Temple-Smith M J, Mulvey G, Keogh L
Centre for the Study of Sexually Transmissible Diseases, La Trobe University.
Sex Transm Infect. 1999 Feb;75(1):41-4. doi: 10.1136/sti.75.1.41.
To examine general practitioners' (GPs') attitudes towards taking a sexual history.
Questions on sexual history taking were included in a random survey on the STD knowledge, attitudes, and practices of 600 GPs practising in Victoria, Australia.
Most GPs commonly asked patients about safe sex (79%), number of sex partners (63%), and injecting drug use (60%) while fewer asked about recent overseas travel (50%) and sex with sex workers (31%). GPs who performed sexual health consultations daily or weekly identified barriers to sexual history taking to be of less concern than those who performed such consultations infrequently. Most GPs (92%) would take a sexual history from a man presenting as the sexual contact of an infected partner, but less than a third would do so for a patient routinely requesting the contraceptive pill (28%), a Papanicolaou (Pap) smear (30%), or advice about immunisation before overseas travel (30%). Female GPs were significantly more likely than male GPs to take a sexual history in those clinical situations involving a female patient and also to perceive these patients as experiencing less embarrassment.
This study highlights both the lack of opportunistic sexual history taking and the main barriers to sexual history taking in general practice in Victoria, Australia. The importance of educating both patients and GPs about sexual history taking are discussed.
研究全科医生(GP)对获取性病史的态度。
在对澳大利亚维多利亚州600名全科医生的性传播疾病知识、态度和行为的随机调查中纳入了有关获取性病史的问题。
大多数全科医生通常会询问患者安全性行为(79%)、性伴侣数量(63%)和注射吸毒情况(60%),而较少询问近期海外旅行情况(50%)和与性工作者的性行为(31%)。每天或每周进行性健康咨询的全科医生认为获取性病史的障碍比不经常进行此类咨询的医生所认为的要少。大多数全科医生(92%)会从作为感染伴侣性接触对象前来就诊的男性那里获取性病史,但对于常规要求开具避孕药(28%)、巴氏涂片检查(30%)或海外旅行前免疫接种建议(30%)的患者,只有不到三分之一的全科医生会这样做。在涉及女性患者的临床情况下,女全科医生比男全科医生更有可能获取性病史,并且也认为这些患者较少感到尴尬。
本研究凸显了澳大利亚维多利亚州全科医疗中机会性获取性病史的不足以及获取性病史的主要障碍。讨论了对患者和全科医生进行性病史获取教育的重要性。