现场妇科咨询实施后，囊性纤维化成年女性的避孕措施覆盖率和妇科保健得到改善。
Improvement in contraceptive coverage and gynecological care of adult women with cystic fibrosis following the implementation of an on-site gynecological consultation.
机构信息
Hospices civils de Lyon, CRCM-Centre Hospitalier Lyon Sud, 165 chemin du grand revoyet, Pierre-Bénite 69310, France; Department of Gynaecological Surgery and Oncology, Obstetrics, Lyon Sud University Hospital, Hospices Civils de Lyon, 165 chemin du grand Revoyet, Pierre-Bénite 69310, France; Université Claude Bernard Lyon 1 - HESPER EA7425, 8 avenue Rockefeller, Lyon cedex 8 69373, France; Departement of Surgery, Leon Bérard Cancer Center, 28 rue Laënnec, Lyon 69008, France.
Hospices civils de Lyon, CRCM-Centre Hospitalier Lyon Sud, 165 chemin du grand revoyet, Pierre-Bénite 69310, France; Université Claude Bernard Lyon 1 - HESPER EA7425, 8 avenue Rockefeller, Lyon cedex 8 69373, France.
出版信息
Contraception. 2020 Mar;101(3):183-188. doi: 10.1016/j.contraception.2019.10.014. Epub 2019 Nov 28.
OBJECTIVE
Our study aimed to evaluate the impact of the introduction of a new gynecologic referral service in our adult Cystic Fibrosis (CF) center on contraceptive coverage, gynecological follow-up regularity, and cervical cancer screening coverage.
STUDY DESIGN
We implemented an on-site gynecological consultation in our adult CF center in 2015. We compared the results of two surveys conducted successively in 2014 and in 2017 in a cohort of women with CF attending the Lyon CF center. Women completed the same self-report written questionnaire as in 2014. Main outcome measures were the comparisons of contraceptive coverage, gynecological follow-up regularity, and cervical cancer screening coverage between 2014 and 2017.
RESULTS
All the 136 women (100%) who attended the clinic in 2017 participated. Contraceptive prevalence rate increased from 69%(CI95%:60.3-78.1) to 86%(CI95%:79.6-92.9) between 2014 and 2017 (p = 0.005). Among transplanted patients, the contraceptive prevalence rate was 92.3%(CI95%:82.0-100) in 2017. Long acting reversible contraceptive use markedly increased from 10% to 21.6% (p = 0.005). The proportion of women that reported an access to gynecological care increased between 2014 and 2017 (74%(CI95%:66.3-82.0) vs 91%(CI95%:86.9-95.4), p < 0.005) and reached 100% among transplanted patients. Cervical cancer screening improved (55%(CI95%:51.2-68.8) vs 85%(CI95%:78.6-90.6) women ever screened) (p < 0.0005) and reached 100% among transplanted patients.
CONCLUSIONS
We observed an improvement in contraceptive coverage and gynecological care of adult women with CF following the implementation of a dedicated gynecological consultation in the CF center.
IMPLICATIONS
Service linkages and formal links between CF centers and gynecologists can facilitate access to disease-specific contraceptive counseling, adequate gynecological management and cervical cancer screening.
目的
我们的研究旨在评估在我们成人囊性纤维化（CF）中心引入新的妇科转诊服务对避孕措施覆盖率、妇科随访规律和宫颈癌筛查覆盖率的影响。
研究设计
我们于 2015 年在成人 CF 中心实施了现场妇科咨询。我们比较了 2014 年和 2017 年在里昂 CF 中心就诊的 CF 女性连续两次调查的结果。女性填写了与 2014 年相同的自我报告书面问卷。主要观察指标是 2014 年至 2017 年期间避孕措施覆盖率、妇科随访规律和宫颈癌筛查覆盖率的比较。
结果
2017 年参加门诊的 136 名女性（100%）全部参与。避孕措施的流行率从 2014 年的 69%（95%CI95%：60.3-78.1）增加到 2017 年的 86%（95%CI95%：79.6-92.9）（p=0.005）。移植患者中，2017 年的避孕措施流行率为 92.3%（95%CI95%：82.0-100）。长效可逆避孕措施的使用率从 10%显著增加到 21.6%（p=0.005）。2014 年至 2017 年，报告获得妇科保健的女性比例增加（74%（95%CI95%：66.3-82.0）与 91%（95%CI95%：86.9-95.4），p<0.005），移植患者达到 100%。宫颈癌筛查有所改善（55%（95%CI95%：51.2-68.8）与 85%（95%CI95%：78.6-90.6）的女性曾接受筛查）（p<0.0005），移植患者达到 100%。
结论
在 CF 中心实施专门的妇科咨询后，我们观察到成年 CF 女性的避孕措施覆盖率和妇科保健得到改善。
意义
CF 中心与妇科医生之间的服务联系和正式联系可以促进获得针对疾病的避孕咨询、充分的妇科管理和宫颈癌筛查。
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