Development and Feasibility of a Group-Based Therapeutic Yoga Program for Women with Chronic Pelvic Pain.

Objective: To develop a group-based therapeutic yoga program for women with chronic pelvic pain (CPP) and explore the effects of this program on pain severity, sexual function, and well-being.

Methods: A yoga therapy program for CPP was developed by a multidisciplinary panel of clinicians, researchers, and yoga consultants. Women reporting moderate to severe pelvic pain for at least six months were recruited into a single-arm trial.

Applying the RE-AIM Framework to Evaluate Integrative Medicine Group Visits Among Diverse Women with Chronic Pelvic Pain.

The purpose of this study was to evaluate group medical visits using an integrative health approach for underserved women with chronic pelvic pain (CPP). We implemented an integrative medicine program to improve quality of life among women with CPP using Centering, a group-based model that combines healthcare assessment, education, and social support. Patients were from university-affiliated and public hospital-affiliated clinics.

Prevalence and use of complementary health approaches among women with chronic pelvic pain in a prospective cohort study.

Objective: The aim of this study was to examine the prevalence of and factors associated with use of complementary health approaches among women with chronic pelvic pain (CPP).

Design: We analyzed data from the Study of Pelvic Problems, Hysterectomy, and Intervention Alternatives, a prospective cohort study of women seeking care for noncancerous pelvic problems with intact uteri at enrollment. Among a subset of 699 participants who reported having CPP, we analyzed the prevalence of complementary health approaches used and associated patient sociodemographic and clinical characteristics, health-related quality of life, attitudes and beliefs, and conventional health care practices.

An innovative acupuncture treatment for primary dysmenorrhea: a randomized, crossover pilot study.

Context: Dysmenorrhea, the occurrence of painful menstrual cramping of the uterus, is a major cause of activity restriction and absences from school and work among young women. Standard pharmaceuticals used to treat dysmenorrhea are not effective for all women and have side effects that limit their use. Studies elsewhere have shown beneficial effects for use of vitamin K1 as an acupoint treatment, but the acceptability of this treatment to women in the United States has been unknown.

Centering as a model for group visits among women with chronic pelvic pain.

Providing comprehensive care for chronic pelvic pain is impeded by time and resource constraints of the standard health care visit. To provide patient education, psychosocial support, and health care assessment, we developed group visits for women with chronic pelvic pain using an evidence-based, holistic nursing approach. In this article, we describe the structure of group visits, the process of conducting Centering group visits focused on empowerment, and the content of a holistic curriculum for women with chronic pelvic pain.

Providing holistic care for women with chronic pelvic pain.

Chronic pelvic pain (CPP) is one of the most common pain conditions affecting women and can have a significant impact on quality of life. Assessment of women with CPP is best approached in a comprehensive, systematic manner that includes exploration of physiological and psychological causes. A range of treatment options that draw from conventional medicine and complementary and alternative modalities should be offered.

Lessons learned: providing a mindfulness-based stress reduction program for low-income multiethnic women with abnormal pap smears.

Although the incidence rate of cervical cancer has decreased over the last several years, low-income ethnic minority women remain at increased risk for morbidity and mortality from cervical cancer. We conducted a pilot study to examine the feasibility and acceptability of mindfulness-based stress reduction (MBSR) program among multiethnic low-income women with abnormal Pap smears. Spanish- and English-speaking women recruited through convenience sampling participated in MBSR classes 2 hours each week over 6 consecutive weeks.

The mysteries and demands of HIV care: qualitative analyses of HIV specialists' views on their expertise.

To deepen our understanding of the mysteries and demands associated with HIV care and to inform the debate about HIV specialization, we conducted in-depth interviews with a purposive sample of 20 identified HIV specialists in the San Francisco Bay Area. Participants were from several medical specialties and reported a median of 50% of their time spent in HIV patient care. Through constant comparison, a template of open codes was constructed to identify themes that emerged from the data.

Factors affecting abnormal Pap smear follow-up among HIV-infected women.

Women with HIV infection are at least 10 times more likely to have an abnormal Pap smear than women who are HIV negative. Unfortunately, many women with HIV do not return for care after an abnormal Pap smear. Through the use of focus groups and individual interviews, HIV-positive women's experiences with abnormal Pap smears and the factors that affected whether they returned for care were explored.

Vulvar intraepithelial neoplasia in women with HIV.

The increasing incidence of lower genital tract neoplasia in HIV-infected women and the inherent difficulties in diagnosis and treatment have undermined effective management and contributed significantly to the morbidity of this population. The Centers for Disease Control and Prevention has included high-grade squamous intraepithelial lesions, as well as cervical carcinoma in situ, as part of the classification of HIV, with invasive cervical cancer as an AIDS-defining condition. The incidence of vulvar intraepithelial neoplasia (VIN) nearly doubled between 1973 and 1987.

Improving adherence to abnormal Pap smear follow-up.

Objective: To gain a better understanding of factors that affect follow-up and the strategies that have been found to improve follow-up after an abnormal Papanicolaou (Pap) smear test.

Data Sources: A computer-based search of the literature was conducted using MEDLINE with the keywords adherence, nonadherence, compliance, follow-up, and abnormal Pap smears.

Study Selection: Research studies published between 1985 and 1999 in the English language were included.

Combination antiretroviral therapy: health care providers confront emerging dilemmas.

Recent editorials, conferences and clinical practice articles have discussed providers' concerns and practices regarding prescribing antiretroviral combination therapy for HIV. We aimed to deepen our understanding of these largely anecdotal reports and of the challenges facing experienced HIV clinicians today using qualitative methodology. Eight focus groups using a structured discussion guide were conducted.

The personal experience of pregnancy for African-American women.

This study describes the personal experiences of pregnancy for African-American women. Data were obtained from two group interviews with four African-American nurse-midwives who had experienced pregnancy and had extensive professional experience in the provision of health care services to pregnant African Americans. Three major themes were constructed from the interview narratives.

A qualitative analysis of how physicians with expertise in domestic violence approach the identification of victims.

Background: Physicians have been called upon to identify victims of domestic violence, but few studies provide insight into how physicians can navigate around the barriers to identification.

Objective: To describe how physicians who are committed to helping battered patients identify victims of domestic violence in health care encounters.

Design: Six focus groups were conducted.

How health care providers help battered women: the survivor's perspective.

This qualitative study aimed to describe, from the perspective of domestic violence survivors, what helped victims in health care encounters improve their situation and thus their health, and how disclosure to and identification by health care providers were related to these helpful experiences. Semi-structured, open-ended interviews were conducted with a purposeful sample of survivors in the San Francisco Bay Area. Data were analyzed using constant comparative techniques and interpretative processes.

Lower genital tract neoplasia in women with HIV infection.

Women who are infected with human immunodeficiency virus (HIV) are at greater risk for the development of lower genital tract neoplasia than are HIV-negative women. Among HIV-positive women, those who are more severely immunosuppressed appear to be at higher risk for cervical intraepithelial neoplasia (CIN), also known as squamous intraepithelial lesions (SILs). Women who are HIV-positive also are more likely than HIV-negative women to have multifocal lower genital tract neoplasia.

Gynecology and family planning care for the woman infected with HIV.

This article reviews the interactions between HIV infection and a variety of gynecologic conditions, including lower genital tract neoplasia, pelvic inflammatory disease, menstrual disorders, sexually transmitted diseases, and vaginitis. Important considerations in choosing a family planning method for women infected with HIV-infected women will respond to standard therapy, but require multiple courses of treatment or use of innovative treatment methods. All HIV-infected women deserve careful evaluation for and treatment of gynecologic diseases.

Prevalence of human immunodeficiency virus infection and drug use in pregnant women: a critical review of the literature.

Many studies have been undertaken in the last 10 years to determine the prevalence of both human immunodeficiency virus (HIV) infection and drug use in pregnant women. These studies could have a serious impact on the delivery of health care as well as the development of health policy. We provide an overview of the key findings from these studies and a critical review of their strengths and weaknesses.

Vulvar intraepithelial neoplasia in women infected with human immunodeficiency virus-1.

The purpose of this study was to determine the response of vulvar intraepithelial neoplasia (VIN) lesions to standard treatment methods in women infected with human immunodeficiency virus (HIV). We reviewed all cases of VIN over a 4-year period at an inner-city hospital. We reviewed the clinical records of these women to abstract demographic information as well as information about tobacco use, injection drug use, results of HIV testing, T cell count, stage of HIV infection, colposcopic and cytologic findings, treatment of lesions, and follow-up.

Women living with HIV infection.

The route of transmission, clinical manifestations, survival time, and the impact on reproductive health are just a few examples of how HIV affects women differently than men. In addition, there are many social factors that also have tremendous impact on the health of women with HIV. This article reviews many of the issues that affect women living with HIV.

Multifocal lower genital tract neoplasia in women with HIV disease.

Lower genital tract neoplasia appears to occur often and in multiple sites in women infected with the human immunodeficiency virus (HIV). To describe the prevalence of lower genital tract neoplasia in HIV-infected women in our clinic we performed a retrospective chart review of 38 HIV-infected women who had received screening colposcopy. Fourteen percent of the women had VIN on biopsy.