Morand Allison, McLeod Shelley, Lim Rodrick
Division of Emergency Medicine, Faculty of Family Medicine, The University of Western Ontario, London, Canada.
Pediatr Emerg Care. 2009 Oct;25(10):629-32. doi: 10.1097/pec.0b013e3181bd9416.
Sexually transmitted infections are on the rise, yet a sexual history of adolescent girls presenting with abdominal pain is not routinely sought or recorded. We developed a survey to examine the barriers to taking a sexual history.
We surveyed 56 medical students and residents rotating through a pediatric emergency department during a 3-month span. Surveys were distributed electronically using Dillman methods, and responses were anonymous.
Although respondents generally believed it was appropriate to routinely take a sexual history from girls as young as 12 years old, in cases where a sexual history was omitted, we found that the young age of the patient, the presence of the patient's parents, and an unsubstantiated belief that the patient was chaste are the barriers to taking a sexual history from adolescent girls presenting to the emergency department with abdominal pain.
The barriers to taking a sexual history in adolescent girls are multifaceted. Further training is needed to expose learners' preconceived notions of sexuality as barriers to taking a sexual history, to provide practical methods for overcoming those barriers, and to further instill in learners the importance of doing so.
性传播感染呈上升趋势，但对于因腹痛就诊的青春期女孩，其性史通常未被常规询问或记录。我们开展了一项调查，以探究获取性史的障碍。
我们对在3个月期间轮转至儿科急诊科的56名医学生和住院医师进行了调查。采用迪尔曼方法以电子方式分发调查问卷，且回答是匿名的。
尽管受访者普遍认为，对年仅12岁的女孩常规询问性史是合适的，但在未询问性史的病例中，我们发现患者年龄小、患者父母在场以及毫无根据的认为患者贞洁是对因腹痛到急诊科就诊的青春期女孩询问性史的障碍。
询问青春期女孩性史的障碍是多方面的。需要进一步培训，以揭示学习者将性方面的先入之见视为获取性史的障碍，提供克服这些障碍的实用方法，并进一步向学习者灌输这样做的重要性。
