妇产科、家庭医学及儿科学住院医师对长效可逆避孕法的了解:2015年全国调查结果及对青少年避孕措施提供的启示
Familiarity with Long-acting Reversible Contraceptives among Obstetrics and Gynecology, Family Medicine, and Pediatrics Residents: Results of a 2015 National Survey and Implications for Contraceptive Provision for Adolescents.
作者信息
Davis Susan A, Braykov Nikolay P, Lathrop Eva, Haddad Lisa B
机构信息
Department of Women's Health, University of Texas at Austin Dell School of Medicine, Austin, Texas.
Children's Healthcare of Atlanta, Atlanta, Georgia.
出版信息
J Pediatr Adolesc Gynecol. 2018 Feb;31(1):40-44. doi: 10.1016/j.jpag.2017.09.007. Epub 2017 Sep 21.
STUDY OBJECTIVE
To assess familiarity with long-acting reversible contraceptives (LARC) among current obstetrics and gynecology (OB/GYN), family medicine (FM), and pediatrics senior residents in the United States. DESIGN, SETTING, PARTICIPANTS, INTERVENTIONS, AND MAIN OUTCOME MEASURES: We selected 156 OB/GYN, FM, and pediatrics residency programs using the American Medical Association Freida database. Senior residents completed a survey addressing any training they had received on LARC, and rated their comfort level counseling about and inserting LARC. Residents rated their likelihood of recommending LARC to an adolescent, nulliparous patient, and indicated whether they would like additional training on LARC. Descriptive and analytic statistics were generated using R statistical software (The R Project for Statistical Computing; https://www.r-project.org).
RESULTS
The survey was completed by 326 of 1,583 residents (20.6% response rate); at least 1 resident completed the survey at 105 (67.3%) of the residency programs contacted. Most programs (84.8%) provided some training on LARC. Residents in OB/GYN programs were comfortable counseling about and inserting contraceptive implants (97%, 83%), copper intrauterine devices (IUDs; 100%, 86%), and levonorgestrel (LNG) IUDs (100%, 86%). In FM programs, fewer residents were comfortable counseling about and inserting contraceptive implants (71%, 47%), copper IUDs (68%, 21%), and LNG IUDs (79%, 18%). Residents in pediatrics programs had low comfort levels counseling about contraceptive implants (14%), copper IUDs (14%), and LNG IUDs (25%); no pediatrics residents were comfortable inserting LARC. OB/GYN residents were significantly more likely to recommend a LARC to an adolescent, nulliparous patient (P = .019). Most pediatric and FM residents desired additional training on LARC (82.7% and 60.7%, respectively).
CONCLUSION
This study shows that knowledge gaps exist regarding LARC among FM and pediatrics residents.
研究目的
评估美国当前妇产科、家庭医学以及儿科学专业的住院医师对长效可逆避孕法(LARC)的熟悉程度。
设计、地点、参与者、干预措施及主要观察指标:我们使用美国医学协会的Freida数据库选取了156个妇产科、家庭医学和儿科学住院医师培训项目。住院医师完成了一项关于他们接受过的任何长效可逆避孕法培训的调查,并对他们在咨询和插入长效可逆避孕法方面的舒适度进行评分。住院医师对向青少年、未生育患者推荐长效可逆避孕法的可能性进行评分,并表明他们是否希望接受更多关于长效可逆避孕法的培训。使用R统计软件(R统计计算项目;https://www.r-project.org)生成描述性和分析性统计数据。
结果
1583名住院医师中有326名完成了调查(回复率为20.6%);在所联系的住院医师培训项目中,有105个(67.3%)至少有1名住院医师完成了调查。大多数项目(84.8%)提供了一些关于长效可逆避孕法的培训。妇产科住院医师在咨询和插入避孕植入物(97%,83%)、铜宫内节育器(IUD;100%,86%)和左炔诺孕酮(LNG)宫内节育器(100%,86%)方面感到舒适。在家庭医学项目中,较少住院医师在咨询和插入避孕植入物(71%,47%)、铜宫内节育器(68%,21%)和LNG宫内节育器(79%,18%)方面感到舒适。儿科学项目的住院医师在咨询避孕植入物(14%)、铜宫内节育器(14%)和LNG宫内节育器(25%)方面舒适度较低;没有儿科学住院医师对插入长效可逆避孕法感到舒适。妇产科住院医师向青少年、未生育患者推荐长效可逆避孕法的可能性显著更高(P = 0.019)。大多数儿科学和家庭医学住院医师希望接受更多关于长效可逆避孕法的培训(分别为82.7%和60.7%)。
结论
本研究表明,家庭医学和儿科学住院医师在长效可逆避孕法方面存在知识差距。