Singer Miriam R, Sood Nikita, Rapoport Eli, Gim Haelynn, Adesman Andrew, Milanaik Ruth
Department of Pediatrics, Steven and Alexandra Cohen Children's Medical Center of New York, Lake Success, NY, USA.
Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, Hempstead, NY, USA.
Int J Adolesc Med Health. 2020 Mar 11;34(3):/j/ijamh.ahead-of-print/ijamh-2019-0179/ijamh-2019-0179.xml. doi: 10.1515/ijamh-2019-0179.
This study investigates whether primary care pediatricians adhere to the American Academy of Pediatrics (AAP) recommendations by routinely evaluating patients' menstrual cycles and educating patients about menstruation and feminine products. Additionally, this study examines pediatricians' knowledge and attitudes surrounding menstrual health topics.
A 53-item online questionnaire was developed to evaluate pediatricians' knowledge, attitudes and clinical practices regarding menstruation-related topics. The questionnaire was emailed to 2500 AAP members using a geographically-stratified sampling approach, with pediatricians in each state selected randomly. Mann-Whitney U tests, t-tests, and logistic regressions were used to assess associations between correlates and pediatricians' knowledge, attitudes and practices.
Five hundred and eighteen out of 2500 pediatricians participated (response rate = 20.7%), 462 met inclusion criteria; 78.8% were female, 79.2% were Caucasian. The majority of the pediatricians (58.2%) were "not at all" or only "slightly" familiar with the AAP guidelines on anticipatory guidance surrounding menarche. Many reported they do not routinely provide anticipatory guidance regarding menstruation to pre-menarchal patients (24.7%), discuss menstruation with post-menarchal patients (33.1%) or ask patients the date of their last period (28.4%). The majority were unlikely to discuss feminine products with patients. Gaps in menstruation-related knowledge were noted. Male pediatricians were significantly less likely to evaluate patients' menstrual cycles and provide patient-education regarding menstruation-related topics, and had significantly lower self-rated and measured knowledge of these topics.
A concerning number of pediatricians in a national sample do not abide by AAP recommendations surrounding menstruation and exhibit knowledge gaps in this area. To effectively address the health needs of female patients, pediatricians should better incorporate menstrual health care into their clinical practice.
本研究调查基层儿科医生是否通过定期评估患者的月经周期以及对患者进行月经和女性用品方面的教育来遵循美国儿科学会（AAP）的建议。此外，本研究还考察了儿科医生关于月经健康主题的知识和态度。
设计了一份包含53个项目的在线问卷，以评估儿科医生关于月经相关主题的知识、态度和临床实践。采用地理分层抽样方法，将问卷通过电子邮件发送给2500名AAP成员，每个州的儿科医生随机选取。使用曼-惠特尼U检验、t检验和逻辑回归来评估相关因素与儿科医生的知识、态度和实践之间的关联。
2500名儿科医生中有518名参与（回复率 = 20.7%），462名符合纳入标准；78.8%为女性，79.2%为白种人。大多数儿科医生（58.2%）对AAP关于初潮预期指导的指南“完全不”熟悉或仅“略有”熟悉。许多人报告说，他们不会定期向前青春期患者提供关于月经的预期指导（24.7%），不会与已来月经的患者讨论月经问题（33.1%），也不会询问患者上次月经的日期（28.4%）。大多数人不太可能与患者讨论女性用品。发现了与月经相关的知识差距。男性儿科医生评估患者月经周期并就月经相关主题提供患者教育的可能性显著更低，并且在这些主题上的自我评估知识和实测知识也显著更低。
在全国样本中，有相当数量的儿科医生不遵守AAP关于月经的建议，并且在该领域存在知识差距。为了有效满足女性患者的健康需求，儿科医生应更好地将月经保健纳入其临床实践。
