在青年诊所中实施数字化性与生殖健康护理服务：瑞典斯德哥尔摩的助产士感知到的障碍和促进因素的定性研究。
Implementing digital sexual and reproductive health care services in youth clinics: a qualitative study on perceived barriers and facilitators among midwives in Stockholm, Sweden.
机构信息
Department of Global Public Health, Karolinska Institutet, Tomtebodavägen 18a, Widerströmska Huset 171 77, Stockholm, Sweden.
Center for Epidemiology and Community Medicine, Region Stockholm, SE-104 31, Stockholm, Box 45436, Sweden.
出版信息
BMC Health Serv Res. 2024 Apr 2;24(1):411. doi: 10.1186/s12913-024-10932-1.
BACKGROUND
Digital health care services have the potential to improve access to sexual and reproductive health care for youth but require substantial implementation efforts to translate into individual and public health gains. Health care providers are influential both regarding implementation and utilization of the services, and hence, their perceptions of digital health care services and the implementation process are essential to identify and address. The aim of this study was to explore midwives' perception of digital sexual and reproductive health care services for youth, and to identify perceived barriers and facilitators of the implementation of digital health care provision in youth clinics.
METHODS
We performed semi-structured interviews with midwives (n = 16) working at youth clinics providing both on-site and digital sexual and reproductive health care services to youth in Stockholm, Sweden. Interview data were analyzed using a content analysis approach guided by the Consolidated Framework for Implementation Research (CFIR).
RESULTS
Midwives acknowledged that the implementation of digital health care improved the overall access and timeliness of the services at youth clinics. The ability to accommodate the needs of youth regarding their preferred meeting environment (digital or on-site) and easy access to follow-up consultations were identified as benefits of digital health care. Challenges to provide digital health care included communication barriers, privacy and confidentiality concerns, time constraints, inability to offer digital appointments for social counselling, and midwives' preference for in person consultations. Experiencing organizational support during the implementation was appreciated but varied between the respondents.
CONCLUSION
Digital sexual and reproductive health care services could increase access and are valuable complements to on-site services in youth clinics. Sufficient training for midwives and organizational support are crucial to ensure high quality health care. Privacy and safety concerns for the youth might aggravate implementation of digital health care. Future research could focus on equitable access and youth' perceptions of digital health care services for sexual and reproductive health.
背景
数字医疗保健服务有可能改善青年获得性健康和生殖健康服务的机会，但需要大量实施工作才能转化为个人和公共健康收益。医疗保健提供者在服务的实施和利用方面都具有影响力，因此，了解和解决他们对数字医疗保健服务的看法和实施过程至关重要。本研究旨在探讨助产士对青年数字性健康和生殖健康服务的看法，并确定在青年诊所实施数字医疗保健服务的障碍和促进因素。
方法
我们对在瑞典斯德哥尔摩的青年诊所工作的助产士（n=16）进行了半结构化访谈，这些诊所为青年提供现场和数字性健康和生殖健康服务。访谈数据采用整合实施研究框架（CFIR）指导的内容分析法进行分析。
结果
助产士承认，数字医疗保健的实施改善了青年诊所服务的整体可及性和及时性。能够满足青年对其首选会议环境（数字或现场）的需求以及方便获得后续咨询被认为是数字医疗保健的好处。提供数字医疗保健的挑战包括沟通障碍、隐私和保密性问题、时间限制、无法为社会咨询提供数字预约以及助产士对面对面咨询的偏好。在实施过程中获得组织支持受到赞赏，但在受访者之间存在差异。
结论
数字性健康和生殖健康服务可以增加可及性，是青年诊所现场服务的有价值的补充。为助产士提供充分的培训和组织支持对于确保高质量的医疗保健至关重要。青年的隐私和安全问题可能会加剧数字医疗保健的实施。未来的研究可以关注数字性健康和生殖健康服务的公平获取和青年的看法。
Zotero 插件