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未婚中年及老年女性在性健康方面的医患沟通。

Patient-provider communication about sexual health among unmarried middle-aged and older women.

作者信息

Politi Mary C, Clark Melissa A, Armstrong Gene, McGarry Kelly A, Sciamanna Christopher N

机构信息

Center for Behavioral Medicine, The Miriam Hospital, Brown Medical School, CORO Building, Suite 500, One Hoppin St, Providence, RI 02903, USA.

出版信息

J Gen Intern Med. 2009 Apr;24(4):511-6. doi: 10.1007/s11606-009-0930-z. Epub 2009 Feb 14.

Abstract

BACKGROUND

Although past studies have highlighted the importance of patient-provider communication about sexual health and intimate relationships (SHIR), much of the research has focused on young women's or married women's experiences when discussing SHIR with their providers.

OBJECTIVE

To describe experiences of unmarried, middle-aged and older women in communicating about SHIR with their health care providers.

DESIGN AND PARTICIPANTS

Qualitative interviews were conducted with 40 unmarried women aged 40-75 years. We compared the responses of 19 sexual minority (lesbian and bisexual) women and 21 heterosexual women.

RESULTS

Women varied in their definitions of intimate relationships. Not all women thought providers should ask about SHIR unless questions were directly related to a health problem, and most were not satisfied with questions about SHIR on medical intake forms. However, the themes women considered to be important in communication about SHIR were remarkably consistent across subgroups (e.g. previously married or never married; sexual minority or heterosexual). Sexual minority women were more hesitant to share information about SHIR because they had had prior negative experiences when disclosing their sexual orientation or perceived that clinicians were not informed about relevant issues.

CONCLUSIONS

Some women felt that providers should ask about SHIR only if questions relate to an associated health problem (e.g. sexually transmitted infection). When providers do ask questions about SHIR, they should do so in ways that can be answered by all women regardless of partnering status, and follow questions with non-judgmental discussions.

摘要

背景

尽管过去的研究强调了患者与医疗服务提供者就性健康和亲密关系(SHIR)进行沟通的重要性,但大部分研究都集中在年轻女性或已婚女性与医疗服务提供者讨论SHIR时的经历。

目的

描述未婚的中年及老年女性与医疗服务提供者就SHIR进行沟通的经历。

设计与参与者

对40名年龄在40 - 75岁的未婚女性进行了定性访谈。我们比较了19名性少数群体(女同性恋和双性恋)女性和21名异性恋女性的回答。

结果

女性对亲密关系的定义各不相同。并非所有女性都认为医疗服务提供者应该询问SHIR,除非问题与健康问题直接相关,而且大多数女性对医疗问诊表格上关于SHIR的问题不满意。然而,女性认为在关于SHIR的沟通中重要的主题在各个亚组(例如曾婚或未婚;性少数群体或异性恋)中非常一致。性少数群体女性在分享SHIR信息时更加犹豫,因为她们在披露性取向时曾有过负面经历,或者认为临床医生不了解相关问题。

结论

一些女性认为,只有当问题与相关健康问题(如性传播感染)相关时,医疗服务提供者才应该询问SHIR。当医疗服务提供者确实询问关于SHIR的问题时,他们应该以所有女性都能回答的方式提问,而不论其伴侣状况如何,并在提问后进行无偏见的讨论。

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