Packel Laura J, Guerry Sarah, Bauer Heidi M, Rhew Miriam, Chow Joan, Samuel Michael, Bolan Gail
California Department of Health Services, STD Control Branch, Richmond, California 94804, USA.
Sex Transm Dis. 2006 Jul;33(7):458-63. doi: 10.1097/01.olq.0000219865.65253.29.
The objective of this study was to examine California clinicians' use of and attitudes toward patient-delivered partner therapy (PDPT) to treat sexual partners of patients infected with chlamydia.
In 2002, a stratified random sample of primary care physicians and nurse practitioners completed a mailed, self-administered survey. Weighted frequencies were calculated to assess partner management practices, including PDPT, and attitudes toward PDPT. Multivariate models were constructed to determine independent predictors of PDPT use.
Of 708 physicians and 895 nurse practitioners, approximately half (47% and 48%, respectively) reported that they use PDPT usually or always. Over 90% agreed that PDPT protects patients from reinfection and provides better care for patients with chlamydia. However, providers reported concerns that PDPT may result in incomplete care for the partner, may be dangerous without knowing the partner's medical or allergy history, is an activity the practice may not get paid for, and may get them sued. Obstetrics/gynecology and family practice physicians were more likely than internal medicine physicians to report routine use of PDPT. Concerns about adverse outcomes of PDPT were associated with less PDPT use.
Although the proportion of California healthcare providers routinely using PDPT is comparatively high, further study is warranted to examine the circumstances under which this partner management strategy is used.
本研究的目的是调查加利福尼亚州临床医生对患者主导的性伴治疗(PDPT)用于治疗衣原体感染患者性伴的使用情况和态度。
2002年,对初级保健医生和执业护士进行分层随机抽样,让他们完成一份邮寄的自填式调查问卷。计算加权频率以评估包括PDPT在内的性伴管理做法以及对PDPT的态度。构建多变量模型以确定PDPT使用的独立预测因素。
在708名医生和895名执业护士中,约一半(分别为47%和48%)报告他们通常或总是使用PDPT。超过90%的人同意PDPT可保护患者免受再次感染,并能为衣原体感染患者提供更好的护理。然而,医疗服务提供者报告担心PDPT可能导致性伴护理不完整,在不了解性伴的病史或过敏史的情况下可能很危险,这是一项医疗机构可能无法获得报酬的活动,而且可能会使他们被起诉。妇产科医生和家庭医生比内科医生更有可能报告常规使用PDPT。对PDPT不良后果的担忧与较少使用PDPT有关。
尽管加利福尼亚州常规使用PDPT的医疗服务提供者比例相对较高,但仍有必要进一步研究这种性伴管理策略的使用情况。