Nursing Department, Universitat Rovira i Virgili, Av/Catalunya, 35, 43002, Tarragona, Spain.
Medicine Department, Universitat Rovira i Virgili, C/Dr. Mallafrè Guasch, 4, 43005, Tarragona, Spain.
Reprod Health. 2021 Nov 27;18(1):237. doi: 10.1186/s12978-021-01254-0.
BACKGROUND: The choice of contraceptive method is a complex decision, and professionals should offer counselling based on the preferences, values and personal situation of the user(s). Some users are unsatisfied with the counselling received, which may, among other consequences, adversely affect method use adherence. In view of this situation, we propose exploring the experiences and needs of users and professionals for contraceptive counselling, in the context of creating a web-based contraceptive decision support tool. METHODS/DESIGN: Qualitative research was conducted through focus group discussions (64 users split into eight groups, and 19 professionals in two groups, in Tarragona, Spain) to explore the subjects' experiences and needs. The data were categorized and the categories were defined and classified based on the three-step protocol or framework for Quality on Contraceptive Counseling (QCC), created by experts, which reviews the quality of interactions between user and professional during the counselling process. RESULTS: In counselling, users demand more information about the different methods, in an environment of erroneous knowledge and misinformation, which lead to false beliefs and myths in the population that are not contrasted by the professional in counselling. They complain that the method is imposed on them and that their views regarding the decision are not considered. Professionals are concerned that their lack of training leads to counselling directed towards the methods they know best. They acknowledge that a paternalistic paradigm persists in the healthcare they provide, and decision support tools may help to improve the situation. CONCLUSIONS: Users feel unsatisfied and/or demand more information and a warmer, more caring approach. Professionals are reluctant to assume a process of shared decision-making. The use of a contraception DST website may solve some shortcomings in counselling detected in our environment.
背景:避孕方法的选择是一个复杂的决策,专业人员应根据用户的偏好、价值观和个人情况提供咨询。一些用户对所接受的咨询不满意,这可能会对方法的使用依从性产生不利影响。鉴于这种情况,我们提出在创建基于网络的避孕决策支持工具的背景下,探索用户和专业人员对避孕咨询的经验和需求。
方法/设计:采用焦点小组讨论(64 名用户分为 8 组,19 名专业人员分为 2 组,地点在西班牙塔拉戈纳)进行定性研究,以探讨研究对象的经验和需求。对数据进行分类,并根据专家制定的三步法协议或框架(QCC)对类别进行定义和分类,该框架审查了咨询过程中用户和专业人员之间互动的质量。
结果:在咨询过程中,用户要求提供更多关于不同方法的信息,因为存在错误的知识和错误信息,导致公众中产生错误的信念和误解,而专业人员在咨询过程中没有对这些内容进行反驳。他们抱怨方法是强加给他们的,他们对决策的看法没有得到考虑。专业人员担心他们缺乏培训会导致咨询仅针对他们最了解的方法。他们承认,在他们提供的医疗保健中仍然存在家长式的思维模式,决策支持工具可能有助于改善这种情况。
结论:用户感到不满意和/或要求提供更多信息,并希望得到更温暖、更贴心的咨询方式。专业人员不愿意承担共同决策的过程。使用避孕决策支持网站可能会解决我们环境中发现的咨询中的一些不足。
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