GYN Self-Care and Military Women in Austere Environments

Approximately 340,000 women serve in the Armed Forces in 95% of all occupational areas, thus at any one time, many women are deployed with their units to austere military environments. Environmental, behavioral and situational factors create microbiological circumstances that are conducive to the development and exacerbation of gynecologic infections such as vaginitis and urinary tract infection (UTI). The burning, itching, vaginal discharge, polyuria and dysuria that result from vaginitis and UTI are miserable and distracting for women in any environment. This research showed that the most likely health care provider available during deployment is a young medic. Military women report that they are embarrassed and less likely to seek care for vaginal and urinary symptoms during deployment than at their home duty stations because of their perceptions about the expertise and confidentiality of the provider. Thus, military women are at a higher risk for development and inadequate management of common gynecologic infections.

Phase I of the study was an anonymous survey of 1534 military women to describe the scope of the problem of gynecologic infections experienced in austere environments, and to demonstrate the need for an alternative to current health care resources under these conditions. Variables included caregiver characteristics, situational and behavioral risk factors, symptoms and self-care behavior during deployment. Some of the findings were reported in Women's Health Issues, 2000.

Phase II was a clinical test of a self-diagnosis kit for women experiencing signs and symptoms of gynecologic infections. When compared to nurse practitioners' clinical diagnoses, the Vaginitis Decision-Making Guide had a sensitivity of 84% for CV, 91.3% for BV, and a specificity of 81.5% for CV, 82.8% for BV (n=52 self-diagnoses). The Cystitis Decision-Making Guide had a sensitivity of 100%, that is, of 22 cases where the APN diagnosed cystitis, all 22 women self-diagnosed cystitis. These findings are reported in Clinical Nursing Research, 2000.

Final report is available on NTRL: https://ntrl.ntis.gov/NTRL/dashboard/searchResults/titleDetail/PB2008112...