Divisions of Clinical Research & Family Planning, Department of Obstetrics and Gynecology, Washington University in St. Louis School of Medicine, St. Louis, MO, USA.
Divisions of Clinical Research & Family Planning, Department of Obstetrics and Gynecology, Washington University in St. Louis School of Medicine, St. Louis, MO, USA.
Contraception. 2021 Feb;103(2):97-102. doi: 10.1016/j.contraception.2020.10.020. Epub 2020 Nov 5.
To characterize patient and counselor satisfaction with structured, tier-based contraceptive counseling provided by a nonclinician.
We conducted a planned secondary analysis of patient and counselor surveys from a study that enrolled women in 2 contraceptive care programs. All participants received structured contraceptive counseling from trained staff members. Women and counselors completed a confidential post-visit survey regarding satisfaction with counseling and medical mistrust. We used univariate and multivariable regressions to examine differences in high satisfaction with counseling (top score), perceived counselor influence, and perceived counselor judgment by participant characteristics.
Nine hundred forty-two participants completed surveys; most reported they felt respected (100.0%), trusted the counseling information (99.5%), and that counseling helped them choose a contraceptive method (83.8%). Black race, high school education, public insurance, an income below the federal poverty level, and enrollment site were associated with high medical mistrust. Participants with high medical mistrust were less likely to be highly satisfied with counseling (adjusted relative risk (RR) 0.72; 95% confidence interval [CI] 0.63-0.82), more likely to perceive influence (RR 1.77; 95% CI 1.37-2.28), and more likely to perceive judgment (adjusted odds ratio 8.91; 95% CI 3.61-22.01). Mostly, counselors felt they were able to answer participant questions (98.8%), establish good rapport (95.9%), and that participants understood the information presented (98.0%).
Overall, participants were satisfied with tier-based contraceptive counseling delivered by nonclinician staff members. Those with high levels of medical mistrust were less likely to be satisfied. The majority of women found the information beneficial in contraceptive decision making.
Overall, women reported high satisfaction with tier-based contraceptive counseling delivered by a nonclinician in 3 federally qualified health centers. However, women with high medical mistrust were less likely to report high levels of satisfaction and more likely to report perceived influence or judgment from the counselor.
描述非临床医生提供的结构化、分层避孕咨询中患者和顾问的满意度。
我们对参加 2 种避孕护理项目的女性进行的一项研究中的患者和顾问调查进行了计划中的二次分析。所有参与者都接受了经过培训的工作人员提供的结构化避孕咨询。女性和顾问在就诊后完成了关于咨询满意度和对医疗不信任的保密性调查。我们使用单变量和多变量回归来检查参与者特征对咨询满意度高（最高评分）、感知顾问影响力和感知顾问判断的差异。
942 名参与者完成了调查；大多数人表示他们感到受到尊重（100.0%）、信任咨询信息（99.5%），并且认为咨询帮助他们选择了避孕方法（83.8%）。黑人种族、高中学历、公共保险、收入低于联邦贫困线和就诊地点与高度医疗不信任有关。高度医疗不信任的参与者不太可能对咨询非常满意（调整后的相对风险 [RR] 0.72；95%置信区间 [CI] 0.63-0.82），更有可能感知到影响力（RR 1.77；95% CI 1.37-2.28），并且更有可能感知到判断（调整后的优势比 8.91；95% CI 3.61-22.01）。大多数顾问认为他们能够回答参与者的问题（98.8%）、建立良好的融洽关系（95.9%），并且参与者理解了所呈现的信息（98.0%）。
总体而言，参与者对非临床医生提供的基于层级的避孕咨询感到满意。那些对医疗有高度不信任的人不太可能感到满意。大多数女性认为这些信息对避孕决策有帮助。
总体而言，在 3 家合格的联邦健康中心，女性对非临床医生提供的基于层级的避孕咨询报告了较高的满意度。然而，对医疗有高度不信任的女性不太可能报告高度满意，并且更有可能报告来自顾问的感知影响或判断。
