UPMC Children's Hospital of Pittsburgh, Division of Child Neurology, 4401 Penn Avenue, Pittsburgh, PA 15224, United States.
UPMC Children's Hospital of Pittsburgh, Division of Child Neurology, 4401 Penn Avenue, Pittsburgh, PA 15224, United States.
Epilepsy Behav. 2021 Jul;120:108001. doi: 10.1016/j.yebeh.2021.108001. Epub 2021 May 5.
To evaluate child neurologists' knowledge, attitudes, and practices regarding sexual and reproductive health (SRH) care for adolescent and young adult women with epilepsy (WWE).
Child neurologists (including attending physicians, residents, fellows, and advanced practitioners) completed an online survey distributed through subspecialty listservs. We analyzed results using descriptive statistics, chi-square, and logistic regression.
Two hundred eight child neurologists completed the survey. Most believed that child neurologists should counsel young WWE on: teratogenesis (99%, n = 206/207), contraception-antiseizure medication interactions (96%, n = 194/202), pregnancy (95%, n = 198/206), contraception (89%, n = 184/206) and folic acid supplementation (70%, n = 144/205). Fewer respondents felt confident with such counseling (teratogenesis: 90%, n = 188/208, drug interactions: 65%, n = 133/208, pregnancy 75%, n = 156/208, contraception: 47-64%, n = 96-134/208, p < 0.05). Ninety-five percent (n = 172/181) reported ever discussing SRH with typically developing young WWE, compared to 78% (n = 141/181) for young WWE with mild intellectual disability (p < 0.01). One third (n = 56/170) who ever discussed SRH did not do so routinely. Respondents correctly answered 87% ± 5% of knowledge questions about SRH for WWE, 80% ± 4% of questions about teratogenic antiseizure medications, and 61% ± 7% of questions about contraception-antiseizure drug interactions. The greatest barrier to SRH care was time constraints (80%, n = 149/186). The majority (64%, n = 119/186) identified solutions including longer appointment times and co-managing SRH care with other specialties.
Findings reveal gaps in SRH care by child neurologists for adolescent and young adult WWE, especially those with mild intellectual disability. Provider-identified barriers and solutions may serve as targets to improve SRH care for this population.
评估儿童神经科医生在青少年和年轻成年女性癫痫（WWE）患者的性与生殖健康（SRH）护理方面的知识、态度和实践。
儿童神经科医生（包括主治医生、住院医生、研究员和高级从业者）完成了一项在线调查，该调查通过专业列表服务分发。我们使用描述性统计、卡方检验和逻辑回归分析结果。
208 名儿童神经科医生完成了调查。大多数人认为儿童神经科医生应该为年轻的 WWE 患者提供以下方面的咨询：致畸性（99%，n=206/207）、避孕-抗癫痫药物相互作用（96%，n=194/202）、妊娠（95%，n=198/206）、避孕（89%，n=184/206）和叶酸补充（70%，n=144/205）。较少的受访者对这些咨询有信心（致畸性：90%，n=188/208，药物相互作用：65%，n=133/208，妊娠 75%，n=156/208，避孕：47-64%，n=96-134/208，p<0.05）。95%（n=172/181）的受访者报告曾与发育正常的年轻 WWE 患者讨论过 SRH，而 78%（n=141/181）的受访者与轻度智力障碍的年轻 WWE 患者讨论过（p<0.01）。三分之一（n=56/170）曾讨论过 SRH 的受访者并非常规讨论。受访者正确回答了 87%±5%的关于 WWE 患者的 SRH 知识问题，80%±4%的关于致畸性抗癫痫药物的问题，以及 61%±7%的关于避孕-抗癫痫药物相互作用的问题。SRH 护理的最大障碍是时间限制（80%，n=149/186）。大多数人（64%，n=119/186）确定了一些解决方案，包括延长预约时间和与其他专业共同管理 SRH 护理。
研究结果显示，儿童神经科医生在青少年和年轻成年女性癫痫患者的 SRH 护理方面存在差距，尤其是在轻度智力障碍患者中。提供者确定的障碍和解决方案可能是改善该人群 SRH 护理的目标。
