Department of Public Health, Erasmus University Medical Center, Rotterdam, The Netherlands.
Pharos, Dutch Centre of Expertise on Health Disparities, Utrecht, The Netherlands.
PLoS One. 2020 Jul 7;15(7):e0235867. doi: 10.1371/journal.pone.0235867. eCollection 2020.
While the general practitioner (GP) in the Netherlands is the first point of entry to and gatekeeper of the healthcare system, no study exists to explore the experiences of women with female genital mutilation or cutting (FGM/C) in general practice. Therefore, the aim of this study is to look into the experiences of women with FGM/C in Dutch general practice.
Semistructured interviews were held with 16 women with FGM/C. Sampling was purposeful. The interview guide and thematic analysis were based on the Illness Perception Model and Kleinman's Explanatory model. Interviews were held in English or Dutch. All data were anonymized, and recordings were transcribed verbatim. Transcripts were coded and thematically analyzed.
The women considered FGM/C to be connected to a range of health problems, for which not all of them sought medical care. They had difficulty discussing such a sensitive topic with their GP, did not know their problems could be relieved or perceived GPs to have insufficient knowledge of FGM/C. Lack of time during consultations and overall dissatisfaction with Dutch GP care hampered trust. They strongly preferred the GP to be proactive and ask about FGM/C.
There is room for improvement as most women would like their GP to discuss their health problems related to FGM/C. GPs should take a proactive attitude and ask about FGM/C. In addition, to develop the trusted relationship needed to discuss sensitive topics and provide culturally sensitive person-centered care, sufficient time during consultations is needed.
荷兰的全科医生(GP)是医疗保健系统的入口和守门人,但目前尚无研究探讨有女性外阴残割/切割(FGM/C)经历的女性在全科实践中的体验。因此,本研究旨在探讨荷兰全科实践中 FGM/C 女性的体验。
对 16 名有 FGM/C 经历的女性进行半结构式访谈。采用目的性抽样。访谈指南和主题分析基于疾病认知模型和克莱曼的解释模型。访谈以英语或荷兰语进行。所有数据均匿名,录音逐字转录。对转录本进行编码和主题分析。
这些女性认为 FGM/C 与一系列健康问题有关,她们并非所有人都因这些问题寻求医疗护理。她们很难与 GP 讨论如此敏感的话题,不知道自己的问题可以得到缓解,或者认为 GP 对 FGM/C 的了解不足。咨询时间有限以及对荷兰全科医生护理的整体不满阻碍了信任的建立。她们强烈希望 GP 主动询问 FGM/C。
大多数女性希望她们的 GP 讨论与 FGM/C 相关的健康问题,因此仍有改进的空间。GP 应采取主动态度并询问 FGM/C。此外,为了建立讨论敏感话题和提供文化敏感、以患者为中心的护理所需的信任关系,需要在咨询期间有足够的时间。