支持以患者为中心的青少年性与生殖健康沟通——构建预约规划工具的视角。
Supporting Patient-centered Communication on Adolescent Sexual and Reproductive Health-Perspectives to Build an Appointment Planning Tool.
机构信息
Department of Social and Behavioral Sciences, 60 College Street, PO Box 208034, Yale School of Public Health, New Haven, CT, 06520-8034, USA.
Global Health Leadership Initiative, 100 Church Street South, Yale School of Public Health, New Haven, CT, 06519, USA; Department of Health Policy and Management, 60 College Street, PO Box 208034, Yale School of Public Health, New Haven, CT, 06520-8034, USA.
出版信息
J Pediatr Adolesc Gynecol. 2021 Oct;34(5):725-731. doi: 10.1016/j.jpag.2021.04.009. Epub 2021 May 12.
STUDY OBJECTIVE
Input from adolescents and healthcare providers is needed to develop electronic tools that can support patient-centered sexual and reproductive (SRH) care. This study explores facilitators and barriers to patient-centered communication in the context of developing an electronic appointment planning tool to promote SRH communication in clinic settings.
DESIGN
In-depth interviews were conducted to explore what constitutes adolescent-friendly SRH care and communication, as well as on the design of the appointment planning tool. Interviews were coded iteratively, and analyzed using the software Atlas.TI v8.
SETTING
An adolescent primary care clinic, and a pediatric and adolescent gynecology clinic.
PARTICIPANTS
Adolescent girls (N=32; ages 14-18) and providers who care for adolescent girls (N=10).
MAIN OUTCOME MEASURES
Thematic analyses explored facilitators/barriers to SRH communication and care and preferences for the tool.
RESULTS
Facilitators identified by adolescents and providers included: direct patient/provider communication; adolescent-driven decision-making regarding care and contraceptive choice; supplementing clinic visits with electronic resources; and holistic care addressing physical, mental, and social needs. Barriers identified by participants included: limited time for appointments; limited adolescent autonomy in appointments; and poor continuity of care when adolescents cannot see the same provider. Given the complexity of issues raised, adolescents and providers were interested in developing an appointment planning tool to guide communication during appointments, and contributed input on its design. The resulting Appointment Planning Tool app pilot is in progress.
CONCLUSIONS
Qualitative interviews with adolescents and providers offer critical insights for the development and implementation of mobile health (mHealth) tools that can foster patient-centered care.
研究目的
需要青少年和医疗保健提供者的投入来开发能够支持以患者为中心的性与生殖健康（SRH）护理的电子工具。本研究探讨了在开发电子预约规划工具以促进临床环境中的 SRH 沟通时，以患者为中心的沟通中的促进因素和障碍。
设计
进行了深入访谈，以探讨构成青少年友好型 SRH 护理和沟通的因素，以及预约规划工具的设计。对访谈进行了迭代编码，并使用 Atlas.TI v8 软件进行了分析。
地点
青少年初级保健诊所和儿科及青少年妇科诊所。
参与者
青少年女孩（N=32；年龄 14-18 岁）和照顾青少年女孩的提供者（N=10）。
主要结果测量
主题分析探讨了 SRH 沟通和护理的促进因素/障碍以及对工具的偏好。
结果
青少年和提供者确定的促进因素包括：直接的医患沟通；青少年在护理和避孕选择方面自主决策；通过电子资源补充诊所就诊；以及满足身体、心理和社会需求的整体护理。参与者确定的障碍包括：预约时间有限；预约时青少年自主权有限；以及当青少年无法看到同一位提供者时，护理的连续性较差。鉴于提出的问题的复杂性，青少年和提供者有兴趣开发预约规划工具来指导预约期间的沟通，并对其设计提出了意见。正在进行的预约规划工具应用程序试点。
结论
与青少年和提供者进行的定性访谈为开发和实施能够促进以患者为中心的护理的移动健康（mHealth）工具提供了重要的见解。
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