加拿大医疗保健专业人员对 COVID-19 大流行期间堕胎服务的看法。
The perspective of Canadian health care professionals on abortion service during the COVID-19 pandemic.
机构信息
Department of Obstetrics and Gynaecology, University of British Columbia, Vancouver, Canada.
The School of Population and Public Health, University of British Columbia, Vancouver, Canada.
出版信息
Fam Pract. 2021 Aug 27;38(Suppl 1):i30-i36. doi: 10.1093/fampra/cmab083.
BACKGROUND
The COVID-19 pandemic and pandemic response created novel challenges for abortion services. Canada was uniquely positioned to transition to telemedicine because internationally common restrictions on abortion medication were removed before the pandemic.
OBJECTIVE
We sought to characterize the experiences of abortion health care professionals in Canada during the COVID-19 pandemic and the impact of the pandemic response on abortion services.
METHODS
We conducted a sequential mixed methods study between July 2020 and January 2021. We invited physicians, nurse practitioners and administrators to participate in a cross-sectional survey containing an open-ended question about the impact of the pandemic response on abortion care. We employed an inductive codebook thematic analysis, which informed the development of a second, primarily quantitative survey.
RESULTS
Our initial survey had 307 respondents and our second had 78. Fifty-three percent were family physicians. Our first survey found respondents considered abortion access essential. We identified three key topicss: access to abortion care was often maintained despite pandemic-related challenges (e.g. difficulty obtaining tests, additional costs); change of practice to low-touch medication abortion care and provider perceptions of patient experience, including shifting demand, telemedicine acceptability and increased rural access. The second survey indicated uptake of telemedicine medication abortion among 89% of participants except in Quebec, where regulations meant procedures were nearly exclusively surgical. Restrictions did not delay care according to 76% of participants.
CONCLUSIONS
Canadian health care professionals report their facilities deemed abortion an essential service. Provinces and territories, except Quebec, described a robust pandemic transition to telemedicine to ensure access to services.
PODCAST
An accompanying podcast is available in the Supplementary Data, in which the authors Dr Madeleine Ennis and Kate Wahl discuss their research on how family planning care and access to abortion services have changed during the COVID-19 pandemic.
背景
COVID-19 大流行及大流行应对措施给堕胎服务带来了新的挑战。加拿大具备向远程医疗过渡的独特条件，因为在大流行之前，国际上对堕胎药物的常见限制已经被取消。
目的
我们旨在描述加拿大堕胎保健专业人员在 COVID-19 大流行期间的经历，以及大流行应对措施对堕胎服务的影响。
方法
我们在 2020 年 7 月至 2021 年 1 月期间进行了一项顺序混合方法研究。我们邀请医生、护士从业者和管理人员参与一项横断面调查，其中包含一个关于大流行应对措施对堕胎护理影响的开放性问题。我们采用了归纳式编码主题分析，该分析为第二份主要是定量调查的制定提供了信息。
结果
我们的初始调查有 307 名受访者，我们的第二次调查有 78 名受访者。53%是家庭医生。我们的第一项调查发现，受访者认为堕胎机会是必不可少的。我们确定了三个关键主题：尽管与大流行相关的挑战（例如，难以获得测试、额外费用），堕胎护理的获取通常得以维持；实践向低接触药物流产护理的转变以及提供者对患者体验的看法，包括需求转移、远程医疗的可接受性和农村获得机会的增加。第二次调查表明，除了魁北克省以外，89%的参与者都接受了远程医疗药物流产，而在魁北克省，法规意味着手术几乎是唯一的程序。根据 76%的参与者的说法，限制并没有延迟护理。
结论
加拿大保健专业人员报告说，他们的机构将堕胎视为一项基本服务。除了魁北克省以外，所有省份和地区都描述了向远程医疗的稳健大流行过渡，以确保服务的可及性。
播客
在补充数据中提供了一个配套的播客，作者 Madeleine Ennis 博士和 Kate Wahl 在播客中讨论了他们关于计划生育护理和堕胎服务在 COVID-19 大流行期间如何变化的研究。
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