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有哪些措施可以改善多囊卵巢综合征(PCOS)的医疗保健?对加拿大女性进行半结构化访谈的见解。

What can be done to improve polycystic ovary syndrome (PCOS) healthcare? Insights from semi-structured interviews with women in Canada.

机构信息

Interdisciplinary School of Health Sciences, University of Ottawa, Ottawa, Canada.

School of International Development and Global Studies, Faculty of Social Sciences, University of Ottawa, 120 University Private, Ottawa, ON, K1N 6N5, Canada.

出版信息

BMC Womens Health. 2022 May 10;22(1):157. doi: 10.1186/s12905-022-01734-w.

Abstract

BACKGROUND

Polycystic ovary syndrome (PCOS) is a common and perplexing condition affecting metabolic, reproductive, cardiovascular, and psychological health in women. Previous studies point to widespread dissatisfaction and frustration in women with the information and care they receive. Studies have found delays with the diagnosis of PCOS and gaps in knowledge in physicians regarding the diagnosis and management of PCOS. Little has been heard from women on what they think can be improved with PCOS care, especially in Canada. This qualitative study explores women's experiences navigating the healthcare system and their insights on what could be improved based on their lived experiences.

METHODS

Twenty-five participants were interviewed remotely over the phone by the first author between October and December 2018.Interviews were semi-structured and in-depth. Data were analyzed using thematic analysis and interpretive description methodology.

RESULTS

Twenty-five in-depth interviews conducted with participants across Canada (ages 18-63) revealed three overall areas in need of improvement. First, women emphasized a need for greater knowledge and awareness of PCOS in primary care physicians (PCPs) as well as the need for the medical community to prioritize women's health. Second, participants advocated for greater PCOS awareness and de-stigmatization in the general community and in women and girls, and any individuals with female reproductive systems. Third, participants brought up several needed resources, such as the need for more PCOS research to be funded and undertaken, more PCOS specialists and experts to be available, credible doctor-provided information (e.g., pamphlets, websites), and age-specific support groups and mental health supports to be available. Participants were generally unaware of existing PCOS organizations and brought up the need for established PCOS organizations to aid in the training and retraining of doctors and local awareness-building in communities.

CONCLUSIONS

Participants believed that PCPs in Canada needed to be well-versed on how to diagnose and manage PCOS to prevent delays in diagnosis and provide easier access to care. Further, greater awareness and de-stigmatization in the general community are needed so women can identify symptoms early and have access to support from those around them. Overall, PCOS may be an overlooked and under-prioritized condition, both in the Canadian healthcare system and general community.

摘要

背景

多囊卵巢综合征(PCOS)是一种常见且令人困惑的病症,会影响女性的代谢、生殖、心血管和心理健康。先前的研究表明,女性对她们所接受的信息和护理普遍不满意和感到沮丧。研究发现,PCOS 的诊断存在延迟,并且医生在 PCOS 的诊断和管理方面存在知识差距。很少有女性就她们认为可以改善 PCOS 护理的方面发表意见,尤其是在加拿大。这项定性研究探讨了女性在医疗保健系统中的体验,以及根据她们的生活经验,她们对可以改善的方面的看法。

方法

2018 年 10 月至 12 月期间,第一作者通过电话对来自加拿大各地的 25 名参与者进行了远程半结构化深入访谈。数据采用主题分析和解释性描述方法进行分析。

结果

对来自加拿大各地(年龄 18-63 岁)的 25 名参与者进行了 25 次深入访谈,结果显示有三个需要改进的总体领域。首先,女性强调初级保健医生(PCP)需要更多地了解和认识 PCOS,并且需要医疗界优先考虑女性健康。其次,参与者倡导在普通社区以及女性和女孩以及任何具有女性生殖系统的个人中提高对 PCOS 的认识和消除污名化。第三,参与者提出了一些必要的资源,例如需要更多的 PCOS 研究资金和开展、更多的 PCOS 专家和专业人员、可信的医生提供的信息(例如小册子、网站)以及特定年龄的支持小组和心理健康支持。参与者通常不知道现有的 PCOS 组织,并提出需要建立 PCOS 组织,以帮助医生培训和再培训以及在社区中提高当地意识。

结论

参与者认为,加拿大的 PCP 应精通如何诊断和管理 PCOS,以防止诊断延迟并提供更容易获得的护理。此外,普通社区需要提高认识和消除污名化,以便女性能够及早识别症状并获得周围人的支持。总体而言,PCOS 可能在加拿大的医疗保健系统和普通社区中都被忽视和重视不足。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8cc9/9092874/47e65260bbec/12905_2022_1734_Fig1_HTML.jpg

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