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Biomedical subjects

W L Graves

Publications and source records attributed to W L Graves.

29 records · Page 2Linked to original sources

Carcinoma of the cervix and sexual function.

Forty-six patients were interviewed more than a year after treatment for carcinoma of the cervix to establish the effects of radiation therapy and of surgical therapy on sexual feelings and performance. Group 1 consisted of 22 patients who had undergone radiation therapy for stage I, II, or III cancer of the cervix. Group 2 consisted of 20 patients who had undergone hysterectomy with or without partial vaginectomy for carcinoma in situ. The irradiated patients experienced statistically significant decreases in sexual enjoyment, ability to attain orgasm, libido, frequency of intercourse, opportunity, and sexual dreams. The surgically treated group had no significant change in sexual function after treatment. Both groups experienced a change in self-image but did not feel that their partners or family viewed them differently. Myths about cancer and the actual effects of pelvic irradiation were found to have disrupted the sexual-marital relationships of many women. Therapeutic programs are discussed through which women can be helped through this difficult time in their lives.

Adult↗

The psychological implications of spontaneous abortions.

Spontaneous abortion occurs in approximately 15% of obstetric patients. Our efforts to decrease bleeding and prevent infection do not take into account the emotional stress of the patient or the sense of grief and loss she might be feeling. Predominantly, the women in this study were concerned with what caused the miscarriage and why it happened. They described themselves as unhappy, depressed, hostile and anxious. In addition, the patients were often misinformed and frequently desired more accurate data. Approximately 25% answered yes to having a psychiatric problem. One-fourth of the patients had been seen earlier in their pregnancies with a threatened abortion; 17.3% had had a previous miscarriage, and 25% felt they were personally responsible for the miscarriage. Recognition of an attention to these facts enables the obstetrician-gynecologist to offer better patient care in the form of reassurance and information at several points of interaction with the patient experiencing a spontaneous abortion.

Abortion, Spontaneous↗

Use of the intrauterine device by inner-city women.

OBJECTIVE: To examine the use, effectiveness, acceptability, and continuation rates of the copper T 380 A intrauterine device (IUD) among women attending an inner-city family planning clinic. DESIGN: A 1-year prospective cohort study. SETTING: The family planning clinic of Grady Memorial Hospital, which serves the inner-city indigent population of Fulton and Dekalb counties in metropolitan Atlanta, Ga. PARTICIPANTS: A total of 115 women with 1 or more live births who were in a mutually monogamous relationship for the previous year had the copper T 380 A IUD inserted between December 20, 1990, and June 28, 1991. MAIN OUTCOME MEASURES: Follow-up, consisting of history and a pelvic examination, was done 2, 6, and 12 months after IUD insertion to determine the status of the IUD and to detect any complications related to its use. At the end of the study, the continuation rates, reasons for removal, and complications related to IUD use were assessed. RESULTS: Thirty-seven women were unavailable for follow-up. Eight of those were seen in other clinics at Grady Memorial Hospital, but no mention was made of their IUD status. Fifty-six of the remaining 78 women were known to continue IUD use without any complications at the end of the 12 months. Among the 22 women known to have the IUD removed, 8 women cited no problems. Pelvic pain, menometrorrhagia, desire for permanent sterilization, and expulsion of the device were mentioned as reasons for other IUD removals. Pelvic inflammatory disease was not documented in any of the patients during the year of follow-up. CONCLUSION: With proper screening and counseling, the IUD may be used successfully in selected patients in inner-city family planning clinics.

Adolescent↗

Beliefs about contraceptive sterilization among low-income urban women.

Among a group of low-income clinic patients planning to be sterilized, the vast majority--95 percent--reported believing that sterilization is the surest way to avoid getting pregnant and that it is safer than other contraceptive methods. Among a comparison group who also wanted no more children but did not plan to be sterilized, the majority also held these beliefs, but the proportion was lower (76-80 percent). In both groups, however, only between 64 and 70 percent knew that sterilization makes it impossible to have children in the future. Between 63 and 68 percent of the women in the sterilization group believed that having the operation would improve their family relationships, emotional state and other aspects of their lives, but only 35-58 percent of the comparison group held these beliefs. On the other hand, women in the comparison group were more likely than those in the sterilization group to believe that sterilization has negative health and psychological effects--for example, changes in menses (more bleeding or cramping) or defeminization. The beliefs held by both groups suggest that it is a conviction regarding the advantages of sterilization, rather than a relative unawareness of the disadvantages, that distinguishes women who plan to be sterilized from those who, although they want no more children, do not have similar plans. The study results have implications for family planning professionals: Counselors need to be aware that some women seeking sterilization may not understand its permanency or may have an unrealistic appraisal of its potential effect on their lives.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗