Nothnagle Melissa, Prine Linda, Goodman Susan
Department of Family Medicine, Brown University/Memorial Hospital of Rhode Island, RI, USA.
Fam Med. 2008 Mar;40(3):204-7.
Given the high prevalence of unintended pregnancy and early pregnancy failure, family physicians frequently encounter these clinical problems. Early abortion care and miscarriage management are within the scope of family medicine, yet few family medicine residency programs' curricula routinely include training in these skills. Comprehensive reproductive health education for family physicians could benefit patients by improving access to safe care for unintended pregnancy and early pregnancy loss and by improving continuity of care, especially for rural and low-income women. By promoting reflection on conflicts between personal beliefs and responsibility to patients, training in options counseling and abortion care fosters patient-centered care and informed decision making. Managing pregnancy loss and termination also improves skills in patient-centered counseling and primary care gynecology. Multiple studies document the feasibility and success of several training models for abortion and miscarriage management in family medicine. Incorporating comprehensive reproductive health care into family medicine residency training enables family physicians to provide a full range of reproductive health services.
鉴于意外怀孕和早期妊娠失败的高发生率,家庭医生经常会遇到这些临床问题。早期流产护理和流产管理属于家庭医学范畴,但很少有家庭医学住院医师培训项目的课程常规包括这些技能的培训。为家庭医生提供全面的生殖健康教育,可通过改善意外怀孕和早期妊娠丢失的安全护理可及性以及改善护理的连续性,使患者受益,尤其是对农村和低收入女性。通过促进对个人信念与对患者责任之间冲突的反思,选择咨询和流产护理培训可促进以患者为中心的护理和知情决策。处理妊娠丢失和终止妊娠还可提高以患者为中心的咨询和初级保健妇科方面的技能。多项研究证明了家庭医学中几种流产和流产管理培训模式的可行性和成功性。将全面的生殖健康护理纳入家庭医学住院医师培训,可使家庭医生提供全方位的生殖健康服务。