急诊科避孕服务的可接受性：一项横断面调查。

Acceptability of Contraceptive Services in the Emergency Department: A Cross-sectional Survey.

作者信息

Alexander Andreia B, Chernoby Kimberly, VanderVinne Nathan, Doos Yancy, Kaur Navneet, Bernard Caitlin, Kline Jeffrey A

机构信息

Indiana University School of Medicine, Department of Emergency Medicine, Indianapolis, Indiana.

Indiana University-Purdue University, School of Science, Indianapolis, Indiana.

出版信息

West J Emerg Med. 2021 May 24;22(3):769-774. doi: 10.5811/westjem.2021.2.49675.

DOI:10.5811/westjem.2021.2.49675

PMID:34125059

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC8203030/

Abstract

INTRODUCTION

Unintended pregnancy disproportionately affects marginalized populations and has significant negative health and financial impacts on women, their families, and society. The emergency department (ED) is a promising alternative setting to increase access to sexual and reproductive health (SRH) services including contraception, especially among marginalized populations. The primary objective of this study was to determine the extent to which adult women of childbearing age who present to the ED would be receptive to receiving contraception and/or information about contraception in the ED. As a secondary objective, we sought to identify the barriers faced in attempting to obtain SRH care in the past.

METHODS

We conducted a quantitative, cross-sectional, assisted, in-person survey of women aged 18-50 in the ED setting at two large, urban, academic EDs between June 2018-September 2019. The survey was approved by the institutional review board. Survey items included demographics, interest in contraception initiation and/or receiving information about contraception in the ED, desire to conceive, prior SRH care utilization, and barriers to SRH.

RESULTS

A total of 505 patients participated in the survey. Participants were predominantly single and Black, with a mean age of 31 years, and reporting not wanting to become pregnant in the next year. Of those participants, 55.2% (n = 279) stated they would be interested in receiving information about birth control AND receiving birth control in the ED if it were available. Of those who reported the ability to get pregnant, and not desiring pregnancy in the next year (n = 279, 55.2%), 32.6% were not currently using anything to prevent pregnancy (n = 91). Only 10.5% of participants stated they had experienced barriers to SRH care in the past (n = 53). Participants who experienced barriers to SRH reported higher interest in receiving information and birth control in the ED (74%, n = 39) compared to those who had not experienced barriers (53%, n = 240); (P = 0.004, 95% confidence interval, 1.30-4.66).

CONCLUSION

The majority of women of childbearing age indicated the desire to access contraception services in the ED setting. This finding suggests favorable patient acceptability for an implementation study of contraception services in emergency care.

摘要

引言

意外怀孕对边缘化人群的影响尤为严重，会对女性及其家庭和社会造成重大的负面健康和经济影响。急诊科是增加获得性与生殖健康（SRH）服务（包括避孕服务）机会的一个有前景的替代场所，特别是在边缘化人群中。本研究的主要目的是确定到急诊科就诊的育龄成年女性接受避孕和/或在急诊科获取避孕信息的程度。作为次要目的，我们试图找出过去在尝试获得性与生殖健康护理时所面临的障碍。

方法

我们于2018年6月至2019年9月期间，在两家大型城市学术性急诊科对18至50岁的女性进行了一项定量的、横断面的、辅助的现场调查。该调查得到了机构审查委员会的批准。调查项目包括人口统计学信息、在急诊科开始避孕和/或获取避孕信息的兴趣、怀孕意愿、既往性与生殖健康护理的利用情况以及获得性与生殖健康护理的障碍。

结果

共有505名患者参与了调查。参与者主要为单身且是黑人，平均年龄为31岁，并表示在未来一年内不想怀孕。在这些参与者中，55.2%（n = 279）表示如果急诊科有相关服务，她们有兴趣在急诊科获取避孕信息并接受避孕措施。在那些报告有怀孕能力且在未来一年内不想怀孕的人中（n = 279，55.2%），32.6%目前没有采取任何措施预防怀孕（n = 91）。只有10.5%的参与者表示她们过去在获得性与生殖健康护理方面遇到过障碍（n = 53）。与未遇到障碍的参与者（53%，n = 240）相比，遇到过障碍的参与者对在急诊科获取信息和避孕措施表现出更高的兴趣（74%，n = 39）；（P = 0.004，95%置信区间，1.30 - 4.66）。