Carolyn Seymore

Influence of position during examination, and sex of examiner on patient anxiety during pelvic examination

It has been reported that adult women prefer the semi-sitting position over the supine position for the pelvic examination. We determined the effect of the pelvic examination position and the examiners gender on adolescent anxiety with the pelvic examination. Adolescent girls (n = 112) aged 12 to 19 years were randomly assigned to a semi-sitting or supine position and to a male or female physician. Before and after the examination questionnaires containing the Spielberger State-Trait Anxiety Inventory and other scales were administered. There were no differences between the groups in pre-examination anxiety or concern. Patients in the semi-sitting group reported fewer negative responses during the examination when examined by a male physician (P less than or equal to 0.009); those in the supine group reported fewer negative responses when examined by a female physician. These findings persisted after controlling for previous pelvic examinations, frequency of sexual activity, and Tanner stage. Patients who had previously had a pelvic examination and were examined in the semi-sitting position by a male physician reported the lowest levels of post-examination anxiety (P less than or equal to 0.02). Patients who had never had a pelvic examination expressed less anxiety if they were examined in the semi-sitting position by a female physician. These data suggest that the patients previous history of pelvic examinations and the gender of the examiner should be considered when selecting the pelvic examination position.

Child development knowledge, childrearing attitudes, and social support among first- and second-time adolescent mothers

This paper compares the parenting characteristics of first- and second-time adolescent mothers. Using a case control design, immediately after delivery and at two months postpartum we administered a pretested questionnaire to 51 second-time adolescent mothers, 47 first-time adolescent mothers, and 25 second-time adult mothers. The questionnaire measured the subjects social support system, contraceptive use, and education level. Scales measuring stressful life events, knowledge of child development, and childrearing attitudes were included. The adolescent groups were similar except that significantly more second-time adolescent mothers dropped out of school (p less than or equal to 0.05). Greater maternal education and higher infant five-minute Apgar scores were associated with less negative childrearing attitudes immediately after the birth (p less than or equal to 0.05). At two months postpartum, the age of the father and the time he spent with the child were associated with positive childrearing attitudes (p less than or equal to 0.05). Increased paternal involvement and completion of high school may enhance adolescent attitudes toward childrearing and improve mother-child relations.

Contraceptive behavior among sexually active Hispanic adolescents

The purpose of this study was to examine those factors associated with the contraceptive behavior of a national representative sample of Hispanic female adolescents. The subjects included all (n = 85) unmarried, sexually active Hispanic women, aged 15 to 19, from the 1982 National Survey of Family Growth. Contraceptive behavior was measured on a normalized scale, ranging from oral contraceptives to no contraception. Mexican/American and Central/South American background females were more likely (p less than 0.031) to use effective birth control than Puerto Rican, Cuban, and other Hispanic background subjects. Twenty additional social, behavioral, and demographic variables were found to be significantly associated (p less than 0.05) with contraceptive behavior. Based on multiple regression analysis, seven of these variables were found to explain 62% (p less than 0.0001) of the variation in the contraceptive behavior of this sample. Poorer contraceptive behavior was associated with noncompliance with the initial birth control method used (33.8%), lower coital frequency (8.3%), older postmenarchial age (5.7%), failure to use birth control at first coitus (4.6%), fewer years dating (4.0%), lower frequency of church attendance (3.3%), and never having experienced a pregnancy scare (2.0%). These findings suggest that the contraceptive behavior of Hispanic female adolescents is a dynamic process that can be understood in the context of previous sexual and contraceptive behavior.

Sexual behavior among hispanic female adolescents in the United States

The purpose of this study was to identify factors associated with sexual activity in a national representative sample of Hispanic female adolescents. The subjects included all (n = 202) 15- to 19-year-old Hispanic female adolescents from the 1982 National Survey of Family Growth subdivided into Mexican-American (n = 119), Puerto Rican (n = 34), Central/South American (n = 23), Cuban (n = 9), and other Hispanic (n = 17) background groups. A total of 42% of the young women were sexually active. More Cubans (69.0%) and Central/South Americans (55.6%) reported sexual activity than the other groups, but the differences were not statistically significant. With multiple regression analysis, a significant amount of variation (total R2 = 0.367, P less than or equal to .001) in sexual activity was explained by the following variables: not being in school (22.5%), no religious affiliation (4.4%), age (3.3%), less church attendance (3.0%), older age at menarche (1.9%), and not living with both parents at age 14 years (1.9%). These findings suggest that maintaining social continuity in the areas of school, church affiliation and involvement, and family structure, as well as physical maturity are associated with Hispanic adolescent girls not becoming sexually active.

Reiter's syndrome in an adolescent female with systemic sequelae

Reiters syndrome (RS) generally affects adult white males. It occurs infrequently in adolescents. This condition is characterized by a triad of symptoms: arthritis, urethritis, and ocular abnormalities, and it usually has a benign course. We report an atypical case of RS in a black adolescent female who developed articular and ocular sequelae. Despite aggressive medical therapy, one year after diagnosis her condition has deteriorated and she is confined to a wheelchair. Although RS is believed to be a brief illness predominantly affecting the joints of the lower extremity, this condition may have severe systemic manifestations with chronic sequelae.