Briscoe Simon, Thompson Coon Jo, Melendez-Torres G J, Abbott Rebecca, Shaw Liz, Nunns Michael, Garside Ruth
Exeter PRP Evidence Review Facility, University of Exeter Medical School, St Luke's Campus, University of Exeter, Exeter, Devon, UK
Exeter PRP Evidence Review Facility, University of Exeter Medical School, St Luke's Campus, University of Exeter, Exeter, Devon, UK.
BJGP Open. 2024 Apr 25;8(1). doi: 10.3399/BJGPO.2023.0133. Print 2024 Apr.
Studies have found that women with gynaecological conditions and symptoms do not feel listened to by primary care clinicians (PCCs). Less understood is whether PCCs perceive that there are challenges around listening to and interacting with this patient group.
To understand PCCs' perspectives on the challenges of listening to and interacting with women patients with gynaecological conditions and symptoms.
DESIGN & SETTING: Systematic review of English-language studies.
We searched ASSIA (Applied Social Sciences Index and Abstracts), CINAHL (Cumulative Index to Nursing and Allied Health Literature), Embase, HMIC (Healthcare Management Information Consortium), and MEDLINE from inception to July 2023. We also conducted forward and backward citation searches of included studies. Identified records were screened independently by two reviewers. Data extraction was undertaken by one reviewer and checked by a second. Quality appraisal used the Wallace checklist. 'Best-fit' framework synthesis was used to synthesise findings around themes that explored the challenges of patient-clinician interaction.
We identified 25 relevant articles. Perceived challenges associated with listening to and interacting with patients with gynaecological conditions and symptoms were identified at four 'levels': individual clinician level factors; structural and organisational factors; community and external factors; and factors related to gynaecological conditions. Interpretive analysis identified specific challenges relating to sociocultural factors affecting the consultation experience; the need for further education, training, or guidance for clinicians; factors affecting referral decisions; and factors related to service structure and organisation.
PCCs acknowledge that empathy, respect, and attentive listening are important when interacting with women patients with gynaecological conditions and symptoms. However, these ideals are impeded by several factors.
研究发现，患有妇科疾病和症状的女性感觉初级保健临床医生（PCCs）没有倾听她们的诉求。而PCCs是否意识到在倾听和与这一患者群体互动方面存在挑战，这一点却鲜为人知。
了解PCCs对于倾听患有妇科疾病和症状的女性患者以及与她们互动所面临挑战的看法。
对英文研究进行系统综述。
我们检索了自数据库创建至2023年7月的ASSIA（应用社会科学索引与摘要）、CINAHL（护理学与健康相关文献累积索引）、Embase、HMIC（医疗保健管理信息联盟）和MEDLINE。我们还对纳入研究进行了向前和向后的引文检索。由两位评审员独立筛选识别出的记录。数据提取由一位评审员进行，并由另一位进行核对。质量评估使用华莱士检查表。采用“最佳匹配”框架综合法围绕探讨患者与临床医生互动挑战的主题来综合研究结果。
我们识别出25篇相关文章。在四个“层面”确定了与倾听患有妇科疾病和症状的患者以及与她们互动相关的感知挑战：个体临床医生层面因素；结构和组织因素；社区和外部因素；以及与妇科疾病相关的因素。诠释性分析确定了与影响会诊体验的社会文化因素相关的具体挑战；临床医生对进一步教育、培训或指导的需求；影响转诊决策的因素；以及与服务结构和组织相关的因素。
PCCs承认，在与患有妇科疾病和症状的女性患者互动时，同理心、尊重和专注倾听很重要。然而，这些理想状态受到若干因素的阻碍。
