初级保健提供者对残疾青少年和青年生殖健康保健指南的遵循情况：一项回顾性匹配队列研究1

Primary care provider adherence to reproductive healthcare guidelines in adolescents and young adults with disabilities: A retrospective matched cohort study1.

作者信息

Roden Rosemary Claire, Oholendt Kyle, Lange Hannah, Noritz Garey, Bonny Andrea E

机构信息

Division of Adolescent Medicine, Nationwide Children's Hospital, Columbus, OH, USA.

The Ohio State University College of Medicine, Columbus, OH, USA.

出版信息

J Pediatr Rehabil Med. 2019;12(3):317-324. doi: 10.3233/PRM-180589.

DOI:10.3233/PRM-180589

PMID:31476181

Abstract

PURPOSE

Assessing provider adherence to preventative sexual and reproductive healthcare guidelines in adolescents and young adults (AYA) patients with physical and intellectual disabilities (PWD).

METHODS

Records of PWD (N= 42) age 12-26 receiving health maintenance between 01/01/11-12/31/16 were reviewed for: (1) initiation and completion of human papilloma virus (HPV) vaccination series, (2) initiation and completion of meningococcal vaccination, (3) screening for human immunodeficiency virus (HIV), and documentation of (4) sexual, (5) menstrual, and (6) pregnancy histories. Unaffected age and gender-matched patients provided comparison data (Comparison Cohort, CC).

RESULTS

The mean age of both groups was 17.3 years ± 3.8 and 40.5% were female. There was no significant difference between groups regarding the completion of HPV or meningococcal vaccine series. Among those 15+ years of age, 7.1% of PWD and 28.6% of CC were screened for HIV (p= 0.04). Sexual history was documented in 19.0% of PWD versus 73.8% of CC (p< 0.001). Among females, menstrual regularity was recorded in 11.8% of PWD versus 47.1% of CC (p= 0.02) and pregnancy history in 0.0% of PWD versus 29.4% of CC (p= 0.04).

CONCLUSIONS

Adherence to sexual health guidelines was suboptimal, and lower among PWD. Vaccination rates did not differ between the two groups.

摘要

目的

评估医疗服务提供者对患有身体和智力残疾（PWD）的青少年及青年成人（AYA）患者预防性性健康和生殖健康护理指南的遵循情况。

方法

回顾了2011年1月1日至2016年12月31日期间接受健康维护的12至26岁PWD患者（N = 42）的记录，内容包括：（1）人乳头瘤病毒（HPV）疫苗接种系列的起始和完成情况；（2）脑膜炎球菌疫苗接种的起始和完成情况；（3）人类免疫缺陷病毒（HIV）筛查；以及（4）性史、（5）月经史和（6）妊娠史的记录。未受影响的年龄和性别匹配患者提供了对照数据（对照队列，CC）。

结果

两组的平均年龄均为17.3岁±3.8岁，40.5%为女性。两组在HPV或脑膜炎球菌疫苗系列的完成情况方面无显著差异。在15岁及以上的人群中，7.1%的PWD患者和28.6%的CC患者接受了HIV筛查（p = 0.04）。19.0%的PWD患者记录了性史，而CC患者为73.8%（p < 0.001）。在女性中，11.8%的PWD患者记录了月经规律，而CC患者为47.1%（p = 0.02）；0.0%的PWD患者记录了妊娠史，而CC患者为29.4%（p = 0.04）。