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临床医生在计划生育服务中对生殖胁迫筛查的看法和经验。

Clinician views and experiences with reproductive coercion screening in a family planning service.

作者信息

Cheng Yan, Rogers Claire, Boerma Clare J, Botfield Jessica R, Estoesta Jane

机构信息

Family Planning NSW, 8 Holker Street, Newington, NSW 2127, Australia.

出版信息

Sex Health. 2023 Feb;20(1):71-79. doi: 10.1071/SH22143.

Abstract

BACKGROUND

Reproductive coercion refers to behaviour that interferes with a person's reproductive autonomy, such as contraceptive sabotage, pregnancy coercion, controlling a pregnancy outcome or forced sterilisation. Routine screening for reproductive coercion, together with clinician education, was implemented at a family planning service in New South Wales, Australia, in December 2018. A study was undertaken to explore the views and experiences of clinicians in undertaking reproductive coercion screening at this service.

METHODS

Clinicians were invited to complete an online survey and interview to discuss their understanding of reproductive coercion and their views and experiences of undertaking reproductive coercion screening. Descriptive and thematic content analysis was conducted.

RESULTS

Clinicians deemed reproductive coercion screening to be relevant and important in family planning services. Key barriers to reproductive coercion screening and responding to disclosures included time constraints and limited appropriate referral pathways. Ongoing education and training with resources such as a decision-support tool on reproductive coercion screening and management, as well as effective multi-disciplinary collaboration, were identified as strategies to improve the screening program.

CONCLUSIONS

Findings from our study highlight that clinicians' perceived reproductive coercion screening as a relevant and important component of sexual and reproductive healthcare. Ongoing reproductive coercion education, training and support would ensure the competency and confidence of clinicians undertaking screening. Identifying appropriate referral pathways with multi-disciplinary collaboration (involving clinicians, social workers, support workers and psychologists) would support clinicians in undertaking screening and responding to disclosures of reproductive coercion in Australian health care settings which provide family planning and sexual and reproductive health services.

摘要

背景

生殖胁迫是指干扰个人生殖自主权的行为,如破坏避孕措施、强迫怀孕、控制妊娠结局或强制绝育。2018年12月,澳大利亚新南威尔士州的一家计划生育服务机构实施了生殖胁迫的常规筛查以及临床医生教育。开展了一项研究,以探讨临床医生在该服务机构进行生殖胁迫筛查的观点和经验。

方法

邀请临床医生完成一项在线调查和访谈,以讨论他们对生殖胁迫的理解以及他们进行生殖胁迫筛查的观点和经验。进行了描述性和主题性内容分析。

结果

临床医生认为生殖胁迫筛查在计划生育服务中具有相关性和重要性。生殖胁迫筛查及对披露情况作出回应的主要障碍包括时间限制和适当的转诊途径有限。确定将持续开展教育和培训,并提供诸如生殖胁迫筛查和管理决策支持工具等资源,以及有效的多学科协作,作为改进筛查项目的策略。

结论

我们的研究结果表明,临床医生将生殖胁迫筛查视为性与生殖健康保健的一个相关且重要的组成部分。持续的生殖胁迫教育、培训和支持将确保进行筛查的临床医生具备能力和信心。确定与多学科协作(包括临床医生、社会工作者、支持人员和心理学家)的适当转诊途径,将有助于临床医生在澳大利亚提供计划生育及性与生殖健康服务的医疗环境中进行筛查并对生殖胁迫的披露情况作出回应。

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