Zielinski Patricia, Vilar Nicole, Lewandowski Tara, Llerena Gabriela E, Nadery Sepideh, Jacobs Robin J
College of Medicine, Nova Southeastern University Dr. Kiran C. Patel College of Osteopathic Medicine, Fort Lauderdale, USA.
Cureus. 2024 May 10;16(5):e60030. doi: 10.7759/cureus.60030. eCollection 2024 May.
Background In the United States, new regulations on access to abortion and, in some cases, penalization of physicians who provide abortions, have been established on a state-by-state basis. The American College of Obstetricians and Gynecologists recommends that medical schools include abortion training in their curriculum. It is still unknown if the Dobbs decision will limit medical students' abortion training and/or discourage them from pursuing a career in obstetrics. The goal of this study was to investigate the attitudes of medical students toward abortion following the Dobbs decision and their beliefs about its possible effect on future medical education and practice. Methods This cross-sectional, observational study collected data from students enrolled in a Florida, United States osteopathic medical school using an anonymous online questionnaire from February to March 2023. The questionnaire contained 35 items that addressed medical students' attitudes towards a range of potential implications on medical training due to the new abortion restrictions. Hypothesis testing was performed using Spearman's rho correlation and multivariate linear regression to explore the relationship between the predictor variables (concerns about future practice regarding abortion, religiosity, and acceptability of abortion based on gestation age) and the predicted variable (attitudes about abortion). Data were analyzed using Statistical Package for the Social Sciences (IBM SPSS Statistics for Windows, IBM Corp., Version 28.0, Armonk, NY). Results In total, 158 participants completed the questionnaire; 91 (57.6%) were women. The mean age was 25.8 (range 21-37 years). Using a stepwise regression analysis, only the variables shown to be statistically associated (per Spearman's rho bivariate correlation) with the predicted variable (abortion attitudes) were entered into the model (i.e., concerns about abortion education and future practice, religiosity, and abortion acceptability based on gestational age). A significant regression equation was found (F(3,134) = 205.750, p < 0.001, R2 = 0.822, R2 adjusted = 0.818). The percentage of variance in the scores accounted for by the model was 82%. Higher levels of feeling that the abortion ban would negatively affect their training and future practice, greater religiosity, and acceptability of abortion at later gestation ages were statistically significant predictors of more positive attitudes toward abortion in this sample of osteopathic medical students. Conclusions The results suggest that the attitudes of medical students toward abortion are related to multiple factors, including concerns about future abortion training, religiosity, and the week of pregnancy acceptable for a woman to have an abortion. Findings also highlight the attitudes of medical students in response to more restrictive abortion legislation, emphasizing their desire for possible curricular enhancements to safeguard their training and education.
背景
在美国,关于堕胎的获取已逐州制定了新规定,在某些情况下,还对提供堕胎服务的医生进行处罚。美国妇产科医师学会建议医学院校在其课程中纳入堕胎培训内容。目前尚不清楚多布斯案的裁决是否会限制医学生的堕胎培训和/或阻碍他们从事产科职业。本研究的目的是调查多布斯案裁决后医学生对堕胎的态度,以及他们对这一裁决可能对未来医学教育和实践产生的影响的看法。
方法
这项横断面观察性研究于2023年2月至3月期间,通过一份匿名在线问卷,收集了美国佛罗里达州一所整骨医学院学生的数据。问卷包含35个项目,涉及医学生对新的堕胎限制给医学培训带来的一系列潜在影响的态度。使用斯皮尔曼等级相关系数和多元线性回归进行假设检验,以探讨预测变量(对未来堕胎实践的担忧、宗教信仰以及基于孕周的堕胎可接受性)与被预测变量(对堕胎的态度)之间的关系。数据使用社会科学统计软件包(IBM SPSS Statistics for Windows,IBM公司,版本28.0,纽约州阿蒙克)进行分析。
结果
共有158名参与者完成了问卷;其中91名(57.6%)为女性。平均年龄为25.8岁(范围21 - 37岁)。采用逐步回归分析,仅将那些经斯皮尔曼等级双变量相关显示与被预测变量(堕胎态度)有统计学关联的变量纳入模型(即对堕胎教育和未来实践的担忧、宗教信仰以及基于孕周的堕胎可接受性)。发现了一个显著的回归方程(F(3,134) = 205.750,p < 0.001,R2 = 0.822,调整后R2 = 0.818)。该模型解释的分数方差百分比为82%。在这组整骨医学院学生样本中,更高程度地感觉堕胎禁令会对他们的培训和未来实践产生负面影响、更强的宗教信仰以及对孕周较大时堕胎的可接受性,是对堕胎更积极态度的统计学显著预测因素。
结论
结果表明,医学生对堕胎的态度与多个因素相关,包括对未来堕胎培训的担忧、宗教信仰以及女性可接受堕胎的孕周。研究结果还突出了医学生对更严格堕胎立法的态度,强调了他们希望可能加强课程设置以保障其培训和教育的愿望。