[The effect of mode of delivery on woman's sexuality]. / Vliv zpusobu porodu na zenskou sexualitu.

AIM: To find out whether the mode of delivery can influence the female sexuality and find out dimensions of female sexuality that can be influenced by the mode of delivery. SETTING: Department of Nursing and Midwifery, Faculty of Medicine, University of Ostrava. METHODS: The research sample was consisted of 99 after delivery. This women gave birth 6 months to 3 years ago. The sample contained 70 women after spontaneous vaginal delivery, 17 women after the section cesarean and 12 women after the optative vaginal delivery. The questionnaire Female sexual function index (FSFI) was used for the purpose of measuring sexuality. The questionnaire evaluates 6 domain sof fiale sexual functioning: desire, arousal, lubrication, orgasm, satisfaction and pain. The surfy was carried out in 3 private gynecologists. RESULTS: The mode of delivery does not affect the overall score in the dimension of desire, arousal,lubrication, orgasm and satisfaction. The differences were found in the incidence then were analysed the individual questionnaire items in the incidence of the problem with achieving and maintaining lubrication, frequency of orgasm and satisfaction with their partner. Women who had an optative vaginal delivery had higher incidence and rate of the pain during intercourse compared with women with vaginal deliveries. CONCLUSION: The mode of delivery affects sexual function of women specially in the adherence and degree of the pain. Cesarean section reduce the level of the pain during intercourse. The women after optative vaginal delivery were the most end angered group so these women would be given special care.

The education of Romany health and social assistants in the Czech Republic.

AIM: This paper presents the Czech national pilot project - the first educational course of Romany health and social assistants for community work with the Romany population in excluded communities. BACKGROUND: The Romany people are the biggest minority in the Czech Republic. The number is ever increasing because of the migration from South-East Europe. At the same time, the health and social problems of the Romany population are rising, too. To begin to address some of the health problems of this population, a pilot community project entitled Romany Health and Social Assistant was implemented in the years 2002-2004 in Ostrava. Ostrava is the third largest city and has the largest Romany population. Based on the outcomes of this project and as part of the national project SASTIPEN - Reduction of Health Inequalities in the Romany Community, the systematic education of selected Romany health and social assistants was carried out in 2005-2007. CONCLUSIONS: These trained Romany assistants are now working in the regions of the Czech Republic where inhabitants live in large Romany communities. The project evaluation was based on a questionnaire investigation of 170 clients living in Romany communities and on the statements of Romany health assistants. They found positive outcomes in several areas: obtaining information on health, motivation to healthy lifestyle, concrete changes in lifestyle and boosting trust towards doctors. Following the end of the project and its evaluation, an educational course will be accredited and certified, and the education of Romany assistants will be widespread across the whole country.