Department of International Health and Sustainable Development, Tulane University School of Public Health and Tropical Medicine, New Orleans, Louisiana, USA.
DKT International, A. G. Leventis Building, Iddo House, Lagos Mainland, Lagos, Nigeria.
J Glob Health. 2024 Feb 2;14:04038. doi: 10.7189/jogh.14.04038.
The focus of family planning counselling is gradually shifting from the tiered-effectiveness model to patient-centred counselling. Although tools exist that aim to make family planning counselling more patient-oriented without increasing the provider's workload, they are not widely used. This scoping review aims to address this by identifying key tools to make family planning care more patient-centred, reviewing the domains of patient-centred care they address, and identifying gaps in the evidence base.
We systematically searched PubMed and SCOPUS for documents on 'patient-centred family planning counselling or support' published between 2013 and 2022. Eligibility criteria included discussion of: 1) strategies for providing patient-centred care; 2) interventions using a patient-centred approach; or 3) the impact of patient-centred approaches. We identified tools for patient-centred care, and mapped them against an existing framework of the main domains of patient-centred care. We reported the available evidence of the impact on those tools.
Our scoping review is based on 33 documents. We identified six tools for increasing the patient-centeredness of family planning counselling. None of the tools addressed all domains of patient-centred care. Evidence about the impact of these tools remains scarce. Although there is some evidence about the acceptability of the tools, key evidence gaps include the effect of the tools on quality of care and family planning outcomes.
Family planning implementers should be aware that existing tools differ in the extent to which they address key domains of patient-centred family planning counselling. There is a need for further research on factors that may deter providers from adopting these tools. A larger evidence base is needed to permit a future systematic review to determine the effect of these tools on family planning outcomes, such as method adoption and continuation.
计划生育咨询的重点逐渐从分层效果模式向以患者为中心的咨询模式转变。虽然有一些工具旨在使计划生育咨询更加以患者为中心，而不增加提供者的工作量，但它们并未得到广泛应用。本范围综述旨在通过确定使计划生育护理更加以患者为中心的关键工具、审查它们所针对的以患者为中心护理的领域，并确定证据基础中的差距来解决这个问题。
我们系统地检索了 PubMed 和 SCOPUS 中 2013 年至 2022 年期间发表的关于“以患者为中心的计划生育咨询或支持”的文献。纳入标准包括：1）讨论提供以患者为中心护理的策略；2）使用以患者为中心方法的干预措施；或 3）以患者为中心方法的影响。我们确定了以患者为中心的护理工具，并将其映射到现有的以患者为中心护理的主要领域框架上。我们报告了这些工具对患者的影响的现有证据。
我们的范围综述基于 33 篇文献。我们确定了 6 种用于提高计划生育咨询以患者为中心程度的工具。这些工具都没有涵盖以患者为中心护理的所有领域。关于这些工具的影响的证据仍然很少。虽然有一些关于这些工具的可接受性的证据，但关键的证据差距包括工具对护理质量和计划生育结果的影响。
计划生育实施者应该意识到，现有工具在多大程度上解决了以患者为中心的计划生育咨询的关键领域存在差异。需要进一步研究可能阻碍提供者采用这些工具的因素。需要更大的证据基础，以便未来的系统综述能够确定这些工具对计划生育结果（如方法采用和持续）的影响。
