Fatma YILDIRIM, Mevlüde ALPASLAN ARAR, Nilüfer ERBİL

Engelli kadınlarda üreme sağlığı sorunları ve hemşirelik yaklaşımı

Dünya genelinde cinsel sağlık ve üreme sağlığı (CS/ÜS) hizmetleri ve bu hizmetlere ulaşım artmış olsa da, özellikle kırsal kesimde yaşayanların, yoksulların ve engelli bireylerin CS/ÜS hizmetlerine erişimde hala büyük engeller bulunmaktadır. Dünya Engellilik Raporuna göre, insanların %15’i fiziksel, duyusal, entelektüel veya zihinsel bir engel ile yaşamaktadır ve bu engelli bireylerin %80’i düşük ve orta gelirli ülkelerdedir. Düşük ve orta gelirli ülkelerde yaşayan engelli kadınların CS/ ÜS hizmetlerine erişimleri, engelli bireylere yönelik sağlık hizmetleri alanındaki altyapı ve eğitim sorunları nedeniyle eşitsizliklerle karşı karşıya kalmaktadır. Engelli kadınların büyük çoğunluğu cinsel ve üreme sağlığı hususunda söz sahibi olamamakta, cinsiyetsiz olarak kabul edilmekte ve üreme hakları yokmuş gibi değerlendirilmektedir. Engelli kadınların cinsel yaşam, aile planlaması, üreme siklusu, menstrual hijyen davranışı, cinsel yolla bulaşan hastalıklardan korunma ve ebeveynliğe uyum sağlamada yaşadıkları sorunlar dikkat çekmektedir. Bu derlemede, engelli kadınların yaşadıkları CS/ÜS sorunlarını tanımlamak, toplumda bu konu ile ilgili farkındalık sağlamak ve sorunlara yönelik geliştirilen hemşirelik yaklaşımlarına yol gösterici olmak amaçlanmıştır.

Reproductive health problems in women with disabilities and nursing approach

Although sexual and reproductive health (SRH) services and access to these services have increased throughout the world, there are still major barriers to access to SRH especially for rural residents, the poor and the disabled. According to the World Disability Report, 15% of people live with a physical, sensory, intellectual or mental disability, and 80% of these disabled individuals are in low and middle income countries. Access of disabled women living in low and middle income countries to SRH services is faced with inequalities due to infrastructure and education problems in the field of health services for people with disabilities. The vast majority of women with disabilities cannot have a say in sexual and reproductive health, they are regarded as genderless and are considered to have no reproductive rights. It is noteworthy that the disabled have problems with sexual life, family planning, reproductive cycle, menstrual hygiene behavior, sexually transmitted diseases and adaptation to parenthood. In this review, it is aimed to describe SRH problems experienced by women with disabilities, to raise awareness about this issue in the society, and to guide nursing approaches developed for these problems.

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