ABSTRACT
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Subject(s)
Middle Aged , Aged , Male , Female , Humans , Menopause , Risk Factors , Spain , Time Factors , Prevalence , Incidence , Prospective Studies , Primary Health Care , Chronic Disease , Follow-Up Studies , Health Promotion , Women's Health Services , Diabetes Mellitus, Type 2ABSTRACT
OBJECTIVE: On the threshold of the third millennium, menopause has become a crucial social and health problem in developed countries. In the present work, we analyze possible healthcare strategies, describing their advantages and disadvantages within the context of different underlying conceptions of menopause. DESIGN: We have considered three theoretical frameworks or "menopause models": the biological model, the psychosocial model, and the holistic or integral model. Each model is examined under three subheadings: concept, contributions, and criticisms. RESULTS: The holistic model is proposed and defended as a valid option for the management of menopause. CONCLUSIONS: Adoption of the holistic model by health personnel may improve the attention given to menopausal women. As characteristics of such a model, the following are important: (1) The positive vision of the climacteric transition as an opportunity for personal growth, (2) the biopsychosocial perspective of the phenomena responsible for the different effects on the level of health and quality of life of women, (3) the development of health policies focused on health promotion, (4) the protagonism of women through strategies based on self-care and self-help groups, and (5) individualized use of hormone replacement therapy.
Subject(s)
Estrogen Replacement Therapy , Health Promotion/organization & administration , Holistic Health , Menopause , Women's Health , Aged , Female , Humans , Middle Aged , Models, Biological , United StatesABSTRACT
OBJECTIVE: To evaluate results of the Papanicolaou cervical cytology test performed between 1986 and 1995. DESIGN: A descriptive and retrospective study. SETTING: Primary care, San Juan Health Centre, Salamanca. PARTICIPANTS: 1,271 women over 15 who had at least one smear during the study period. INTERVENTION: Review of clinical histories and cytology reports. RESULTS: 2,056 smears were carried out. 50% were on women < 35, for whom family planning was the main reason for the test. Only 31% of the women between 35 and 65 had a smear. 35% of the women recruited had a further cytology test. 56% had morphological or microbiological disorders, 43.1% were negative and only 0.9% could not be evaluated by the pathologist. There were benign morphological alterations in 48.4% and infections in 27.3%. Only 15 smears (0.7%), corresponding to 12 women (1.2%), had suspected malignity, with dysplasia confirmed in 3 cases (0.24%). CONCLUSIONS: There were few cases of cervical cancer detected with the methods followed at our centre. The effectiveness of the intervention should be improved by selective screening based on risk scales, setting up computerised systems of identification and the extension of the interval between smears to 5 years.
