Jonas Kim, Crutzen Rik, Krumeich Anja, Roman Nicolette, van den Borne Bart, Reddy Priscilla
School of Public Health and Primary Care (CAPHRI), Department of Health Promotion, Faculty of Heath, Medicine and Life Sciences, Maastricht University, P.O. Box 616, 6200 MD, Maastricht, the Netherlands.
Division of Child and Adolescent Psychiatry, Adolescent Health Research Unit, University of Cape Town, Rondebosch, Cape Town, South Africa.
BMC Health Serv Res. 2018 Feb 13;18(1):109. doi: 10.1186/s12913-018-2917-0.
Adolescents' sexual and reproductive healthcare (SRH) needs have been prioritized globally, and they have the rights to access and utilize SRH services for their needs. However, adolescents under-utilize SRH services, especially in sub-Saharan Africa. Many factors play a role in the under-utilization of SRH services by adolescents, such as the attitude and behaviour of healthcare workers. The aim of this study therefore, was to explore and gain an in-depth understanding of healthcare workers' beliefs, motivations and behaviours affecting adequate provision of these services to adolescents in South Africa.
Twenty-four healthcare workers in public SRH services in Cape Town, South Africa participated in this qualitative study through focus group discussions. To fulfill the aims of this study, nine focus group discussions were conducted among the SRH nurses.
SRH nurses indicated that they are experiencing challenges with the concept and practice of termination of pregnancy. They explained that this practice contradicted their opposing beliefs and values. Some nurses felt that they had insufficient SRH skills, which hinder their provision of adequate SRH services to adolescents, while others described constraints within the health system such as not enough time to provide the necessary care. They also explained having limited access to schools where they can provide SRH education and pregnancy prevention services in the surrounding area.
Nurses are faced with numerous challenges when providing SRH services to adolescents. Providing the nurses with training programmes that emphasize value clarification may help them to separate their personal beliefs and norms from the workplace practice. This may help them to focus on the needs of the adolescent in a way that is beneficial to them. At the health systems level, issues such as clinic operating hours need to be structured such that the time pressure and constraints upon the nurse is relieved.
青少年的性与生殖健康需求在全球范围内得到了优先关注，他们有权获取并利用满足自身需求的性与生殖健康服务。然而，青少年对性与生殖健康服务的利用率较低，尤其是在撒哈拉以南非洲地区。许多因素导致青少年对性与生殖健康服务的利用率不高，比如医护人员的态度和行为。因此，本研究的目的是探索并深入了解医护人员的信念、动机以及行为，这些因素影响着在南非为青少年充分提供这些服务。
南非开普敦公共性与生殖健康服务领域的24名医护人员通过焦点小组讨论参与了这项定性研究。为实现本研究的目的，在性与生殖健康护士中进行了9次焦点小组讨论。
性与生殖健康护士表示，他们在终止妊娠的概念和实践方面面临挑战。他们解释说，这种做法与他们相反的信念和价值观相矛盾。一些护士觉得自己的性与生殖健康技能不足，这妨碍了他们为青少年提供充分的性与生殖健康服务，而另一些护士则描述了卫生系统内部的限制，比如没有足够时间提供必要的护理。他们还解释说，在周边地区能够提供性与生殖健康教育和预防怀孕服务的学校数量有限。
护士在为青少年提供性与生殖健康服务时面临诸多挑战。为护士提供强调价值澄清的培训项目，可能有助于他们将个人信念和规范与工作场所的实践区分开来。这可能有助于他们以有利于青少年的方式关注其需求。在卫生系统层面，需要对诸如诊所营业时间等问题进行规划，以减轻护士的时间压力和限制。
