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女性以人为主导的计划生育护理体验:社会人口学特征差异

Women's experiences with person-centered family planning care: Differences by sociodemographic characteristics.

作者信息

Welti Kate, Manlove Jennifer, Finocharo Jane, Faccio Bianca, Kim Lisa

机构信息

Child Trends, Bethesda, MD, United States.

出版信息

Contracept X. 2022 Jul 25;4:100081. doi: 10.1016/j.conx.2022.100081. eCollection 2022.

Abstract

OBJECTIVE

Person-centered contraceptive care is associated with positive reproductive health outcomes. Our objective was to analyze patients' ratings on the newly developed Person-Centered Contraceptive Counseling scale (PCCC) to provide distributions for a nationally representative population and to assess differences by sociodemographic characteristics.

STUDY DESIGN

Using data from 2017 to 2019 National Survey of Family Growth (NSFG), we analyzed ratings across the four PCCC items among 2242 women who received contraceptive counseling in the past year. Items measured patients' reports of how providers respected them, let them describe their contraceptive preferences, took their preferences seriously, and adequately informed them about their options. We studied each PCCC item individually as well as the combined scale, distinguishing between ratings of "excellent" versus lower ratings. Bivariate and multivariate logistic regression models assessed how patients' characteristics (age, race/ethnicity and English proficiency, sexual orientation, income, and parity) and provider type were associated with the likelihood of experiencing person-centered care.

RESULTS

The majority of women (59%-69%) reported that their family planning provider was "excellent" across the four PCCC items and just over half (51%) reported "excellent" on all items. In multivariate analyses, having a lower income, Black race, non-heterosexual identity, and Hispanic ethnicity combined with low English proficiency were associated with lower PCCC ratings.

CONCLUSIONS

In a nationally representative sample, the PCCC captured variation in women's experiences with person-centered family planning care by sociodemographic characteristics. Findings highlight the need for contraceptive counseling that centers on clients' preferences and experiences, particularly for patients who belong to groups experiencing health inequities.

IMPLICATIONS

Person-centered care is a key component of high-quality family planning services. This analysis highlights sociodemographic disparities in person-centered care by analyzing PCCC ratings. Findings show the value of this new health care performance measure and affirm the need for family planning care that centers individuals' preferences and lived experiences.

摘要

目的

以患者为中心的避孕护理与积极的生殖健康结果相关。我们的目的是分析患者对新开发的以患者为中心的避孕咨询量表(PCCC)的评分,以提供全国代表性人群的分布情况,并按社会人口学特征评估差异。

研究设计

利用2017年至2019年全国家庭成长调查(NSFG)的数据,我们分析了过去一年接受避孕咨询的2242名女性对PCCC四个项目的评分。这些项目衡量了患者关于提供者如何尊重他们、让他们描述避孕偏好、认真对待他们的偏好以及充分告知他们选择的报告。我们分别研究了每个PCCC项目以及综合量表,区分了“优秀”评分与较低评分。双变量和多变量逻辑回归模型评估了患者特征(年龄、种族/族裔和英语水平、性取向、收入和生育次数)以及提供者类型与体验以患者为中心护理的可能性之间的关联。

结果

大多数女性(59%-69%)报告称,她们的计划生育提供者在PCCC的四个项目上表现“优秀”,略超过一半(51%)的女性在所有项目上都报告“优秀”。在多变量分析中,收入较低、黑人种族、非异性恋身份以及西班牙裔族裔与低英语水平相结合,与较低的PCCC评分相关。

结论

在全国代表性样本中,PCCC通过社会人口学特征反映了女性在以患者为中心的计划生育护理方面的经历差异。研究结果凸显了以客户偏好和经历为中心的避孕咨询的必要性,特别是对于属于健康不平等群体的患者。

启示

以患者为中心的护理是高质量计划生育服务的关键组成部分。本分析通过分析PCCC评分突出了以患者为中心护理中的社会人口学差异。研究结果显示了这一新的医疗保健绩效指标的价值,并肯定了以个人偏好和生活经历为中心的计划生育护理的必要性。

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