Dawson Angela J, Homer Caroline S
Health Services and Practice Research Group, Faculty of Health, University of Technology, Sydney, NSW, Australia.
J Clin Nurs. 2013 Dec;22(23-24):3597-609. doi: 10.1111/jocn.12191. Epub 2013 Oct 8.
To explore client and provider experiences and related health outcomes of sexual and reproductive health interventions that have been led by or that have involved mining companies.
Miners, and those living in communities surrounding mines in developing countries, are a vulnerable population with a high sexual and reproductive health burden. People in these communities require specific healthcare services although the exact delivery needs are unclear. There are no systematic reviews of evidence to guide delivery of sexual and reproductive health interventions to best address the needs of men and women in mining communities.
A narrative synthesis.
A search of peer-reviewed literature from 2000-2012 was undertaken with retrieved documents assessed using an inclusion/exclusion criterion and quality appraisal guided by critical assessment tools. Concepts were analysed thematically.
A desire for HIV testing and treatment was associated with the recognition of personal vulnerability, but this was affected by fear of stigma. Regular on-site services facilitated access to voluntary counselling and testing and HIV care, but concerns for confidentiality were a serious barrier. The provision of HIV and sexually transmitted infection clinical and promotive services revealed mixed health outcomes. Recommended service improvements included rapid HIV testing, the integration of sexual and reproductive health into regular health services also available to family members and culturally competent, ethical, providers who are better supported to involve consumers in health promotion.
There is a need for research to better inform health interventions so that they build on local cultural norms and values and address social needs. A holistic approach to sexual and reproductive health beyond a focus on HIV may better engage community members, mining companies and governments in healthcare delivery.
Nurses may require appropriate workplace support and incentives to deliver sexual and reproductive health interventions in developing mining contexts where task shifting exists.
探讨由矿业公司主导或涉及矿业公司的性与生殖健康干预措施中服务对象及提供者的经历以及相关健康结果。
在发展中国家，矿工以及生活在矿区周边社区的居民是性与生殖健康负担沉重的弱势群体。这些社区的人们需要特定的医疗服务，尽管确切的服务需求尚不清楚。目前尚无系统的证据综述来指导提供性与生殖健康干预措施，以最佳地满足矿区社区男性和女性的需求。
叙述性综合分析。
检索2000年至2012年的同行评审文献，使用纳入/排除标准对检索到的文献进行评估，并采用批判性评估工具进行质量评估。对概念进行主题分析。
对艾滋病毒检测和治疗的需求与对个人易感性的认识相关，但这受到耻辱感恐惧的影响。定期的现场服务便利了自愿咨询检测和艾滋病毒护理的获取，但对保密性的担忧是一个严重障碍。艾滋病毒和性传播感染临床及促进服务的提供显示出混合的健康结果。建议的服务改进包括快速艾滋病毒检测、将性与生殖健康纳入家庭成员也可获得的常规健康服务，以及具备文化能力、符合伦理道德且得到更好支持以便让消费者参与健康促进的提供者。
需要开展研究，以便为健康干预措施提供更充分的信息，使其基于当地文化规范和价值观并满足社会需求。采取超越关注艾滋病毒的整体性性与生殖健康方法，可能会更好地促使社区成员、矿业公司和政府参与医疗服务提供。
在存在任务转移的发展中矿区环境中，护士可能需要适当的工作场所支持和激励措施来提供性与生殖健康干预措施。
