Griffiths C, Gerressu M, French R S
Centre for Sexual Health and HIV Research, University College London, Mortimer Market Centre, off Capper Street, London WC1E6JB, UK.
Sex Transm Infect. 2008 Oct;84(5):395-9. doi: 10.1136/sti.2008.030833. Epub 2008 Jul 2.
Traditionally, genitourinary medicine (GUM) and contraceptive services have been provided separately. Providing these services on one site, as a one-stop shop, has been suggested as a way of improving access to care. There is little evidence about the acceptability of such an approach. We aimed to assess acceptability of different one-stop shop models (a young people's, an all ages (mainstream) and a general practice service) of sexual health provision among different community groups.
Between April and December 2005, 19 semi-structured interviews and 14 focus groups were conducted with young heterosexual men (n = 48), men who have sex with men (MSM; n = 46) and minority ethnic men and women (n = 28) across England.
Knowledge of one-stop shops was limited. The concept was acceptable to participants (except MSM), although there was variation as to the preferred model. Young men and African individuals described distrust of general practice confidentiality, preferring young people's or mainstream models, respectively. South Asians associated stigma with GUM, preferring instead a general practice one-stop shop. Regardless of model, respondents expressed preference for one provider/one session to provide GUM and contraceptive care.
In terms of acceptability there can be no blue print one-stop shop model. Local assessments should determine whether a one-stop shop would have public health benefit and if so how best one should be set up to maximise access. To accommodate client preference for one provider/session for their sexual health needs it may be that the development of "integrated training" for providers across clinical specialties is a more realistic way forward.
传统上,性健康与泌尿生殖医学(GUM)服务和避孕服务是分开提供的。有人建议将这些服务整合在一个场所,一站式提供,以此改善医疗服务的可及性。但关于这种方式的可接受性,相关证据很少。我们旨在评估不同社区群体对不同一站式性健康服务模式(青少年模式、全年龄段(主流)模式和全科医疗服务模式)的接受程度。
2005年4月至12月期间,在英格兰对年轻异性恋男性(n = 48)、男男性行为者(MSM;n = 46)以及少数族裔男性和女性(n = 28)进行了19次半结构化访谈和14次焦点小组访谈。
对一站式服务的了解有限。尽管对于首选模式存在差异,但参与者(男男性行为者除外)对这一概念表示接受。年轻男性和非洲裔受访者分别表示不信任全科医疗的保密性,更倾向于青少年模式或主流模式。南亚人将性健康与泌尿生殖医学服务与污名联系在一起,更倾向于全科医疗一站式服务。无论哪种模式,受访者都表示更倾向于由一名提供者/一次就诊来提供性健康与泌尿生殖医学服务和避孕护理。
就可接受性而言,不存在统一的一站式服务模式。应进行本地评估,以确定一站式服务是否对公共卫生有益,如果有益,应如何以最佳方式设立以最大限度地提高可及性。为满足客户对由一名提供者/一次就诊来满足其性健康需求的偏好,或许为各临床专科的提供者开展“综合培训”是更现实的前进方向。