title: Caregiver awareness of reproductive health issues for women with intellectual disabilities.
abstract: BACKGROUND
  Limited attention has been paid to the issue of reproductive health as it affects women with intellectual disabilities, despite reproductive health being a vital issue in public health policy for women in the general population. This paper describes caregiver awareness of reproductive health issues relative to women with intellectual disabilities who are being cared for in welfare institutions in Taiwan.
  
  
  METHODS
  The study employed a cross-sectional, questionnaire-based study which recruited 1,152 caregivers (response rate = 71.87%) from 32 registered disability welfare institutions in Taiwan. We classified their understanding/awareness of reproductive health issues into four domains: menstrual (1) and menopause (2) issues, sex education (3), and reproductive health services (4). Each domain had five associated yes/no questions and the total score for the four domains was out of a maximum of 20. Data were analyzed using SPSS 15.0 software.
  
  
  RESULTS
  We found that most of the caregivers were familiar with matters concerning sex education, menopause, and reproductive health services, but they lacked adequate understanding of issues associated with menstruation in women with ID. Many aspects of reproductive health such as "menstrual pain", "age at menarche", "masturbation", "diet during perimenopause", and "publicly available reproductive health services" were issues in which caregivers lacked adequate knowledge and required further instruction. Logistic regression analysis revealed that female caregivers with a university degree, and those who had experience assisting with reproductive health care were more inclined to have higher reproductive health awareness scores than their counterparts.
  
  
  CONCLUSIONS
  This study highlights that service providers should offer appropriate reproductive health education to institutional caregivers, and that more attention be focused on the personal experiences and concerns of intellectually disabled women in future research.
authors.affiliation: Graduate Institute of Life Sciences, National Defense Medical Center, Taipei, Taiwan.
authors.forename: Lan-Ping
authors.initials: LP
authors.lastname: Lin
authors.forename: Pei-Ying
authors.initials: PY
authors.lastname: Lin
authors.forename: Shang-Wei
authors.initials: SW
authors.lastname: Hsu
authors.forename: Ching-Hui
authors.initials: CH
authors.lastname: Loh
authors.forename: Jin-Ding
authors.initials: JD
authors.lastname: Lin
authors.forename: Chia-Im
authors.initials: CI
authors.lastname: Lai
authors.forename: Wu-Chien
authors.initials: WC
authors.lastname: Chien
authors.forename: Fu-Gong
authors.initials: FG
authors.lastname: Lin
mesh_terms: D000328:Adult; D000368:Aged; D017028:Caregivers; D003430:Cross-Sectional Studies; D005260:Female; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D007326:Institutionalization; D008607:Intellectual Disability; D008297:Male; D008875:Middle Aged; D018456:Reproductive Medicine; D013624:Taiwan; D055815:Young Adult