Do Khoi, Minichiello Victor, Hussain Rafat, Khan Asaduzzaman
School of Rural Medicine, University of New England, Armidale, NSW 2350, Australia.
BMC Public Health. 2014 Nov 4;14:1133. doi: 10.1186/1471-2458-14-1133.
Sexually transmitted infections (STIs) are a public health problem in Vietnam with sub-optimal care in medical practice. Identifying practitioners' perceived barriers to STI care is important to improve care for patients with STIs.
A cross-sectional survey was conducted among 451 physicians. These physicians were dermatology and venereology (D&V) doctors, obstetrical/gynaecological (Ob/Gyn) doctors, general practitioners, and assistant doctors working in health facilities at provincial, district and communal levels in three provinces in Vietnam.
Almost all (99%) respondents mentioned at least one barrier to STI care. The barriers were "lack of STI training" (57%), "lack of professional resources" (41%), "lack of time" (38%), "lack of reimbursement" (21%), "lack of privacy/confidentiality" (17%), "lack of counselling" (15%), and "not the role of primary care provider" (7%). Multivariable logistic regression analysis showed that "lack of professional resources" was associated with respondents being in medical practice for ten years or under (vs. 11-20 years), and working at district or communal health facilities (vs. provincial facilities); "lack of time" were associated with respondents being female, seeing more than 30 patients a week (vs. <15 patients/week); and "lack of privacy/confidentiality" was associated with physicians' seeing more than 30 patients a week (vs. <15 patients/week).
The study has identified several barriers to STI care in medical practice in Vietnam. Results of the study can be used to improve areas in STI care including policy and practice implications.
性传播感染(STIs)是越南的一个公共卫生问题,医疗实践中的护理水平欠佳。识别从业者在性传播感染护理方面察觉到的障碍对于改善性传播感染患者的护理至关重要。
对451名医生进行了横断面调查。这些医生是越南三个省份省级、区级和社区级卫生机构的皮肤科和性病科(D&V)医生、妇产科(Ob/Gyn)医生、全科医生和助理医生。
几乎所有(99%)的受访者都提到了至少一个性传播感染护理的障碍。这些障碍包括“缺乏性传播感染培训”(57%)、“缺乏专业资源”(41%)、“缺乏时间”(38%)、“缺乏报销”(21%)、“缺乏隐私/保密性”(17%)、“缺乏咨询”(15%)以及“不是初级保健提供者的职责”(7%)。多变量逻辑回归分析表明,“缺乏专业资源”与从事医疗工作十年及以下(与11 - 20年相比)以及在区级或社区卫生机构工作(与省级机构相比)的受访者有关;“缺乏时间”与女性受访者、每周看诊超过30名患者(与每周<15名患者相比)有关;“缺乏隐私/保密性”与每周看诊超过30名患者的医生(与每周<15名患者相比)有关。
该研究确定了越南医疗实践中性传播感染护理的几个障碍。研究结果可用于改善性传播感染护理领域,包括政策和实践方面的影响。