年轻人与避孕护理提供者的接触：乌干达两个地区的模拟客户研究
Young peoples' interface with providers of contraceptive care: a simulated client study in two Ugandan districts.
作者信息
Nalwadda Gorrette, Mirembe Florence, Byamugisha Josaphat, Tumwesigye Nazarius M, Faxelid Elisabeth
机构信息
Department of Nursing, College of Health Sciences Makerere University, P.O Box 7072, Kampala, Uganda.
Department of Obstetrics and Gynecology, College of Health Sciences Makerere University, P.O Box 7072, Kampala, Uganda.
出版信息
Contracept Reprod Med. 2016 Sep 7;1:15. doi: 10.1186/s40834-016-0027-0. eCollection 2016.
BACKGROUND
Young people in Uganda have a large unmet need for modern contraception, and the reasons are unclear. This study describes young peoples' experiences of contraceptive care, client-provider interactions and its aftermath on choice, access and satisfaction.
METHODS
Simulated client method, with 128 encounters with providers in public and private health care facilities was used. Semi-structured narrative debriefing and a structured questionnaire were used to collect data. Content analysis, descriptive and inferential statistics were applied.
RESULTS
Both qualitative and quantitative results highlight favorable reception, provider bias, low client satisfaction and reservations about contraceptive methods. Two thirds of the providers choose a contraceptive method for the client. The clients reported satisfaction with contraceptive services in 29 % of the consultations. Privacy was reported to be observed in 42 % and clients felt respectfully treated in 50 % of the consultations. However, most clients would not recommend the visited facility to others. Client-provider interactions revealed contradictory views on methods to use, whether to first have children, and whether to use contraceptives at all. Younger clients seemed to be treated differently than older clients; contraceptives were provided after a prolonged debate. Inaccurate information about contraceptives was provided and costs were high. Providers conveyed potential adverse effects of contraceptives to young people in a way that indicated providers own fears and doubts.
CONCLUSION
Young people are not able to exercise their rights to choose, obtain and use contraceptives when needed. Overall satisfaction with the services was rated low and client- provider interactions were often unfavorable.
背景
乌干达的年轻人对现代避孕措施有着大量未被满足的需求，而原因尚不清楚。本研究描述了年轻人在避孕护理方面的经历、医患互动及其对选择、获取和满意度的影响。
方法
采用模拟客户法，在公共和私立医疗机构与医护人员进行了128次接触。使用半结构化叙事汇报和结构化问卷收集数据。应用了内容分析、描述性和推断性统计方法。
结果
定性和定量结果均突出了良好的接待、提供者偏见、较低的客户满意度以及对避孕方法的保留意见。三分之二的提供者为客户选择避孕方法。在29%的咨询中，客户报告对避孕服务感到满意。据报告，42%的咨询中观察到了隐私，50%的咨询中客户感到受到了尊重。然而，大多数客户不会向他人推荐所就诊的机构。医患互动揭示了在使用方法、是否先生育以及是否使用避孕药具等问题上存在矛盾观点。年轻客户似乎比年长客户受到不同对待；经过长时间辩论后才提供避孕药具。提供了关于避孕药具的不准确信息，且费用高昂。提供者向年轻人传达避孕药具潜在副作用的方式表明了提供者自身的恐惧和疑虑。
结论
年轻人无法行使其在需要时选择、获取和使用避孕药具的权利。对服务的总体满意度较低，医患互动往往不尽如人意。
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