University of California San Francisco, School of Medicine, San Francisco, California.
Advancing New Standards in Reproductive Health (ANSIRH), Bixby Center for Global Reproductive Health, Department of Obstetrics, Gynecology and Reproductive Sciences, University of California San Francisco, Oakland, California.
Womens Health Issues. 2020 Jul-Aug;30(4):277-282. doi: 10.1016/j.whi.2020.04.004. Epub 2020 Jun 5.
Research on the impact of providers disclosing personal contraceptive experiences with patients is limited. In this study, we examine patient and provider perspectives about provider self-disclosure (PSD) of personal contraceptive experiences and its effects on contraceptive decision making and the provider-patient relationship.
We conducted 18 one-on-one telephone interviews with clinicians who provide contraceptive services to young women and 17 patients seeking emergency contraception from three Bay Area community-based, youth-friendly clinics regarding their contraceptive counseling practices and experiences, respectively. After transcribing and coding all interviews, we summarized structural codes related to contraceptive counseling and PSD.
Although providers noted that PSD could help to build rapport and increase patient comfort, most did not report self-disclosing their contraceptive experiences, primarily owing to concerns that it might cross professional boundaries or compromise patient autonomy. All patients held positive attitudes toward and welcomed PSD practices, with many noting that it increased their comfort and trust in their provider.
There were notable differences between patient and provider attitudes toward PSD of contraceptive method use, with patients expressing more positive feelings about the practice than providers. Community-based providers should consider that many young women welcome self-disclosure of provider contraceptive experiences and that more research is needed to understand the effects of PSD practices around contraception on the patient-provider relationship and autonomous contraceptive decision making.
关于提供者向患者透露个人避孕经验的影响的研究有限。在这项研究中，我们研究了患者和提供者对提供者自我披露（PSD）个人避孕经验及其对避孕决策和医患关系的看法。
我们对分别为年轻女性提供避孕服务的临床医生和从三个湾区社区友好型青年诊所寻求紧急避孕的 17 名患者进行了 18 次一对一的电话访谈，分别了解他们的避孕咨询实践和经验。在转录和编码所有访谈后，我们总结了与避孕咨询和 PSD 相关的结构代码。
尽管提供者指出 PSD 可以帮助建立融洽关系并提高患者的舒适度，但大多数人并没有报告自我披露他们的避孕经验，主要是因为担心这可能会跨越专业界限或损害患者的自主权。所有患者对 PSD 做法都持有积极的态度，并表示欢迎，许多患者表示这增加了他们对提供者的舒适度和信任。
患者和提供者对避孕方法使用的 PSD 态度存在显著差异，患者对该实践的感觉比提供者更积极。基于社区的提供者应考虑到许多年轻女性欢迎提供者披露避孕经验，并且需要更多的研究来了解避孕方面的 PSD 实践对医患关系和自主避孕决策的影响。
