Gee Royal
Sacramento Family Medical Clinic, Sacramento, California, USA.
J Am Acad Nurse Pract. 2006 Apr;18(4):144-53. doi: 10.1111/j.1745-7599.2006.00117.x.
The purpose of the article is to examine "appropriate" health care for men who have sex with men (MSM), which is not to suggest "special" health care. As a group, MSM are at increased risk for sexually transmitted infections, anal cancer, and mental health disorders. Focus areas in this article will address health issues that the primary care nurse practitioner (NP) may encounter in clinical practice: anal carcinoma, sexually transmitted diseases (STDs), high-risk sexual practices, depression, and substance abuse were topics chosen for inclusion in this article. These topics were among those highlighted in the Healthy People 2010 Companion Document for LGBT Health, which served to examine the healthcare disparities and lack of access to needed services related to sexual orientation.
Extensive literature review of research articles, journals, clinical practice guidelines, books, and public health department Internet Web sites.
There are unique health disparities that exist for MSM related to social, emotional, and mental health factors, in addition to physical issues such as STDs. There is an increasing need for primary care providers to be aware of these disparities, as well as the factors that influence these disparities, in order to provide multidimensional care and health counseling that is unique to NP practice.
Both the primary care NP and the patient should be aware of the unique healthcare issues among MSM that should be incorporated into the patient's routine health maintenance program. As primary care providers, it is within the standards of practice for NPs to provide culturally competent care, along with health promotion and disease prevention for MSM.
本文旨在探讨男男性行为者(MSM)的“适当”医疗保健,而非“特殊”医疗保健。作为一个群体,男男性行为者感染性传播感染、患肛门癌和心理健康障碍的风险增加。本文的重点领域将涉及初级保健执业护士(NP)在临床实践中可能遇到的健康问题:肛门癌、性传播疾病(STD)、高风险性行为、抑郁症和药物滥用是本文选择纳入的主题。这些主题是《2010年美国人健康计划》LGBT健康配套文件中重点强调的内容,该文件旨在研究与性取向相关的医疗保健差异以及获得所需服务的不足。
对研究文章、期刊、临床实践指南、书籍和公共卫生部门互联网网站进行广泛的文献综述。
除了性传播疾病等身体问题外,男男性行为者还存在与社会、情感和心理健康因素相关的独特健康差异。初级保健提供者越来越需要了解这些差异以及影响这些差异的因素,以便提供NP实践中特有的多维度护理和健康咨询。
初级保健NP和患者都应了解男男性行为者中独特的医疗保健问题,并将其纳入患者的常规健康维护计划。作为初级保健提供者,NP按照实践标准为男男性行为者提供具有文化能力的护理以及健康促进和疾病预防服务。