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What is a woman? A female person more than 18 years old. Women is plural of woman. A woman has to be distinguished from a man, a child, or an adolescent girl. What should a women know relevant to doctor’s consultation? Human pregnancy is not the only issue that a woman brings to a doctor. Women can have many other issues. What is women's health? Women's health refers to health issues specific to human female anatomy. How has women health consultation been elaborated? Health issues relevant to her pregnancy now. Health issues relevant to her previous pregnancy. Health issues not relevant to her pregnancy. What should I know about you? Address Activities of everyday living Annual health assessment Assets Abilities/skills Communications Complaint/problem Contraception History Duties Detention Education Emergency Contact Family Medical History Hospitalization Impairment Rating and Disability Determination Language Menstrual History Pregnancy History (if you have not ever been pregnant, skip to the next section) Photograph Profession Personality questions Referrals Survival Needs Stress Social History Sexual History Travel history How should you answer these questions? Answer to the best of your ability and knowledge. What should you write if a question is not applicable to you? This is not applicable to me at this point. Questions relevant to female medical history Take a look at this. Questions you need to answer. |
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Question 2
What is your name? | |||||||||||||||||||||||||||||||||||||||||||
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Question 3
What is your date of birth? | |||||||||||||||||||||||||||||||||||||||||||
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Question 4
What languages can you understand? | |||||||||||||||||||||||||||||||||||||||||||
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Question 5
What is your telephone number? | |||||||||||||||||||||||||||||||||||||||||||
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Question 6
Where is the patient now? | |||||||||||||||||||||||||||||||||||||||||||
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Question 7
How old is the patient? | |||||||||||||||||||||||||||||||||||||||||||
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Question 8
What is the gender of the patient? | |||||||||||||||||||||||||||||||||||||||||||
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Question 9
What is your complaint or problem relevant to being a woman? Activities of everyday living issues Annual health assessment issues Assets issues Abilities/skills issues Contraception issues Communications issues Duties Detention issues Education issues Emergency contact details issues Family issues Hospitalization issues Impairment rating and disability determination Language issues Menstruation issues Pregnancy issues Profession issues Personality questions Referrals issues Relationships issues Survival needs issues Stress issues Social issues Sexual issues Signs of genital or breast lumps, discharge, or sores. Issues not specified above | |||||||||||||||||||||||||||||||||||||||||||
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Question 10
What best describes the patient?: | |||||||||||||||||||||||||||||||||||||||||||
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Question 11
In general, how is your physical and mental health? | |||||||||||||||||||||||||||||||||||||||||||
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Question 12
Do you have any appointments scheduled with doctors or other specialists? |
Yes No | ||||||||||||||||||||||||||||||||||||||||||
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Question 13
Have you been in the hospital in the last month? |
Yes No | ||||||||||||||||||||||||||||||||||||||||||
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Question 14
Do you have health problems that you need help with right away? |
Yes No | ||||||||||||||||||||||||||||||||||||||||||
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Question 15
Do you need extra help to access services, such as a wheelchair ramp, a computer screen reader or large print materials? |
Yes No | ||||||||||||||||||||||||||||||||||||||||||
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Question 16
Screening for survival needs Do you have enough of these resources from the state? Food Clothing Housing Health care Transportation Security Education Consumer goods Communication Do you need any of these resources to be enhanced? | |||||||||||||||||||||||||||||||||||||||||||
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Question 17
Are you currently breastfeeding? | |||||||||||||||||||||||||||||||||||||||||||
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Question 18
Is your complete medical history ready? |
Yes No | ||||||||||||||||||||||||||||||||||||||||||
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Question 19
Primary Care Physician Name, Address and Phone:__________________ Emergency Contact Name:______________ Relationship:________________________ | |||||||||||||||||||||||||||||||||||||||||||
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Question 20
Your Height:_________________________ Your Weight:_________________________ | |||||||||||||||||||||||||||||||||||||||||||
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Question 21
Referred by:_________________________ | |||||||||||||||||||||||||||||||||||||||||||
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Question 22
What seems to be the problem? | |||||||||||||||||||||||||||||||||||||||||||
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Question 23
What is the reason for consultation? | |||||||||||||||||||||||||||||||||||||||||||
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Question 24
What best describes problem of the patient? Sleep problems. Anger. Relationship problem. Not taking care of self. Not taking care of others. Misinterpreting the facts. Recent social withdrawal or loss of interest in others. Illogical thinking typical of childhood but in an adult. Repeatedly checking or doing activities that seem abnormal. Restlessness. Administrative abuse/harms from others. Thoughts or threats to hurt oneself or others. Social withdrawal after death of a person known to the patient. Communication problem (speech, writing, reading, expression). Not enough food, clothing, housing needs, transportation, health care, or education. Other issues. You need to give details of the issues or problems. Life-threatening conditions. Suicidal thoughts. Homicidal thoughts. Assault, violent actions or behavior. Delirium or extreme agitation. Feeling that harms have been inflicted or are being inflicted, and that harms are going to be inflicted that need to be prevented. | |||||||||||||||||||||||||||||||||||||||||||
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Question 25
Is the claim any one of these? Psychological torture Physical torture Corruption in politics of regulations Racism Deprivations of rights under the color of law Political abuse Discrimination Disruption Exclusion | |||||||||||||||||||||||||||||||||||||||||||
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Question 26
Did anyone beat or torture you at any point since birth? | |||||||||||||||||||||||||||||||||||||||||||
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Question 27
Is there any incident or issue in past, present, or future that is causing distress to you? | |||||||||||||||||||||||||||||||||||||||||||
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Question 28
Did you experience any one of these that has troubled you since the day you were born? Assault. Accidents. Child abuse or captivity. Childbirth. Death of a loved one. Fire. Rape. Natural disaster (hurricanes, earthquakes, tsunamis). Road traffic crash. Building collapse. Fire. Shooting. Neglect of a child leading to a serious harms. Domestic violence. War. Genocide. Torture. If yes, what are the details? If any other traumatic, stressful, harmful, or horrifying event, give more details. | |||||||||||||||||||||||||||||||||||||||||||
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Question 29
What conditions require emergency psychiatry consultation? 1. Attempted suicide. 2. Attempted homicide. 3. Substance abuse. 4. Psychosis(delusions, hallucinations, catatonia, thought disorder, loss of contact with reality). 5. Suicidal thoughts, homicidal thoughts. 6. Violence or other rapid changes in behavior. 7. Abuse. 8. Environmental factors (hostile environment). 9. Functional impairment (not taking care of self. inability to gain relevant skills and knowledge relevant to age). 10. Personality disorders (harmful to others). 11. Panic attacks. 12. Loosening of social inhibitions. 13. Likely to be harmful to self or others. 14. Serious drug reactions with psychiatric or non-psychiatric medications. 15. Intentional enforced harms. 16. Other. Here are further guidelines. What best describes you? | |||||||||||||||||||||||||||||||||||||||||||
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Question 30
Is the individual on any medication? | |||||||||||||||||||||||||||||||||||||||||||
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Question 31
Intentional enforced harms What are intentional enforced harms? | |||||||||||||||||||||||||||||||||||||||||||
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Question 32
Commons Signs and Symptoms of Major Mental Illnesses Anxiety Bi-Polar Disorder Chemical Dependency Depression Psychotic Disorders Take a look at this. What best describes you? |
Aggressive Anger Anxiety Avoidance of situations Being unable to limit the amount of alcohol you drink Blunted Building a tolerance so that you need an increasing number of drinks to feel the effects Carelessness about personal grooming Change in appetite Changed sleeping pattern Changes in Behavior – Sleep disturbance Changes in Emotion and Motivation Changes in Thinking and Perception Chest pain Choking Chronic fatigue, lack of energy Confusion Constipation Crying spells Decrease concentration and memory Decreased appetite Decreased coordination Delusions Depression Depression as the drug wears off Diarrhea, muscle aches Difficulties with concentration or attention Difficulty concentrating Distress in social situations Dizziness Drinking alone or in secret Drowsiness Dry mouth Elated mood Especially if alcohol isn't available Euphoria Experiencing physical withdrawal symptoms such as nausea, sweating and shaking Feeling a need or compulsion to drink Feeling that self or others have changed or are acting different in some way Flashbacks, a re-experience of the hallucinations — even years later Flat or inappropriate emotion Flushing Frequent self-criticism Grandiose delusions Greatly impaired perception of reality, for example, interpreting input from one of your senses as another, such as hearing colors guilt Gulping drinks, ordering doubles, becoming intoxicated intentionally to feel good or drinking to feel "normal" Hallucinations Having legal problems Having problems with relationships Headache, sweating Heart palpitations Helplessness High blood pressure Hopelessness Hyperventilation Impaired memory and concentration Impaired motor function Impatience Increased appetite Increased blood pressure and heart rate Increased energy and overactivity Increased heart rate Increased heart rate, blood pressure and temperature Indecisiveness and confusion Indecisiveness, irritability Insomnia Irregular menstrual cycle Irritability Irritability when your usual drinking time nears Keeping alcohol in unlikely places at home Lack of coordination Lack of emotional responsiveness Lack of energy, overeating or loss of appetite Lack of inhibitions Lack of insight. Losing interest in activities and hobbies that used to bring pleasure Loss of appetite Loss of interest in hobbies, sports, and other favorite activities Loss of interest in personal appearance(Social grooming) Loss of memory Loss of motivation, chronic fatigue Loss of motivation, drug or alcohol use Loss of sexual desire Making a ritual of having drinks before, with or after dinner and becoming annoyed when this ritual is disturbed or questioned Memory impairment Mind racing or going blank Mood swings Nasal congestion and damage to the mucous membrane of the nose in users who Snort drugs Nausea and vomiting Nausea, vomiting Needing less sleep than usual Needle marks (if injecting drugs) Neglect of responsibilities Not remembering conversations or commitments, sometimes referred to as blacking out Numbness Obsessive or compulsive behavior Overeating or loss of appetite Panic Paranoia Paranoid thinking Permanent mental changes in perception Phobic behavior Poor memory Rapid heartbeat Rapid speech Rapid thinking and speech Red eyes Red or glassy eyes Reduced ability to carry out work or other roles. Reduced energy and motivation Reduced sense of pain Restlessness Restlessness or feeling “on edge” or nervousness Runny nose Sadness Sedation Self-blame, pessimism Self-criticism, self-blame, pessimism Sense of alteration of self Sensory Changes(A heightened sense of visual, auditory and taste perception. A reduction or greater intensity of smell, sound or color) Shortness of breath Sleep disturbance sleeping too much or too little Slowed breathing Slowed breathing and decreased blood pressure Slowed reaction time Slurred speech Social isolation or withdrawal Strange ideas Sudden change in behavior Sudden mood swings Suspiciousness Tendency to believe others see you in a negative light Thoughts of death and suicide Tingling and numbness Tiredness Tremors Tremors/shaking Unexplained aches and pains Unrealistic and/or excessive fear and worry Unusual perceptual experiences Violent Behavior Vivid dreams Weight loss Weight loss or gain Withdrawal from family members and/or long-term friends Withdrawal from others Worrying | ||||||||||||||||||||||||||||||||||||||||||
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Question 33
What is the date you are documenting these facts? | |||||||||||||||||||||||||||||||||||||||||||
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Question 34
What is troubling you? | |||||||||||||||||||||||||||||||||||||||||||
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Question 35
Address What is your mailing address? ________________________ ________________________ ________________________ ________________________ | |||||||||||||||||||||||||||||||||||||||||||
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Question 36
Where are you located now? | |||||||||||||||||||||||||||||||||||||||||||
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Question 37
What was your mailing address from birth until now? _________________________ _________________________ _________________________ _________________________ | |||||||||||||||||||||||||||||||||||||||||||
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Question 38
Where do you live now? | |||||||||||||||||||||||||||||||||||||||||||
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Question 39
How long have you lived at this address? | |||||||||||||||||||||||||||||||||||||||||||
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Question 40
What is your contact information including current mailing address, telephone, e-mail, and any other details, and person to contact in case of emergency? | |||||||||||||||||||||||||||||||||||||||||||
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Question 41
How long do you plan to live at this address? | |||||||||||||||||||||||||||||||||||||||||||
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Question 42
Abilities/skills What are your abilities and skills? | |||||||||||||||||||||||||||||||||||||||||||
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Question 43
Annual health assessment When was your last annual health assessment done? | |||||||||||||||||||||||||||||||||||||||||||
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Question 44
Who did your last annual health assessment? | |||||||||||||||||||||||||||||||||||||||||||
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Question 45
What were the findings? | |||||||||||||||||||||||||||||||||||||||||||
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Question 46
What were the recommendations? | |||||||||||||||||||||||||||||||||||||||||||
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Question 47
Did the recommendations help? | |||||||||||||||||||||||||||||||||||||||||||
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Question 48
Was it an annual health assessment or evaluation of a new problem? | |||||||||||||||||||||||||||||||||||||||||||
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Question 49
When did you last see a medical doctor? | |||||||||||||||||||||||||||||||||||||||||||
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Question 50
Did you see a medical doctor for an annual health assessment or a new problem? | |||||||||||||||||||||||||||||||||||||||||||
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Question 51
What seemed to be the problem? | |||||||||||||||||||||||||||||||||||||||||||
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Question 52
What was the diagnosis and treatment? | |||||||||||||||||||||||||||||||||||||||||||
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Question 53
What is the name and contact information of the medical doctor who gave you this diagnosis and treatment? | |||||||||||||||||||||||||||||||||||||||||||
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Question 54
Communications What is the best method to communicate with you? E-mail. Fax. Telephone call. Postal mail. Communication through media. | |||||||||||||||||||||||||||||||||||||||||||
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Question 55
Complaint/problem Do you have any complaint/problem relevant to human health care today? | |||||||||||||||||||||||||||||||||||||||||||
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Question 56
If you have any complaint/problem relevant to human health care today, what are the details? | |||||||||||||||||||||||||||||||||||||||||||
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Question 57
What are the sources of medical history? | |||||||||||||||||||||||||||||||||||||||||||
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Question 58
Do you think there are any other issues relevant to woman? | |||||||||||||||||||||||||||||||||||||||||||
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Question 59
What are the details of the issue or issues? | |||||||||||||||||||||||||||||||||||||||||||
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Question 60
How are you feeling today? | |||||||||||||||||||||||||||||||||||||||||||
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Question 61
Do you have any problems today? | |||||||||||||||||||||||||||||||||||||||||||
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Question 62
What seems to be the problem? | |||||||||||||||||||||||||||||||||||||||||||
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Question 63
Do you have any other problems? | |||||||||||||||||||||||||||||||||||||||||||
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Question 64
Can you explain? | |||||||||||||||||||||||||||||||||||||||||||
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Question 65
Who raised you from birth until you were 18 years old? Biological mother Biological father Foster mother Foster father Medicolegal case | |||||||||||||||||||||||||||||||||||||||||||
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Question 66
What values were you raised with at home? | |||||||||||||||||||||||||||||||||||||||||||
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Question 67
What values were you raised with in school? | |||||||||||||||||||||||||||||||||||||||||||
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Question 68
What values were you raised with in the community? _________________________ Religious values, liberal sexploration values. Honesty, compassion, integrity, forgiveness, love, knowledge, discipline, faith, and leadership (positive values). Prejudice, hatred, greed, selfishness (negative values). | |||||||||||||||||||||||||||||||||||||||||||
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Question 69
Emergency contact You need to mention at least one woman to contact in case of emergency, and one more in case this woman is not available. What is the name, date of birth, contact details, including current mailing address, telephone, e-mail, and profile of an individual or individuals who should be contacted in case of emergency relevant to you? | |||||||||||||||||||||||||||||||||||||||||||
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Question 70
How is this individual related to you? | |||||||||||||||||||||||||||||||||||||||||||
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Question 71
Do you need a good charactered, well behaved, competent legal guardian? | |||||||||||||||||||||||||||||||||||||||||||
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Question 72
When was your last menstrual period? | |||||||||||||||||||||||||||||||||||||||||||
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Question 73
Are you in a sexual relationship now? | |||||||||||||||||||||||||||||||||||||||||||
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Question 74
Have you ever been a victim of a physical or sexual assault? | |||||||||||||||||||||||||||||||||||||||||||
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Question 75
Have you been in a relationship which involved hitting, slapping, kicking or other physical abuse? | |||||||||||||||||||||||||||||||||||||||||||
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Question 76
Has anyone forced you to have sexual activities? | |||||||||||||||||||||||||||||||||||||||||||
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Question 77
What surgeries have you had? | |||||||||||||||||||||||||||||||||||||||||||
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Question 78
Do you have any past or present medical or mental health problems that require a doctor’s care? | |||||||||||||||||||||||||||||||||||||||||||
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Question 79
Do you experience pain with intercourse? | |||||||||||||||||||||||||||||||||||||||||||
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Question 80
Do you experience bleeding after intercourse? | |||||||||||||||||||||||||||||||||||||||||||
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Question 81
Do you experience pain between periods? | |||||||||||||||||||||||||||||||||||||||||||
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Question 82
Are you currently experiencing vaginal discharge? | |||||||||||||||||||||||||||||||||||||||||||
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Question 83
Are you currently experiencing vaginal itching or discomfort? | |||||||||||||||||||||||||||||||||||||||||||
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Question 84
Have you experienced prolapse of bladder uterus or bowel? | |||||||||||||||||||||||||||||||||||||||||||
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Question 85
Have you experienced leakage from bladder or bowel? | |||||||||||||||||||||||||||||||||||||||||||
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Question 86
Who currently lives in household? | |||||||||||||||||||||||||||||||||||||||||||
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Question 87
Do you regularly exercise? | |||||||||||||||||||||||||||||||||||||||||||
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Question 88
Have you ever had a sexually-transmitted disease? | |||||||||||||||||||||||||||||||||||||||||||
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Question 89
Do you smoke cigarettes? | |||||||||||||||||||||||||||||||||||||||||||
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Question 90
Have you ever smoked cigarettes? | |||||||||||||||||||||||||||||||||||||||||||
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Question 91
Do you use other tobacco products? | |||||||||||||||||||||||||||||||||||||||||||
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Question 92
Do you drink alcohol? | |||||||||||||||||||||||||||||||||||||||||||
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Question 93
Have you ever been physically abused or hurt? | |||||||||||||||||||||||||||||||||||||||||||
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Question 94
Have you ever been forced to have sexual activity? | |||||||||||||||||||||||||||||||||||||||||||
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Question 95
Are there firearms in your home? | |||||||||||||||||||||||||||||||||||||||||||
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Question 96
Do you have any medical problems or additional concerns not mentioned above? | |||||||||||||||||||||||||||||||||||||||||||
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Question 97
Impairment Rating and Disability Determination Health status How would you describe your health status relevant to your age? 100% mentally fit. 100% physically fit. | |||||||||||||||||||||||||||||||||||||||||||
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Question 98
Do you have any problems with activities mentioned below relevant to your age? Walking Seeing Hearing Speaking Breathing Learning Working Caring for oneself (eating, dressing, toileting, etc.) Performing manual tasks Getting started after sleep Sitting Sleeping | |||||||||||||||||||||||||||||||||||||||||||
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Question 99
Menstrual history What was the first day of your last menstrual period? (dd/mm/yy) Don’t know | |||||||||||||||||||||||||||||||||||||||||||
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Question 100
Are you sure of that date? Yes No N/A | |||||||||||||||||||||||||||||||||||||||||||
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Question 101
How many days does your period last? days | |||||||||||||||||||||||||||||||||||||||||||
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Question 102
How many days are there between your periods? days | |||||||||||||||||||||||||||||||||||||||||||
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Question 103
Are your periods regular? Yes No N/A | |||||||||||||||||||||||||||||||||||||||||||
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Question 104
Pregnancy history How many times have you been pregnant in total (including this one)? | |||||||||||||||||||||||||||||||||||||||||||
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Question 105
Deliveries
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Question 106
Miscarriage, abortion, and ectopic
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Question 107
Have you had an ultrasound scan during your current pregnancy? _________________________ Yes No If yes, please bring copy to your appointment | |||||||||||||||||||||||||||||||||||||||||||
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Question 108
Have you had any pain during your current pregnancy? | |||||||||||||||||||||||||||||||||||||||||||
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Question 109
Have you had any bleeding during your current pregnancy? | |||||||||||||||||||||||||||||||||||||||||||
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Question 110
Have you had any nausea or vomiting during your current pregnancy? | |||||||||||||||||||||||||||||||||||||||||||
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Question 111
What are the issues? | |||||||||||||||||||||||||||||||||||||||||||
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Question 112
Who is writing answers to these questions? The patient. Someone else on behalf of patient. If someone else is answering these questions on behalf of the patient, how are you related to the patient? Sister Cousin Brother Mother Father Case manager Relative Primary care physician Nurse If other, specify. | |||||||||||||||||||||||||||||||||||||||||||
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Question 113
Harms/abuse screening What best describes harms/abuse on you? Harmed by an individual living in the household. Harmed by an individual living in the same building or house. Harmed by an individual living within walking distance. Harmed on the way. Harmed at workplace. Harmed by others. | |||||||||||||||||||||||||||||||||||||||||||
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Question 114
Can you elaborate on the harms/abuses? | |||||||||||||||||||||||||||||||||||||||||||
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Question 115
What is the profile and location of the individual or individuals involved in harms? | |||||||||||||||||||||||||||||||||||||||||||
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Question 116
How should you elaborate on the harms/abuses? Day/date/location/individual or individuals involved. Continuous harms (this also can include survival needs). | |||||||||||||||||||||||||||||||||||||||||||
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These are basic questions. There are many more. Once the above listed relevant questions about comprehensive patient assessment are answered and received, you will get another questions list relevant to age, gender, location, problems, or issues, if any. This will be followed by specific recommendations. | |||||||||||||||||||||||||||||||||||||||||||
| Once you reply to these questions, you will get questions relevant to your issues with recommendations. | |||||||||||||||||||||||||||||||||||||||||||
| How should you communicate with your medical doctor? | |||||||||||||||||||||||||||||||||||||||||||
| How to Become an OB/GYN Doctor | |||||||||||||||||||||||||||||||||||||||||||
| Obstetrics | |||||||||||||||||||||||||||||||||||||||||||
| Gynecology | |||||||||||||||||||||||||||||||||||||||||||
| Here are further guidelines. | |||||||||||||||||||||||||||||||||||||||||||
| Last Updated: March 19, 2014 | |||||||||||||||||||||||||||||||||||||||||||