Starzyk Erin J, Kelley Michele A, Caskey Rachel N, Schwartz Alan, Kennelly Joan F, Bailey Robert C
University of Illinois at Chicago, School of Public Health, Division of Community Health Sciences, Chicago, Illinois, United States of America.
University of Illinois at Chicago, College of Medicine, Department of Internal Medicine and Pediatrics, Chicago, Illinois, United States of America.
PLoS One. 2015 Jan 30;10(1):e0115891. doi: 10.1371/journal.pone.0115891. eCollection 2015.
The emerging science demonstrates various health benefits associated with infant male circumcision and adult male circumcision; yet rates are declining in the United States. The American Academy of Pediatrics and the Centers for Disease Control and Prevention recommend that healthcare providers present evidence-based risk and benefit information for infant male circumcision to parent(s) and guardian(s). The purpose of this study was to assess providers' level of infant male circumcision knowledge and to identify the associated characteristics.
An online survey was administered to healthcare providers in the family medicine, obstetrics, and pediatrics medical specialties at an urban academic health center. To assess infant male circumcision knowledge, a 17 point summary score was constructed to identify level of provider knowledge within the survey.
Ninety-two providers completed the survey. Providers scored high for the following knowledge items: adverse event rates, protects against phimosis and urinary tract infections, and does not prevent hypospadias. Providers scored lower for items related to more recent research: protection against cervical cancer, genital ulcer disease, bacterial vaginosis, and reduction in HIV acquisition. Two models were constructed looking at (1) overall knowledge about male circumcision, and (2) knowledge about male circumcision reduction in HIV acquisition. Pediatricians demonstrated greater overall infant male circumcision knowledge, while obstetricians exhibited significantly greater knowledge for the HIV acquisition item.
Providers' knowledge levels regarding the risks and benefits of infant male circumcision are highly variable, indicating the need for system-based educational interventions.
新兴科学表明，男性婴儿包皮环切术和成年男性包皮环切术对健康有诸多益处；然而在美国，接受包皮环切术的比例却在下降。美国儿科学会和疾病控制与预防中心建议，医疗服务提供者应向父母和监护人提供基于证据的男性婴儿包皮环切术的风险和益处信息。本研究的目的是评估医疗服务提供者对男性婴儿包皮环切术的知识水平，并确定相关特征。
对一家城市学术健康中心的家庭医学、妇产科和儿科医学专业的医疗服务提供者进行了在线调查。为评估男性婴儿包皮环切术的知识，构建了一个17分的总结分数，以确定调查中提供者的知识水平。
92名提供者完成了调查。提供者在以下知识项目上得分较高：不良事件发生率、预防包茎和尿路感染，以及不能预防尿道下裂。对于与最新研究相关的项目，提供者得分较低：预防宫颈癌、生殖器溃疡疾病、细菌性阴道病，以及降低感染艾滋病毒的风险。构建了两个模型，分别关注（1）关于男性包皮环切术的总体知识，以及（2）关于男性包皮环切术降低感染艾滋病毒风险的知识。儿科医生对男性婴儿包皮环切术表现出更丰富的总体知识，而产科医生在感染艾滋病毒这一项目上表现出显著更丰富的知识。
医疗服务提供者对男性婴儿包皮环切术的风险和益处的知识水平差异很大，这表明需要基于系统的教育干预措施。
