Baxter Susan, Blank Lindsay, Guillaume Louise, Squires Hazel, Payne Nick
Section of Public Health, School of Health and Related Research, University of Sheffield, UK.
J Fam Plann Reprod Health Care. 2011 Apr;37(2):71-84. doi: 10.1136/jfprhc.2010.0014.
Despite widespread availability of contraceptives and increasing service provision in the UK, rates of teenage pregnancy remain a concern. It has been suggested that young people face particular obstacles in accessing services, leading to a need for specialist provision. This systematic review examined the literature reporting views of service providers and young people. Data were synthesised in order to develop key themes to inform the development of contraceptive services for this population.
A total of 59 papers reporting studies carried out within the UK were included. Forty-five of these provided qualitative or mixed method data and 14 reported survey findings. Seven key themes were identified: perceptions of services; accessibility; embarrassment; anonymity and confidentiality; the clinic environment; the consultation; and service organisation.
This review suggests that the most significant concern for young people is the preservation of anonymity and confidentiality. There seems to be a need for young people to be given greater assurances about this, with process and environmental changes suggested. The fear of staff being critical or unfriendly also presents a considerable obstacle to some young people. Issues of service accessibility - such as convenience of location and opening hours - are also highlighted, with lifestyle factors and restrictions on where under-18s can go suggested as important aspects. The review suggests that varying preferences among young people with regard to which service to access requires choice to be preserved and, where possible, extended. This requires services to work effectively together to consider provision across a locality.
尽管在英国避孕药具广泛可得且服务提供不断增加，但青少年怀孕率仍是一个令人担忧的问题。有人认为年轻人在获取服务方面面临特殊障碍，因此需要提供专门服务。本系统评价考察了报告服务提供者和年轻人观点的文献。对数据进行综合分析，以形成关键主题，为针对这一人群的避孕服务发展提供参考。
共纳入59篇报告在英国开展的研究的论文。其中45篇提供了定性或混合方法数据，14篇报告了调查结果。确定了七个关键主题：对服务的认知；可及性；尴尬；匿名与保密；诊所环境；咨询；以及服务组织。
本评价表明，年轻人最关心的是保持匿名和保密。似乎需要给予年轻人更多关于这方面的保证，并建议在流程和环境方面做出改变。担心工作人员批评或不友好也给一些年轻人带来了相当大的障碍。还强调了服务可及性问题，如地点便利性和开放时间，以及生活方式因素和对18岁以下青少年可去场所的限制等重要方面。评价表明，年轻人在选择获取何种服务方面存在不同偏好，这就需要保留并在可能的情况下扩大选择范围。这要求各服务机构有效协作，考虑整个地区的服务提供情况。
