Dr. Kathleen Digre and Dr. Caren Frost. Women’s health expert Dr. Kirtly Parker Jones speaks with Digre and Frost about the seven domains and why it is so important for doctors and patients to understand how they work.">

Oct 21, 2016 — A woman’s holistic sense of health is more than just her cholesterol levels or blood pressure. It’s an interconnected web of factors from the physical and emotional to the social and spiritual. These seven domains of health are explored in a new book edited by Dr. Kathleen Digre and Dr. Caren Frost. Women’s health expert Dr. Kirtly Parker Jones speaks with Digre and Frost about the seven domains and why it is so important for doctors and patients to understand how they work.

Interview

Dr. Jones: If women have told us that their holistic sense of health involves much more than their cholesterol level or their blood pressure, what do we want our health team to know about us? This is Dr. Kirtly Jones from Obstetrics and Gynecology at University of Utah Health Care and this is "The Scope" of women's health.

Announcer: Covering all aspects of women's health, this is the "Seven Domains of Women's Health" with Dr. Kirtly Jones on "The Scope".

Dr. Jones: How should our medical home think about our overall health? The seven domains of women's health - physical, emotional, social, intellectual, environmental, financial and spiritual - are all important to us. Today in "The Scope" studio, we have two professionals who've thought a lot about these seven domains. Dr. Kathleen Digre is a neuro-opthalmologist who is a specialist in headache and is the director of The Center of Excellence in Women's Health. Dr. Caren Frost is the director of The Center for Research on Migration and Refugee Integration. Together, the published a book on the seven domains of women's health. Thank you for coming to "The Scope".

Kathleen, why is it important for the health professions to understand the seven domains of women's health?

Dr. Digre: So this is really not a new concept. The WHO (World Health Organization) really defined that health is more than just physical health, but it involves emotional health and other types of health. And at the Center of Excellence in Women's Health, our members have really thought about this that if we're going to be really healthy, we have to be thinking about all the various aspects that fit into health.

So I think the importance of this is that one domain is going to affect another. For example, if you have very poor social health and you have no social support, how are you going to get to a medical doctor's office in the first place?

Dr. Jones: Caren, you come at this problem from the social part, help me understand why this matters as we begin to educate health care professionals?

Dr. Frost: I think that we're moving more and more towards interdisciplinary teams, so health professionals, nursing professionals, as well as social work professionals, they need all be aware of these different seven domains so when there's a need for resources or identifying resources for people, somebody on the team can say, "Oh, I think you're having trouble with your financial health. Let's figure out someone that you can go and speak with." So I think thinking about it in a holistic way where we have different professionals working on things together is really why this is so important.

Dr. Jones: That's why the university has been so insistent that we think about our healthcare as a medical home with many professionals on the team. Kathleen?

Dr. Digre: I would like to just add that physicians are guilty in many ways of not thinking about health in these factors. Nursing has been way ahead of physicians in team care and I really feel that this is a sea change. This is a change in our new direction in medical home thinking and also in medical care thinking.

Dr. Jones: We've been trying actually to integrate this concept of multi-disciplinary teaming into our first and second year and third year curriculums now at the School of Medicine. So we're trying but also, folks, we need some help. We need a book. So what about this book, why this book, and why now? We talked a little bit about it but tell us about the book.

Dr. Digre: The idea for this book came many years ago. When we started the Center of Excellence over 10 years ago, we started having a problem talking about what is health and what involves health. So we tasked our librarian who is part of our team to actually research what are domains of health? And they came back to us with seven domains of health. And then all the members of the team really picked up on this as really vitally important especially for women's health because we are juggling so many things in our families and in our lives.

And then Caren, because she's so cool and has a social work background, she was able to work with students and start getting some literature together in each of these domains and then the idea came, actually, we should write a book. We should have a test. We should put this out to the public so that we can make this more freely available to everybody.

Dr. Jones: Caren, who are your collaborators? You two are the editors but I see you've got collaborators all over the university.

Dr. Frost: We do. We have collaborators from what we call main campus as well as the health sciences campus. What we tried to do with every chapter was to make sure that we had a medical health sciences professional as well as a professional from another field so we got an interdisciplinary kind of discussion going on with each of the chapters. So we have people from nursing and from the OB/Gyn as well as neuro-opthalmology. And we have people from public health, people from social work, people from the College of Health, communications, and we have people from all over campus who agreed to write pieces and parts of chapters so that we could pull that altogether and show a real interdisciplinary way of looking at these seven domains.

Dr. Jones: And who's your intended audience?

Dr. Digre: Of course, the medical students. We'll have to get that as part of the curriculum but who else?

Dr. Frost: I think we saw anybody involved in patient care. So medical students, nursing students, also the College of Health students, pharmacy students. It should be permeating everything that we do. So I would say anybody, any provider that provides care to patients.

Dr. Jones: Caren, I would say it's for anybody who cares for persons because sometimes people out in the community, maybe someone who's doing resources within the social domains for communities of refugees, those patients aren't patients. Those persons aren't patients. They're persons. So maybe as we think about those who care about persons should take that. What do you think about that?

Dr. Frost: I think that is an excellent suggestion. One of the things that the Center of Excellence group had been talking about is how do we make sure that this information becomes tangible to everybody out in the community as well so we've been talking about and using what we call our circle of health in different settings so for example when I do workshops with refugee women, we have translated what we call our circle of health into two or three different languages and when we present it to refugee women in that language who say that that's exactly it. That is health. All of those domains, they're all connected. And they're always so glad that we see it the same way they do so we've used that model.

Dr. Digre: I would like to add that I think that when we have presented this in public, it really resonates with people. They say yes, of course, all of this is related. We can't just separate one piece from another. It's all integrated into one piece.

Dr. Jones: So this book is unique because they're not just words, there are some added attractions. Tell us about that.

Dr. Digre: I think that one thing that's cool about this book are all the discussion questions. If we're in a classroom and we want to discuss a certain domain of health, we've got actual questions that help people guide discussions in a group setting and help you to explore the seven domains.

Dr. Jones: Caren?

Dr. Frost: We also have case studies at the back of the book and we were lucky enough to get a number of different professionals on campus to come in and one person was a simulated patient. Dr. Jones was one of our simulated patients.

Dr. Jones: I get to be an old, slightly demented person. It was fantastic. Thank you.

Dr. Frost: And then we had a number of professionals come in from health sciences, the medical field, as well as the social work field and talk about a variety of different kinds of needs that somebody would need to have addressed during that discussion with an interdisciplinary team. We have that in there as well and the link to those case studies is available for people to use.

Dr. Jones: We hope that our healthcare team and the professionals who teach them can realize that we as women take our healthcare holistically is this circle of health in our circle of life and thank you for joining us on "The Scope".

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