College of Medicine and Public Health, Flinders University, Bedford Park, SA, Australia.
College of Nursing and Health Sciences, Flinders University, Bedford Park, SA, Australia.
J Clin Nurs. 2020 May;29(9-10):1499-1512. doi: 10.1111/jocn.15220. Epub 2020 Mar 10.
What are the views of healthcare professionals outside of the general practice setting on long-acting reversible contraception?
Despite global sexual health organisations advocating for widespread prescription of long-acting reversible contraception, uptake in developed countries remains relatively low. The role of healthcare professionals outside of the general practice setting in long-acting reversible contraception provision requires further attention.
Systematic review.
Five electronic databases were searched for existing qualitative findings using terms related to long-acting reversible contraception and healthcare professional views for the period 2013-2018. A rigorous protocol was applied following the Preferred Reporting Items for Systematic Meta-Analyses checklist and flow diagram. The Critical Appraisal Skills Programme tool was used to assess the quality of studies. A total of six studies were included for thematic analysis.
Three key themes emerged through analysis that had significant impact on healthcare professional views of long-acting reversible contraception: (a) contraceptive counselling practices and constraints; (b) knowledge and training about long-acting reversible contraception; and (c) concerns and personal beliefs about long-acting reversible contraception.
Healthcare professional views on long-acting reversible contraception are shaped by practical time constraints, levels of knowledge and training, and personal beliefs and concerns. Further research is required to address these issues in order to improve clinical training and guidelines for all settings, not just general practice.
Settings outside of general practice need to be included within the scope of initiatives that aim to improve clinical practice around access to new and emerging contraceptive methods. Further research could inform models of clinical practice that enable healthcare professionals to take enough time to talk through all contraceptive options with patients in a way that both focuses on their individual needs and is fully informed by up-to-date evidence and training.
非普通科医疗专业人员对长效可逆避孕措施的看法是什么?
尽管全球性健康组织提倡广泛处方长效可逆避孕措施,但在发达国家的使用率仍然相对较低。非普通科医疗专业人员在长效可逆避孕措施提供方面的作用需要进一步关注。
系统评价。
使用与长效可逆避孕措施和医疗专业人员观点相关的术语,在 2013 年至 2018 年期间,在五个电子数据库中搜索现有的定性研究结果。按照系统评价和荟萃分析的首选报告项目清单和流程图应用严格的方案。使用关键评估技能计划工具评估研究的质量。共有六项研究被纳入主题分析。
通过分析,出现了三个对医疗专业人员对长效可逆避孕措施的看法有重大影响的关键主题:(a) 避孕咨询实践和限制;(b) 长效可逆避孕措施的知识和培训;(c) 对长效可逆避孕措施的关注和个人信念。
医疗专业人员对长效可逆避孕措施的看法受到实际时间限制、知识和培训水平以及个人信念和关注的影响。需要进一步研究这些问题,以改善所有环境(不仅仅是普通科)的临床培训和指南。
除普通科以外的环境需要纳入旨在改善获得新出现避孕方法的临床实践的举措范围内。进一步的研究可以为临床实践模型提供信息,使医疗专业人员能够花足够的时间与患者讨论所有避孕选择,既要关注他们的个人需求,又要充分了解最新的证据和培训。