WEEK 12 RESPONSES

RESPONSE 1 ON STI

Thank you for your excellent post on Sexually Transmitted Infections. Sexually Transmitted Infections has been in resurgence for some time. There are different theories associated with the rise in sexually transmitted infections including the social media app and multiple sexual partner activities. Studies have shown that sexually transmitted diseases are treatable or at least manageable; examples are chlamydia, gonorrhea, syphilis, and even HIV now have effective treatment to manage the infection and people living a normal life with minimal or no interference of HIV symptoms, etc. (Yan et al. 2020).One of the groups of people at the highest risk for STIs is those with multiple partners and those whose partners also have multiple partners. Pregnant women with sexually transmitted infections are also at risk of infecting their unborn child, which could lead to complications (Happel et al. 2020). An advanced nurse practitioner must obtain a detailed history of the patient during the consultation so that appropriate screening and treatment can be targeted to the specific type of STI the patient presents. APRN’s must also ask the woman in her 50’s questions such as sexual history, her sexual orientation, how many multiple partners she has been involved with, and whether she uses condoms or not. These questions can help inform the APRN’s on the type of education and treatment to offer to the patient.I agree with your recommended guidelines, and it is essential to increase patients’ awareness of these guidelines. More importantly, APRNs must harness education on STI’s to all sexually active patients and the significance of using sexual barriers like condoms. The patient must also be encouraged to have their partners screened and treated to prevent the risk of re-infection.ReferencesHappel, A. Singh, R., & Mitchev, N. et al. (2020). Testing the regulatory framework in South Africa – a single-blind randomized pilot trial of commercial probiotic supplementation to standard therapy in women with bacterial vaginosis. BMC Infectious Diseases, 20, 491. https://doi.org/10.1186/s12879-020-05210-4Yan, X. Li, Y., & Su, H. et al. (2020). Protect MSM from HIV and other sexually transmitted diseases by providing mobile health services of partner notification: protocol for a pragmatic stepped wedge cluster randomized controlled trial. BMC Public Health, 20, 1107. https://doi.org/10.1186/s12889-020-09162-x

RESPONSE 2 ON BREAST CANCER

Great Post !

The purpose of this post is to discuss how health care disparities could affect the care of breast cancer patients.

Hi Mary, thank you clearly outlining the American Cancer Society’s (ACS) recommendations for women regarding mammogram screenings. Breast cancer continues to be a significant cause of mortality and morbidity all over the world. Williams & Thompson (2017) reported that breast cancer is the most diagnosed cancer in females and the second leading cause of death in females after lung cancer in the United States. Sadly, health care disparities continue to interfere with breast cancer care that includes, screening, diagnosis, and treatment. Some of these disparities are race, geographical location, socioeconomic status, and mental health.

As Chesnay & Anderson (2020) stated the ‘skin you are in’ plays an important role in how a person interacts with the healthcare system. They reported that racial minorities continue to suffer from longstanding oppressive institutional, interpersonal, and internalized effects of prejudice and exclusion. For example, the United States National Cancer Database reported that black women with hormone receptor-positive breast cancer died at twice the rate of white women diagnosed with the same exact cancer. They argued that even after factoring in genetics, socio-economic, and access, the discrepancies were still stack and they attributed these to poorer quality of care afforded to minorities, and fewer opportunities to participate in research. They also found that providers offered minorities fewer treatment and trial options, these they termed as ‘implicit bias’ (Bryant, 2020).

Mental health is another potential healthcare disparity that does not get as much attention. Evidence-based research (EBP) suggests that women with mental illness often do not receive preventative services that include mammogram screening in a timely manner compared to the rest of the population. As such, by the time the cancer is diagnosed, it is usually bigger, is a higher-grade tumor or has spread. They attributed these findings to the stigma faced by these women that makes them less apt to keep up with regular primary care visits, ineffective communication with providers and, access difficulties (Hwong et al., 2020).

Summary

According to Kaiser Family Foundation (KFF), healthcare disparities add 93 billion dollars in medical costs and approximately 42 billion in lost productivity per year. But besides, the economic cost, health disparities are linked to higher rates of preventable morbidity and mortality (Artiga et al., 2020). Unfortunately, breast cancer continues to be commonly diagnosed and as noted above, race, mental illness, and other disparities such as lower socioeconomic status can lead to poorer quality of care and access difficulties amongst others. As such, healthcare providers and legislators should work hand in hand to eliminate these barriers for the sake of equity and improved health outcomes for all.

References

Artiga, S., Orgera, K., & Pham, O. (2020, April 1). Disparities in health and health care: Five key questions and answers. KFF. https://www.kff.org/disparities-policy/issue-brief/disparities-in-health-and-health-care-five-key-questions-and-answers/

Bryant, A. (2020, May 5). UpToDate. https://www.uptodate.com/contents/racial-and-ethnic-disparities-in-obstetric-and-gynecologic-care-and-role-of-implicit-biases?search=disparities%20affecting%20black%20women%20in%20breast%20cancer%20care&source=search_result&selectedTitle=3~150&usage_type=default&display_rank=3

Chesnay, M. D., & Anderson, B. A. (2020). Caring for the vulnerable: perspectives in nursing theory, practice, and research. Burlington, MA: Jones & Bartlett Learning.

Hwong, A., Wang, K., Bent, S., & Mangurian, C. (2020). Breast cancer screening in women with schizophrenia: A systematic review and meta-analysis. Psychiatric Services, 3, 263. https://doi.org/10.1176/appi.ps.201900318C.

Williams, F., & Thompson, E. (2017). Disparities in Breast Cancer Stage at Diagnosis: Importance of Race, Poverty, and Age. Journal of Health Disparities Research and Practice, 10(3), 34–45.