Center for Research and Business Intelligence, Rotterdam, The Netherlands.
Centre for Infectious Disease Control, National Institute for Public Health and the Environment, Bilthoven, The Netherlands.
BMC Infect Dis. 2018 May 29;18(1):243. doi: 10.1186/s12879-018-3139-0.
Chlamydia prevalence in the Netherlands remains high despite targeted efforts. Effective Partner Notification (PN) and Partner Treatment (PT) can interrupt transmission and prevent re-infections. Patient Initiated Partner Treatment (PIPT) may strengthen chlamydia control. This study explores the current practice of PN and PT, and benefits of, and barriers and facilitators for PIPT among professionals in sexual health care in the Netherlands.
A qualitative study was performed among GPs, GP-assistants (GPAs), physicians and nurses working at Sexual Health Clinics (SHC) and key-informants on ethnical diversity using topic lists in focus groups (N = 40) and semi-structured questionnaires in individual interviews (N = 9). Topics included current practices regarding PN and PT, attitude regarding PIPT, and perceived barriers and facilitators for PIPT. Interviews were taped, transcribed verbatim, and coded using ATLAS.ti. A quantitative online questionnaire on the same topics was sent to all physicians and nurses employed at Dutch SHC (complete response rate 26% (84/321)).
The qualitative study showed that all professionals support the need for more attention to PN, and that they saw advantages in PIPT. Mentioned barriers included unwilling PN-behaviour, Dutch legislation, several medical considerations and inadequate skills of GPs. Also, concerns about limited knowledge of cultural sensitivity around PN and PT were raised. Mentioned facilitators of PIPT were reliable home based test-kits, phone-contact between professionals and notified partners, more consultation time for GPs or GPAs and additional training. The online questionnaire showed that SHC employees agreed that partners should be treated as soon as possible, but also that they were reluctant towards PIPT without counselling and testing.
Professionals saw advantages in PIPT, but they also identified barriers hampering the potential introduction of PIPT. Improving PN and counselling skills with specific focus on cultural sensitivity is needed. PIPT could be considered for specific partners. PIPT in combination with home based testing and using e-healthcare should be further explored and developed.
尽管荷兰已经采取了有针对性的措施，但衣原体的患病率仍然很高。有效的性伴侣通知（PN）和性伴侣治疗（PT）可以阻断传播并预防再次感染。患者发起的性伴侣治疗（PIPT）可能会加强衣原体的控制。本研究旨在探索荷兰性健康护理专业人员目前在 PN 和 PT 方面的实践情况，以及 PIPT 的益处、障碍和促进因素。
采用主题列表的焦点小组（N=40）和半结构式个人访谈（N=9），对从事全科医生、全科医生助理（GPAs）、性健康诊所（SHC）的医生和护士以及多元化的关键信息员进行了定性研究。主题包括关于 PN 和 PT 的当前实践、对 PIPT 的态度以及对 PIPT 的障碍和促进因素的看法。访谈进行了录音、逐字转录，并使用 ATLAS.ti 进行了编码。关于相同主题的定量在线问卷发送给了所有在荷兰 SHC 工作的医生和护士（完整回复率为 26%（84/321））。
定性研究表明，所有专业人员都支持更多关注 PN 的需求，并认为 PIPT 有优势。提到的障碍包括不愿意进行 PN 行为、荷兰立法、一些医疗考虑因素以及全科医生和全科医生助理的技能不足。此外，还提到了对 PN 和 PT 方面文化敏感性知识有限的担忧。提到的 PIPT 促进因素包括可靠的家庭检测试剂盒、专业人员与通知的性伴侣之间的电话联系、为全科医生或全科医生助理提供更多的咨询时间以及额外的培训。在线问卷显示，SHC 员工认为应该尽快治疗性伴侣，但也认为如果没有咨询和检测，他们不愿意进行 PIPT。
专业人员认为 PIPT 有优势，但他们也确定了阻碍潜在引入 PIPT 的障碍。需要提高 PN 和咨询技能，并特别关注文化敏感性。可以考虑为特定的伴侣提供 PIPT。应进一步探索和开发结合家庭检测和使用电子医疗保健的 PIPT。
