| Learning Objective #1: Discuss the relationship of the created environment to the clinical care of obese women | |||
| Learning Objective #2: Identify gynecologic risk reduction challenges and strategies for obese women |
Objective: The overall purpose of this qualitative study was to identify factors that influence well woman gynecologic care practices of overweight and obese women.
Design: The interpretive method of naturalistic inquiry (Lincoln & Guba, 1985) was used to explore the context and meaning of the data from the perspective of the participants. Betty Neuman's System's Model guided the study.
Population, Sample & Setting: The participants included fifteen, suburban, middle class, racially diverse women who self-identified as overweight or obese. Women were recruited through announcements at a community church, by word-of-mouth, and through purposive snowball sampling.
Method: Intensive interviews were conducted using a semi-structured interview guide with open-ended questions. Data were analyzed using the constant comparative method.
Findings: Findings suggest that women's perception of their fatness, feelings about their bodies, and health are embodied in their created-environment (Neuman, 1990). Their perceptions influenced their participation and experiences with well gynecologic care. One third of the group chose not to participate in annual examinations in spite of recognizing the health importance of annual pap smears.
Conclusions: The well gynecologic experiences of obese women are similar to experiences of normal weight women. Given the heightened risk for endometrial and breast cancer in obese women, it is important to recognize obese women's feelings about their bodies that support/hinder their participation in health care.
Implications: Sensitivity to obese women's individual health needs can mediate stressors and enhance strengths that support well gynecologic care in this population. Assessment for level of comfort with examination and educational needs regarding weight and gynecologic risk factors must be addressed. Women's faith in the quality of their examination, given difficulty with bimanual examination in obese women, needs further exploration.
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