Division of Child Neurology, UPMC Children's Hospital of Pittsburgh, Pittsburgh, Pennsylvania.
Division of General Academic Pediatrics, UPMC Children's Hospital of Pittsburgh, Pittsburgh, Pennsylvania.
J Pediatr Adolesc Gynecol. 2022 Feb;35(1):39-47.e1. doi: 10.1016/j.jpag.2021.09.004. Epub 2021 Sep 20.
To evaluate knowledge, attitudes, and practices about sexual and reproductive health (SRH) for adolescent and young adult (AYA) women with epilepsy among general pediatricians, adolescent medicine specialists, and pediatric gynecologists.
Survey comprising previously validated and novel items that underwent content validity testing and was distributed through specialty listservs. Categorical variables analyzed with χ or Fisher exact tests, and continuous variables with Kruskal-Wallis tests.
Online.
Physicians and Advanced practice providers.
Online survey.
MAIN OUTCOME MEASURE(S): Questions testing SRH knowledge, assessing confidence in SRH counseling practices and frequency of intended SRH counseling, and identifying barriers and facilitators to SRH provision for AYA women with epilepsy.
Of 329 participants, 57% were general pediatricians, 27% were adolescent medicine specialists, and 16% were pediatric gynecologists. On 15 items assessing knowledge, general pediatricians scored significantly lower than respondents in the other specialties (P < .01). Among 11 items about confidence in SRH skills, general pediatricians were significantly less confident than respondents in the other specialties (P < .01). General pediatricians reported that they would perform annual counseling less often on 7 SRH counseling topics compared with respondents in the other specialties (P < .01). In all, 54% of the respondents reported that barriers to SRH provision include limited time during visits and lack of epilepsy knowledge. Respondents identified facilitators including guidelines/algorithms for managing SRH (83%), provider education (61%), and electronic health record alerts (60%).
Responses suggest suboptimal knowledge, confidence, and care provision regarding SRH for AYA women with epilepsy, particularly among general pediatricians. Identified barriers and facilitators may serve as targets for interventions to improve SRH provision.
评估普通儿科医生、青少年医学专家和儿科妇科医生对患有癫痫的青少年和年轻女性（AYA）的性与生殖健康（SRH）知识、态度和实践。
调查包括先前经过验证和新的项目，这些项目经过了内容有效性测试，并通过专业列表服务进行了分发。使用 χ 或 Fisher 精确检验分析分类变量，使用 Kruskal-Wallis 检验分析连续变量。
在线。
医生和高级实践提供者。
在线调查。
测试 SRH 知识的问题，评估对 SRH 咨询实践的信心和预期 SRH 咨询的频率，以及确定为患有癫痫的 AYA 女性提供 SRH 的障碍和促进因素。
在 329 名参与者中，57%是普通儿科医生，27%是青少年医学专家，16%是儿科妇科医生。在 15 项评估知识的项目中，普通儿科医生的得分明显低于其他专业的受访者（P <.01）。在 11 项关于 SRH 技能信心的项目中，普通儿科医生的信心明显低于其他专业的受访者（P <.01）。与其他专业的受访者相比，普通儿科医生报告在 7 个 SRH 咨询主题上每年进行咨询的频率较低（P <.01）。总共有 54%的受访者报告说，SRH 提供的障碍包括就诊期间时间有限和缺乏癫痫知识。受访者确定了促进因素，包括管理 SRH 的指南/算法（83%）、提供者教育（61%）和电子健康记录警报（60%）。
回应表明，特别是在普通儿科医生中，对患有癫痫的 AYA 女性的 SRH 知识、信心和护理提供情况不佳。确定的障碍和促进因素可以作为改善 SRH 提供的干预措施的目标。
