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美国东南部麻醉提供者对堕胎服务的看法:一项定性研究的归纳结果

Southeastern US anesthesia providers' perspectives on abortion provision: Inductive findings from a qualitative study.

作者信息

Reeves Jennifer A, Goedken Peggy, Hall Kelli S, Lee Simon C, Cwiak Carrie A

机构信息

Department of Gynecology and Obstetrics, Emory University School of Medicine, Atlanta, GA, USA.

Department of Behavioral Sciences and Health Education, Emory University Rollins School of Public Health, Atlanta, GA, USA.

出版信息

Contraception. 2023 Aug;124:110058. doi: 10.1016/j.contraception.2023.110058. Epub 2023 May 8.

Abstract

OBJECTIVES

Health care providers, including anesthesia providers, hold varied personal views on abortion, which influences their involvement in multidisciplinary abortion care. We aimed to explore Southeastern US anesthesia providers' perspectives on abortion provision and factors impacting their decision to provide anesthesia for hospital-based induced abortion.

STUDY DESIGN

We conducted in-depth, individual interviews with currently practicing anesthesia providers in the Southeastern United States. We recruited participants from regional anesthesiology conferences and via snowball sampling. A semistructured interview guide explored domains of obstetric experiences, standardized abortion cases, and personal abortion attitudes. We coded data iteratively and analyzed data thematically using inductive approaches with qualitative software.

RESULTS

Fifteen participants completed interviews, at which point thematic saturation occurred. Participants represented a range of provider type and prior abortion experience. Participants weighed "personal and professional viewpoints" in considering their willingness to provide anesthesia care for hospital-based abortion. Many participants who personally disagreed with some abortion indications were still willing to provide anesthesia in those cases, some implicitly naming principles of medical ethics to justify differing professional and personal opinions. Participants also considered their "role in abortion decision-making": all participants reported that the abortion decision belongs to the patient or their obstetrician and not the anesthesia provider.

CONCLUSIONS

Southeastern US anesthesia providers are influenced by multiple factors when considering their participation in hospital-based abortion care. Acknowledging differences in professional and personal viewpoints and identifying roles in abortion decision-making might be important to engaging anesthesia providers in abortion care, especially for high-risk medical or fetal indications.

IMPLICATIONS

This original, qualitative study identified several inductive themes that characterize how Southeastern US anesthesia providers formulate their level of participation in hospital-based abortion care. Acknowledging differences in professional and personal viewpoints and identifying roles in abortion decision-making might facilitate interdisciplinary abortion care, especially for high-risk medical or fetal indications.

摘要

目标

包括麻醉医生在内的医疗服务提供者对堕胎持有不同的个人观点,这影响了他们参与多学科堕胎护理的情况。我们旨在探讨美国东南部麻醉医生对提供堕胎服务的看法以及影响他们决定为医院引产提供麻醉的因素。

研究设计

我们对美国东南部目前执业的麻醉医生进行了深入的个人访谈。我们从地区麻醉学会议和通过滚雪球抽样招募参与者。一份半结构化访谈指南探讨了产科经历、标准化堕胎病例和个人堕胎态度等领域。我们对数据进行反复编码,并使用定性软件采用归纳法进行主题分析。

结果

15名参与者完成了访谈,此时出现了主题饱和。参与者代表了一系列提供者类型和既往堕胎经历。参与者在考虑是否愿意为医院堕胎提供麻醉护理时权衡了“个人和专业观点”。许多个人不同意某些堕胎指征的参与者在这些情况下仍愿意提供麻醉,一些人含蓄地引用医学伦理原则来为不同的专业和个人观点辩护。参与者还考虑了他们“在堕胎决策中的角色”:所有参与者都报告说,堕胎决策属于患者或其产科医生,而不是麻醉提供者。

结论

美国东南部的麻醉医生在考虑参与医院堕胎护理时受到多种因素的影响。认识到专业和个人观点的差异以及确定在堕胎决策中的角色对于让麻醉医生参与堕胎护理可能很重要,特别是对于高风险的医学或胎儿指征。

启示

这项原创的定性研究确定了几个归纳主题,这些主题描述了美国东南部麻醉医生如何制定他们参与医院堕胎护理的程度。认识到专业和个人观点的差异以及确定在堕胎决策中的角色可能有助于跨学科的堕胎护理,特别是对于高风险的医学或胎儿指征。

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