licence to examine the most intimate parts of the body; indeed, they are expected and required to do so. The vulnerable moment of examination may provide an opportunity for the patient to get in touch with feelings. Sometimes [...]

ANALYSIS OF THE FAMILY PLANNING CONSULTATION – MODELS OF THE CONSULTATION (CATEGORIZING)

Over the last two decades, doctors and psychologists have attempted to construct models of the consultation which give insight into the complex interactions between doctors and patients.1 Even earlier, methods of effective counselling had been developed which greatly enhanced communication within a consultation. The first attempt to categorize consultations grew out of good counselling practice [...]

PSYCHOSEXUAL PROBLEMS IN THE CONTRACEPTIVE CONSULTATION – EXAMINING THE WHOLE PATIENT (AVOIDING THE PHYSICAL EXAMINATION)

Doctors who notice that they are avoiding the physical examination of a patient need to understand the reasons. Perhaps the patient behaves in a sexual way, so that the doctor feels not like a doctor, but more like a potential sexual partner. Although more common between a male doctor and a female patient, awareness of [...]

SEXUALITY WITHOUT FERTILITY – SEXUAL FEELINGS

The problem of separating sexual feelings from emotions connected with babies in relation to the advantages, for some people, of the slight failure rate of the IUCD. Some women find, often at an unconscious level, that they can only allow themselves the loss of control and joy of sex only if it is somehow legitimized [...]

POLITICAL/DEMOGRAPHIC CONSIDERATIONS IN THE UK

People from ethnic minorities account for a small proportion of the UK population. They are, however, concentrated in a few localities where they provide a disproportionate workload in the field of reproductive medicine. The 1981 census data showed that 3.2% of the heads of households of England and Wales were born in new Commonwealth countries [...]

BREAST CANCER: CHEMOTHERAPY AND HAIR LOSS

Sometimes hair begins to grow back before the end of chemotherapy. This does not mean that the drugs are not working! It is just more evidence that everyone is different. As your hair grows in, it will probably be curly (even if you have always had straight hair). It may straighten out as it gets [...]

BREAST CANCER/RADIATION THERAPY: RADIATION PLANNING

Before beginning radiation, you will have an appointment for radiation planning. This is a painless procedure, but one which many women find emotionally difficult because the environment is strange and the machines may seem quite intimidating. Ask questions if you wish. You will be asked to lie still, your hand up under your head and [...]

BREAST CANCER: SURGICAL CHOICES (LOCAL TREATMENT)

You may need to decide simultaneously about both local (mastectomy or lumpectomy/ radiation) and systemic (chemotherapy or hormone therapy) treatments. You will feel confused and overwhelmed. Again, remember that your best resources are your doctors, other women who have gone through this, and information from books, medical journals, and magazines. Again, it may be important [...]

BREAST CANCER/PERSONAL RELATIONSHIPS: CONCERNS OF SINGLE WOMEN

Women who do not have life partners may experience special stresses and worries as they move through the experience of having breast cancer. Remember that being married or having a committed, significant other is no guarantee of receiving unconditional and constant support. Many single women have friends who serve as family during this crisis in [...]

BREAST CANCER: CHOOSE YOUR TEAM

In the immediate aftermath of hearing that you have breast cancer, you may find it is difficult to think clearly and make the choices that will influence the rest of your treatment. You may be completely satisfied with the doctor or hospital where you heard the diagnosis, or you may wish to consider other possibilities. [...]