Myran Daniel T, Carew Caitlin L, Tang Jingyang, Whyte Helena, Fisher William A
Schulich School of Medicine and Dentistry, Western University, London ON.
Department of Psychology, Western University, London ON; Department of Obstetrics and Gynaecology, Western University, London ON.
J Obstet Gynaecol Can. 2015 Mar;37(3):236-244. doi: 10.1016/S1701-2163(15)30309-1.
Lack of providers is a barrier to accessing abortion in Canada. The factors influencing the number of abortion providers are poorly understood. In this study, we assessed the attitudes and intentions of medical students towards abortion training and provision to gain insight into the future supply of abortion providers.
We surveyed first, second, and third year medical students at an Ontario university to determine their intentions to train in and provide abortion services during different stages of training and in future practice. We assessed students' attitudes and intentions towards training in and providing abortions, their perceptions of social support, their perceived ability to receive training in and to provide abortion services, and their attitudes towards the legality of abortion.
Surveys were completed by 337 of 508 potential respondents (66.7%). The responses indicated that the students in the survey held relatively positive attitudes towards the legality and availability of abortion in Canada. Respondents had significantly more positive attitudes towards first trimester medical abortions (and a greater intention to provide them) than towards second trimester surgical abortions. Thirty-five percent of students planned to enter a specialty in which they could perform abortions, but fewer than 30% of these students planned to provide any type of abortion. Intentions to provide abortions were correlated with positive attitudes toward abortion in general and greater perceived social support for abortion provision.
A small proportion of students sampled intended both to enter a specialty in which abortion would be within the scope of practice and to provide abortion services. Lack of perceived social support for providing abortions and the perceived inability to obtain abortion training or to logistically provide abortions were identified as two potentially modifiable barriers to abortion provision. We propose increasing education on abortion provision and creating policies to promote medical abortion as a method of improving access to abortion across Canada.
在加拿大,医疗服务提供者短缺是获得堕胎服务的一个障碍。影响堕胎服务提供者数量的因素尚不清楚。在本研究中,我们评估了医学生对堕胎培训和提供堕胎服务的态度及意向,以深入了解未来堕胎服务提供者的供应情况。
我们对安大略省一所大学的一、二、三年级医学生进行了调查,以确定他们在不同培训阶段及未来执业时进行堕胎培训和提供堕胎服务的意向。我们评估了学生对堕胎培训和提供堕胎服务的态度及意向、他们对社会支持的认知、他们认为接受堕胎培训及提供堕胎服务的能力,以及他们对堕胎合法性的态度。
508名潜在受访者中有337人(66.7%)完成了调查。调查结果表明,参与调查的学生对加拿大堕胎的合法性和可获得性持相对积极的态度。与中期妊娠手术堕胎相比,受访者对早期妊娠药物流产的态度更为积极(且更有意提供此类服务)。35%的学生计划进入能进行堕胎手术的专业领域,但这些学生中计划提供任何类型堕胎服务的不到30%。提供堕胎服务的意向与对堕胎总体上的积极态度以及更大程度上感知到的社会对提供堕胎服务的支持相关。
抽样的学生中只有一小部分既打算进入堕胎属于执业范围内的专业领域,又打算提供堕胎服务。缺乏对提供堕胎服务的社会支持感以及认为无法获得堕胎培训或在后勤上提供堕胎服务,被确定为提供堕胎服务的两个潜在可改变的障碍。我们建议增加关于提供堕胎服务的教育,并制定政策来推广药物流产,以此作为改善加拿大各地堕胎服务可及性的一种方法。