Baldwin Maureen K, Overcarsh Patricia, Patel Ashlesha, Zimmerman Lindsay, Edelman Alison
1Department of Obstetrics & Gynecology, Oregon Health & Science University, 3181 SW Sam Jackson Park Road, Portland, OR 97239 USA.
2Division of Family Planning, Department of Obstetrics and Gynecology, John H Stroger Jr., Hospital of Cook County, 1969 Ogden Ave, Chicago, IL 60612 USA.
Contracept Reprod Med. 2018 Dec 17;3:21. doi: 10.1186/s40834-018-0074-9. eCollection 2018.
Federal and clinical guidelines support integration of reproductive life planning in the care of female patients to aid in the reduction of unplanned pregnancies. A multitude of tools have been created to help in the counseling component, but further research is needed regarding how and whether they facilitate patient-provider communication.
We performed a randomized controlled trial to evaluate if patients report whether a detailed or simple pregnancy intention screening tool is helpful for communication of reproductive life plans. We compared a novel reproductive counseling aid, the Family Planning Quotient (FPQ), to a simple tool based on the One Key Question® (OKQ). Providers also evaluated whether they thought the tool used at the visit was helpful. We randomized 93 patients to complete a survey including identical demographic questions and either the FPQ or OKQ reproductive counseling tool. We did not provide further instructions to either the patient or provider. Following the visits, we collected 84 subject evaluations and 79 provider evaluations. A similar proportion of subjects using either reproductive counseling tool found it helpful in communicating their reproductive life plans to their providers (approximately 66%), but there was no difference between the two tools studied. Less than half of providers reported that the FPQ tool was helpful (FPQ: 16/43, 37.2% versus OKQ: 18/36, 50%; = 0.25).
Two-thirds of patients reported either a detailed or simple reproductive plan screening tool was helpful to facilitate communication with their provider, but only half of providers found either tool helpful. Use of reproductive screening tools should be followed by patient-centered counseling to help patients meet their reproductive life goals.
联邦和临床指南支持在女性患者护理中纳入生殖生活规划，以帮助减少意外怀孕。已经创建了许多工具来辅助咨询环节，但关于这些工具如何以及是否促进医患沟通，还需要进一步研究。
我们进行了一项随机对照试验，以评估患者是否报告详细或简单的怀孕意向筛查工具对生殖生活计划的沟通是否有帮助。我们将一种新型生殖咨询辅助工具——计划生育商数（FPQ），与基于“一个关键问题”（OKQ）的简单工具进行了比较。提供者还评估了他们认为就诊时使用的工具是否有帮助。我们将93名患者随机分组，让他们完成一项包括相同人口统计学问题以及FPQ或OKQ生殖咨询工具的调查。我们没有向患者或提供者提供进一步的说明。就诊后，我们收集了84份患者评估和79份提供者评估。使用这两种生殖咨询工具的患者中，认为其有助于向提供者传达生殖生活计划的比例相似（约66%），但所研究的两种工具之间没有差异。不到一半的提供者报告称FPQ工具有用（FPQ：16/43，37.2%；OKQ：18/36，50%；P = 0.25）。
三分之二的患者报告详细或简单的生殖计划筛查工具有助于促进与提供者的沟通，但只有一半的提供者认为这两种工具有用。使用生殖筛查工具后，应进行以患者为中心的咨询，以帮助患者实现其生殖生活目标。
