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在社区卫生环境中,关于青少年痛经我们了解多少?

What is known about adolescent dysmenorrhoea in (and for) community health settings?

作者信息

Dixon Sharon, Hirst Jennifer, Taghinejadi Neda, Duddy Claire, Vincent Katy, Ziebland Sue

机构信息

Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, United Kingdom.

Nuffield Department of Women's and Reproductive Health, University of Oxford, Oxford, United Kingdom.

出版信息

Front Reprod Health. 2024 Jul 23;6:1394978. doi: 10.3389/frph.2024.1394978. eCollection 2024.

Abstract

INTRODUCTION

Dysmenorrhoea affects many adolescents with significant impacts on education and well-being. In the UK, most of the adolescents who seek care (and many never do), will do so through general practice (primary care). Knowing how best to care for adolescents reporting menstrual pain is an area where UK general practitioners would like better guidance and resources.

METHODS

This mixed-methods narrative synthesis collates community and specialist evidence from 320 papers about adolescent dysmenorrhoea, with a UK general practice community health perspective.

RESULTS

We report a narrative summary of symptoms, cause, consequences and treatments for adolescent dysmenorrhoea. We highlight areas of tension or conflicted evidence relevant to primary care alongside areas of uncertainty and research gaps identified through this synthesis with input from lived experience advisers.

DISCUSSION

There is little evidence about primary care management of adolescent dysmenorrhoea or specific resources to support shared-decision making in general practice, although there are evidence-based treatments to offer. Primary care encounters also represent potential opportunities to consider whether the possibility of underlying or associated health conditions contributing to symptoms of dysmenorrhoea, but there is little epidemiological evidence about prevalence from within community health settings to inform this. The areas where there is little or uncertain evidence along the care journey for adolescent dysmenorrhoea, including at the interface between experience and expression of symptoms and potential underlying contributory causes warrant further exploration.

SYSTEMATIC REVIEW REGISTRATION

https://www.crd.york.ac.uk/PROSPEROFILES/256458_STRATEGY_20210608.pdf, identifier (CRD42021256458).

摘要

引言

痛经影响着许多青少年,对他们的教育和幸福产生重大影响。在英国,大多数寻求治疗的青少年(以及许多从未寻求治疗的青少年)会通过全科医疗(初级保健)来解决。了解如何最好地照顾报告有经期疼痛的青少年是英国全科医生希望获得更好指导和资源的领域。

方法

本混合方法的叙述性综述从320篇关于青少年痛经的论文中整理社区和专家证据,采用英国全科医疗社区健康视角。

结果

我们报告了青少年痛经的症状、病因、后果及治疗方法的叙述性总结。我们强调了与初级保健相关的存在紧张或相互矛盾证据的领域,以及通过与有实际经验的顾问共同参与此次综述确定的不确定性和研究空白领域。

讨论

尽管有循证治疗方法,但关于青少年痛经的初级保健管理或支持全科医疗中共同决策的具体资源的证据很少。初级保健问诊也提供了潜在机会,可考虑是否存在潜在或相关健康状况导致痛经症状,但社区健康环境中关于患病率的流行病学证据很少,无法为此提供参考。在青少年痛经的护理过程中,包括症状体验与表达以及潜在促成原因之间的界面,几乎没有或证据不确定的领域值得进一步探索。

系统评价注册

https://www.crd.york.ac.uk/PROSPEROFILES/256458_STRATEGY_20210608.pdf,标识符(CRD42021256458)

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/81f1/11300274/8e5425a3a489/frph-06-1394978-g001.jpg

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