Silent no more! The lived experiences of women with lichen sclerosis

Purpose: Lichen Sclerosis (LS) is an often unrecognized and misdiagnosed chronic inflammatory skin condition of the anogenital area that affects quality of life, bringing severe discomfort and distress to affected men, women, and children. The purpose of this qualitative study is to explore the lived experiences of women with LS. Data sources: Content analysis was conducted of data obtained from three public online forums/blogs used by women with LS. A total of 527 postings/entries were analyzed for patterns and themes by four researchers. Conclusions: Five core themes emerged as a result of this study, revealing feelings of frustration and despair stemming from healthcare providers' lack of knowledge in relation to Lichen Sclerosis, often leading to misdiagnosis, prolonged suffering, and an altered quality of life. Implications for practice: Knowledgeable healthcare providers and additional research into the cause, treatment, and cure of Lichen Sclerosis are needed. Advance‐practice nurses stand to play an important role in the areas of education, research, policy making, and clinical practice to advocate for and empower women with LS.Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/92447/1/j.1745-7599.2012.00715.x.pd

Identification of Undiagnosed Depression in Patients with Chronic Musculoskeletal Low Back Pain in a Nurse Practitioner Urban Primary Care Practice

This study examined: (a) the incidence of concomitant depression in the chronic pain population at a clinic serving the underserved in a metropolitan area, (b) the reported incidence of depression in men vs. women, (c) the reported uses of substances in the depressed population, and (d) the perception of adequately treated pain in the depressed population and how it related to comorbid occurence of depression. Dorthea Orem's Self Care Theory, which states that every individual has the ability to perform self-care for optimum health, is the theoretical framework used for this study. Utilizing a convenience sample of subjects, men and women between the ages of 18-64 who were previously diagnosed with low back musculoskeletal pain and met inclusion criteria were recruited from a clinic providing primary care for the underserved population in a metropolitan area. Potential participants were approached and asked to complete an initial screening tool to determine suitability for participation in the study. Participants (N=42) completed a demographic and data questionnaire and a Beck Depression Inventory-Fast Screen (BDI). Results of this study revealed that in the chronic pain population, men were more depressed than women. Of those who were previously diagnosed with depression, 1/4 of them received a referral for treatment, but 72% of those with depression were currently not being treated. In this study, findings revealed more men (40.7%) than women (33.3%) were diagnosed as depressed, though distribution of level of depression differed. Scores on the BDI - fast screen showed that more men (38.7%) than women (13.3%) scored as moderate to severely depressed, where as more women (46.7% than men (26.9%) scored as minimal to mildly depressed. Of those diagnosed with depression, only 42.1% said their pain was adequately treated, leaving 57.9% to express that they were not adequately treated. This study supports the use of routine assessment of levels of depression and initiating treatment when needed in the chronic pain population. Implications for nursing practice include recommendation for the use of an assessment tool to screen and diagnose for depression, such as the BDI-fast screen, which identifies the severity of depression.Master'sSchool of Health Professions and Studies: NursingUniversity of Michiganhttp://deepblue.lib.umich.edu/bitstream/2027.42/118030/1/Erickson.pd