Archive for April 7th, 2009
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ANALYSIS OF THE FAMILY PLANNING CONSULTATION – NEGOTIATING A PLAN
Middleton’s model consists of reconciling the patient’s and doctor’s agendas and drawing up a negotiated plan. The two agendas are not always compatible and it is well known that compliance is poor if the patient does not wholeheartedly back the plan of campaign. The days of giving out authoritarian, prescriptive advice are long since over. [...]
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PSYCHOSEXUAL PROBLEMS IN THE CONTRACEPTIVE CONSULTATION – BEGINNING SEXUAL ACTIVITY (CONCLUSION)
Here was a girl pretending to her friend and to the clinic that she was sexually active. She changed her partners frequently, perhaps because they became too pressing for intimacy, or because, like the doctor, they were made to feel clumsy and intrusive. Her lack of sexual activity was not through choice and her avoidance [...]
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CONTRACEPTIVE CARE OF THE OLDER PATIENT – DESIRE FOR PREGNANCY? (AMBIVALENT FEELINGS)
Some women are able to recognize their ambivalence only when their desire for a pregnancy looks as if it could become a reality. Mrs Y. and her husband decided to stop using the sheath. She was 38 years old and her youngest child was at secondary school. She had always loved having babies and decided [...]
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CULTURAL PERCEPTIONS AND MISCONCEPTIONS – CULTURE AS AN ISSUE FOR THE PATIENT (GENERAL INFORMATION)
More often the cultural issue arises obliquely. If a patient is in difficulties with her contraception it is often hard for her to be straightforward in discussing exactly why one method is unsuitable. This is made even worse if she does not speak very good English, and if she is not used to discussing family [...]
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THE SEXUAL NEEDS OF PEOPLE WITH DISABILITIES – EMOTIONAL NEEDS (MAJOR TRAUMA)
A necessary, albeit painful, area to address is the feeling of loss that occurs when a person has experienced a major trauma, for instance the loss of a limb, or the loss of function following a head injury, stroke or progressive disease. The change in body image is very damaging to most people. The temptation [...]