Donnelly Kyla Z, Foster Tina C, Thompson Rachel
The Dartmouth Institute for Health Policy and Clinical Practice, Dartmouth College, Hanover, NH, USA.
The Dartmouth Institute for Health Policy and Clinical Practice, Dartmouth College, Hanover, NH, USA; Dartmouth-Hitchcock Medical Center, Lebanon, NH, USA.
Contraception. 2014 Sep;90(3):280-7. doi: 10.1016/j.contraception.2014.04.012. Epub 2014 Apr 30.
OBJECTIVE(S): The objective of this study was to identify women's and health care providers' information priorities for contraceptive decision making and counseling, respectively.
Cross-sectional surveys were administered online to convenience samples of 417 women and 188 contraceptive care providers residing in the United States. Participants were provided with a list of 34 questions related to the features of contraceptive options and rated the importance of each. Participants also ranked the questions in descending order of importance. For both women and providers, we calculated the mean importance rating for each question and the proportion that ranked each question in their three most important questions.
The average importance ratings given by women and providers were similar for 18 questions, but dissimilar for the remaining 16 questions. The question rated most important for women was "How does it work to prevent pregnancy?" whereas, for providers, "How often does a patient need to remember to use it?" and "How is it used?" were rated equally. The eight questions most frequently selected in the top three by women and/or providers were related to the safety of the method, mechanism of action, mode of use, side effects, typical- and perfect-use effectiveness, frequency of administration and when it begins to prevent pregnancy.
CONCLUSION(S): Although we found considerable concordance between women's and provider's information priorities, the presence of some inconsistencies highlights the importance of patient-centered contraceptive counseling and, in particular, shared contraceptive decision making.
This study provides insights into the information priorities of women for their contraceptive decision making and health care providers for contraceptive counseling. These insights are critical both to inform the development of decision support tools for implementation in contraceptive care and to guide the delivery of patient-centered care.
本研究的目的分别是确定女性和医疗保健提供者在避孕决策和咨询方面的信息优先事项。
对居住在美国的417名女性和188名避孕护理提供者的便利样本进行了在线横断面调查。参与者收到一份与避孕方法特征相关的34个问题的清单，并对每个问题的重要性进行评分。参与者还将问题按重要性从高到低排序。对于女性和提供者，我们计算了每个问题的平均重要性评分以及将每个问题列为最重要的三个问题之一的比例。
女性和提供者给出的平均重要性评分在18个问题上相似，但在其余16个问题上不同。女性认为最重要的问题是“它是如何预防怀孕的？”，而对于提供者来说，“患者需要多久记得使用一次？”和“如何使用？”的评分相同。女性和/或提供者最常在前三位中选择的八个问题与方法的安全性、作用机制、使用方式、副作用、典型使用和完美使用效果、给药频率以及何时开始预防怀孕有关。
尽管我们发现女性和提供者的信息优先事项之间有相当程度的一致性，但一些不一致之处凸显了以患者为中心的避孕咨询的重要性，特别是共享避孕决策。
本研究深入了解了女性在避孕决策方面的信息优先事项以及医疗保健提供者在避孕咨询方面的信息优先事项。这些见解对于为避孕护理中实施的决策支持工具的开发提供信息以及指导以患者为中心的护理提供至关重要。
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