The state of organized family planning programs in the United States, 1973.
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Biomedical subjects
Publications and source records attributed to M Corey.
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The 79 female and 147 male patients constituting the population with cystic fibrosis (CF) aged 16 years and older attending The Hospital for Sick Children were asked to complete the Cornell Medical Index (CMI) and Tennessee Self-Concept Scale (TSCS); 64 female (81%) and 112 male (76%) subjects participated. Analysis of CMI results showed 43% of female subjects to have moderate to severe emotional disturbance compared to 19% of male subjects. This female : male ratio for severity of emotional disturbance is found in ostensibly healthy groups, but the percentages of disturbance approach values for medical patient populations. The frequency of emotional disability is greater in those more than 20 than in those 16-19 years old. The TSCS results portray a generally normal self-concept except for scores of positive physical self and psychosis for patients aged 20 years and older; these scores approach psychiatric values, suggesting that some reality distortion facilitates emotional adjustment to adult life with CF. The TSCS and CMI results correlate significantly, indicating a connection between self-concept and emotional status. However, TSCS and CMI scores do not correlate with measures of disease severity except for correlations between lung function and physical self-concept in older male patients. These results suggest that psychologic functioning is independent of the degree of physical impairment in older patients with CF, with the long-surviving male patients more realistically appraising the limitations their disease imposes and utilizing denial and minimization to a lesser degree. Demographic data on the clinic population reveal that most patients aged 16 years and older cope with their intellectual, developmental, and socioeconomic tasks commensurate with normal age expectations.
Eighty-five 12- to 15-year-old adolescents regularly attending the cystic fibrosis (CF) clinic of The Hospital for Sick Children were asked to complete the Children's Health Locus of Control and the Tennessee Self Concept Scale. Their parents were requested to complete the Child Behavior Checklist. Thirty-four males (72%) and 28 females (74%) participated in the study. This study found that adolescents with CF are able to maintain a good self concept, be socially competent, and perceive that they are in control of their health while showing an increase in behavior problems. Females rely heavily on denial and are more behaviorally compliant, whereas boys use less denial but show more behavior problems. Males appear to integrate having a physical disorder into their self concept, whereas females do not. The findings demonstrate a difference in mechanisms of coping with cystic fibrosis between male and female adolescents with CF, which may contribute to the decline in physical status in females and better survival of males.
One hundred and twenty-six 6 to 11-year-old latency age children with Cystic Fibrosis regularly attending the CF clinic of the Hospital for Sick Children were asked to complete the Piers-Harris Self-Concept Scale and the Children's Health Locus of Control. Their parents were requested to complete the Child Behavior Checklist and the Family Assessment Measure. One hundred and eight (86%) participated in the study. Twenty-three percent of the children were found to have sufficient behavior problems to indicate a significant degree of maladjustment. Latency-age CF children show an increase in problems compared to a pre-school group, suggesting that leaving the protection of the family is problematic for a child with a chronic physical disorder. Males show more behavior problems than females. Males' behavior is characterized by somatic complaint profile. In spite of difficulties, CF latency children are able to maintain good social competence and self-concept suggesting compensatory mechanisms. These mechanisms are different for males and females. Females' self-concept and social competence are supportive of each other, whereas for males, this is not the case. Similarly, female behavior is relevant to family functioning. Males and females adjust to difficulty as indicated by differences in behavior profiles.
Most organized family planning programs combine the delivery of contraceptive services with a wide range of preventive health services. An estimated 3.3 million women, 97 percent of all who received family planning services in organized programs in FY 1974, received one or more medical services. At least 2.7 mission women received each of the 'core' medical services recommended by DHEW -- pap smear, blood pressure and pelvic and breast examinations. About 2.4 million women were tested for VD; 2.1 million women received urinalyses and 1.9 million received blood tests. Other services provided included pregnancy testing, infertility workup, and rubella and sickle cell screening.