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妇产科住院医师规范化培训中的性健康教育——住院医师调查。

Sexual Health Education in Obstetrics and Gynecology (Ob-Gyn) Residencies-A Resident Physician Survey.

机构信息

Department of Ob-Gyn, The Ohio State University Wexner College of Medicine, Columbus, OH, USA.

Department of Ob-Gyn, The University of Arizona College of Medicine, Phoenix, AZ, USA.

出版信息

J Sex Med. 2021 Jun;18(6):1042-1052. doi: 10.1016/j.jsxm.2021.03.005. Epub 2021 May 18.

Abstract

BACKGROUND

Many women will experience a sexual health concern and present to their Obstetrics and Gynecology (Ob-Gyn) care provider, yet a large portion of graduating Ob-Gyn resident physicians in the United States may not feel comfortable helping patients with some sexual health issues.

AIM

To perform a cross-sectional study of U.S. Ob-Gyn resident physicians that assesses sexual health education didactic sessions and comfort level with sexual health clinical vignettes.

METHODS

A 32-item anonymous survey was sent to all 4,065 Ob-Gyn residents on June 7, 2016. Respondents voluntarily completed the survey electronically.

OUTCOMES

The primary outcome measures are the comfort level of Ob-Gyn resident physicians in taking a sexual history and providing counseling to patients represented in clinical vignettes, which were based on sexual health learning objectives from the Council on Resident Education in Obstetrics and Gynecology (CREOG).

RESULTS

Of the 4,065 eligible U.S. examinees, 968 (23.8%) agreed to participate in the study, and 802 (19.7%) completed the survey and were included in the final analysis. Nearly two-thirds of the residents indicated that sexual health training was a priority in residency. However, more than half were not able to describe the disorders of sexual function or list common medications that effect sexual function. When posed with clinical vignettes, residents felt very comfortable obtaining a sexual history (98.5%) and providing counseling (97.0%) for a 16-year-old seeking contraception, yet fewer felt very comfortable obtaining a history and providing counseling for a 26-year-old who is a refugee from Somalia (77.2% and 73.8%). Smaller cohorts felt prepared to take a sexual history and provide counseling for a 17-year-old who discloses that she is a victim of sex trafficking (61.2% and 57.7%), and for a 58-year-old transgender patient planning hormone therapy and surgery (49.9% and 37.9%). In logistic regression analysis, the factors that were influential in an Ob-Gyn resident physician's program to prepare them to describe the disorders of sexual function were post-graduate year (OR 1.387, 95% CI 1.189, 1.618; P = .0001), those that rated the importance of a sexual health curriculum highly (OR 0.701, 95% CI 0.569, 0.864; P = .0012), and a greater number of didactic sessions on sexual health in the residency curriculum (OR 0.685, 95% CI 0.626, 0.750; P < .0001).

CONCLUSION

These findings highlight strengths in the comfort of Ob-Gyn resident physicians about sexual health and illustrate areas of opportunity to engage resident learners by improving the sexual health curriculum. Worly B, Manriquez M, Stagg A, et al. Sexual Health Education in Obstetrics and Gynecology (Ob-Gyn) Residencies-A Resident Physician Survey. J Sex Med 2021;18:1042-1052.

摘要

背景

许多女性会遇到性健康问题,并向妇产科(Ob-Gyn)护理提供者就诊,但美国很大一部分即将毕业的妇产科住院医师可能对帮助患者解决某些性健康问题感到不自在。

目的

对美国妇产科住院医师进行横断面研究,评估性健康教育培训课程和对性健康临床案例的舒适度。

方法

2016 年 6 月 7 日,向所有 4065 名妇产科住院医师发送了一份 32 项匿名调查。受访者自愿以电子方式完成调查。

结果

在 4065 名符合条件的美国应试者中,有 968 名(23.8%)同意参加研究,有 802 名(19.7%)完成了调查并被纳入最终分析。近三分之二的住院医师表示,性健康培训是住院医师培训的重点。然而,超过一半的人无法描述性功能障碍或列出影响性功能的常见药物。当面对临床案例时,住院医师非常愿意获取 16 岁寻求避孕的患者的性病史(98.5%)并提供咨询(97.0%),但对于 26 岁来自索马里的难民,他们感到不太舒服(77.2%和 73.8%)。较小的人群则更有准备为 17 岁的性交易受害者(61.2%和 57.7%)和 58 岁的变性患者(49.9%和 37.9%)获取性病史并提供咨询。在逻辑回归分析中,影响妇产科住院医师准备描述性功能障碍的因素包括研究生年限(比值比 1.387,95%置信区间 1.189-1.618;P=0.0001)、对性健康课程重要性评价较高(比值比 0.701,95%置信区间 0.569-0.864;P=0.0012)以及住院医师课程中增加性健康教学课程(比值比 0.685,95%置信区间 0.626-0.750;P<0.0001)。

结论

这些发现突出了妇产科住院医师对性健康的舒适度优势,并说明了通过改善性健康课程来吸引住院医师学习者的机会领域。Worly B, Manriquez M, Stagg A, et al. 妇产科住院医师的性健康教育(Ob-Gyn)-住院医师调查。J 性医学 2021;18:1042-1052.

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