Haley Nancy, Maheux Brigitte, Rivard Michèle, Gervais André
Department of Pediatrics, Université de Montréal, Quebec, Canada.
Prev Med. 2002 Jun;34(6):632-7. doi: 10.1006/pmed.2002.1030.
Unsafe sexual practices, substance abuse, and domestic violence impact women's health. This study examined whether lifestyle risk assessment during a general medical examination and counseling about sexually transmitted disease during consultations for adolescent contraception and treatment of a sexually transmitted disease were more frequently done by recently trained obstetricians-gynecologists compared to those of obstetrician-gynecologists licensed before 1990. It also documented obstetrician-gynecologists' evaluations of their medical training in that area.
A pretested anonymous mail survey was conducted in 1995 with all 241 obstetrician-gynecologists practicing in Quebec, Canada; 66% responded (N = 158).
Compared to less recently trained obstetrician-gynecologists, recently trained obstetrician-gynecologists reported routinely assessing tobacco use (77 vs 51%, P = 0.01), alcohol use (50 vs 23%, P = 0.004), and illicit drug use (33 vs 17%, P = 0.05) more frequently during a patient's general medical evaluation. However, they did not assess condom use (50%), number of sexual partners, sexual partners' sexually transmitted disease risk (30%), or experiences of sexual abuse or domestic violence (3%) more frequently than less recently trained obstetrician-gynecologists. They were also not more likely to counsel teenagers about sexually transmitted disease prevention during a contraceptive consultation (30-60%) or to discuss human immunodeficiency virus infection (29%) and hepatitis B immunization (13%) during a sexually transmitted disease consultation.
Although evaluation of substance use was better among recently trained OB-Gyn physicians, little or no improvement has been noted regarding STD prevention or the evaluation of sexual abuse or domestic violence, all important lifestyle risks that directly affect women's health and well-being.
不安全的性行为、药物滥用和家庭暴力会影响女性健康。本研究调查了与1990年前获得执照的妇产科医生相比，近期接受培训的妇产科医生在一般体格检查期间进行生活方式风险评估以及在青少年避孕咨询和性传播疾病治疗期间提供性传播疾病咨询的频率是否更高。研究还记录了妇产科医生对其在该领域医学培训的评价。
1995年对加拿大魁北克省执业的所有241名妇产科医生进行了一项预先测试的匿名邮件调查；66%的医生回复（N = 158）。
与近期未接受培训的妇产科医生相比，近期接受培训的妇产科医生报告在患者的一般体格检查期间更频繁地常规评估烟草使用情况（77%对51%，P = 0.01）、酒精使用情况（50%对23%，P = 0.004）和非法药物使用情况（33%对17%，P = 0.05）。然而，他们在评估避孕套使用情况（50%）、性伴侣数量、性伴侣的性传播疾病风险（30%）或性虐待或家庭暴力经历（3%）方面并不比近期未接受培训的妇产科医生更频繁。在避孕咨询期间，他们也不太可能就性传播疾病预防向青少年提供咨询（30 - 60%），在性传播疾病咨询期间讨论人类免疫缺陷病毒感染（29%）和乙肝疫苗接种（13%）的可能性也不大。
尽管近期接受培训的妇产科医生在药物使用评估方面表现更好，但在性传播疾病预防或性虐待或家庭暴力评估方面几乎没有改善，而这些都是直接影响女性健康和幸福的重要生活方式风险因素。
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