Page 583 - Encyclopedia of Nursing Research

550 n WOMen’S heALTh

osteoporosis, breast and ovarian cancer, uri-
Women’s health nary incontinence, the autoimmune diseases,
W–Z violence, and poverty.
health had been construed such that
“Women’s health” is a phrase that has male behavior was regarded as normative,
changed dramatically in meaning over the and research conducted exclusively on males
past few decades. Although it used to denote was typically generalized to all human
a focus on health care issues that affected beings. When women did not fare as well
only women—historically involving matters with the same treatment, they were regarded
such as gynecologic, reproductive, obstet- as atypical. It was simply not considered that
ric, and breast health or disease—it now the female body responded to health prob-
denotes a focus on the experience of women lems and to treatment modalities differently
with health. This encompasses an expanded from the male. From Freud to Kohlberg, the-
biopsychosocial perspective that takes into oretical models had been constructed so that
account the overall well-being of the woman, women were regarded as less developed
which is shaped by the fit between the when they did not act in a fashion similar
woman and her environment. In this new to men. even when studied, the sociocul-
era, women’s health is concerned not only tural factors shaping health problems in girls
with women’s diseases, but their diseases, and women were ignored, for example, the
too, and coincides with nursing’s longstand- relationship between learned helplessness
ing emphasis on the interface between and and some kinds of depression, and between
among genetic, physiologic, psychosocial, anorexia and the popular (yet unhealthy)
economic, cultural, generational, develop- admonition that you can never be too rich
mental, and lifestyle factors in determining nor too thin.
health. Women’s health now includes wom- Social health systems also had been prej-
en’s experiences with all health and illness udicial in important respects. Insurance pol-
states, and, importantly, woman’s responses icies did not necessarily cover health matters
to these various states. unique to women, for example, breast pros-
Women’s health research began as a cri- theses post mastectomy. Women were not in
tique of existing practices and their effects research and policy-making positions pro-
on women’s well-being. In 1985, the Public portionate to their numbers, responsibilities,
health Service Task Force on Women’s and educational preparation. The burden of
health Issues examined the role of the family caregiving that women largely bear
Department of health and human Services remained invisible, notably in estimates of
in addressing women’s health and found that the gross national product.
women were often not included as subjects in The Office of Research on Women’s
health research. Women, especially women health (ORWh) was established in 1990
of childbearing potential, had historically within the Office of the Director of the
been excluded from the first two stages of national Institutes of health (nIh) to address
drug testing due to concerns about affect- these lacunae. A decade later, not coinciden-
ing current or future pregnancy outcomes tally, the majority of human subjects enrolled
and effects from normal hormonal changes in all extramural nIh research were women,
in women subjects during trials. even female and they were represented in Phase III clin-
animals had typically not been used in con- ical trials.
structing animal models because of “their Often led by nurses, women’s health
hormonal fluctuations.” The health problems research became relatively mainstream in
that women suffer from disproportionately the ensuing years. S. K. Donaldson (2000)
were also not often studied, for example, analyzed the achievements of nursing