医疗服务提供者对女性生殖器切割(FGM/C)的知识、态度和实践以及女性的就医经历:对加拿大和美国证据的范围审查
Knowledge, Attitudes, and Practices of Healthcare Providers and Healthcare Experiences of Women Regarding Female Genital Mutilation/Cutting (FGM/C): A Scoping Review of Evidence from Canada and the United States.
作者信息
Dhakal Apekshya, Alhassan Jacob Albin Korem
机构信息
Department of Psychology and Health Studies, College of Arts and Science, University of Saskatchewan, Saskatoon, Canada.
Department of Community Health and Epidemiology, College of Medicine, University of Saskatchewan, Health Sciences Bldg, Saskatoon, S7N 2Z4, Canada.
出版信息
J Immigr Minor Health. 2025 Apr;27(2):386-399. doi: 10.1007/s10903-025-01671-4. Epub 2025 Jan 30.
Healthcare providers (HCPs) play a critical role in the care of women with experience of FGM/C although there is limited research on knowledge about FGM/C among HCPs in Canada and USA. Research evidence suggests that many women with experience of FGM/C have negative care experiences. We sought to investigate the knowledge, attitudes, and practices of Canadian and USA HCPs regarding FGM/C, along with women's healthcare experiences with FGM/C in both countries. We conducted a scoping review guided by Arksey & O'Malley's framework. We exported 4054 peer-reviewed records from Embase, Global Health PubMed, Medline, and Scopus databases. After screening titles, abstracts and full texts using inclusion criteria such as publication between 2000 and 2023, a focus on FGM/C and studies conducted in USA and Canada, we included 13 articles in the final review. Care provider studies revealed that HCPs reported a desire for more knowledge and training to enable them to provide high-quality care for women with FGM/C. Majority of the studies have revealed reliance of HCPs on informal learning channels to gain knowledge on FGM/C. Findings reveal that many women with experiences of FGM/C have reported insensitive comments from HCPs including some nurses' unsympathetic behavior toward FGM/C related postpartum discomfort. In some studies, majority of the women felt their doctors were unable to care for them while other women noted that shame and discomfort deterred them from further care seeking. HCPs play an important role in caring for FGM/C patients. Nonetheless HCPs often receive no training or training that is inadequate (insufficient to make providers feel confident to provide care) on how to provide high-quality, culturally competent care leading to poor experiences for women. This necessitates concerted efforts to provide high-quality training of HCPs for better care for women with FGM/C.
医疗保健提供者(HCPs)在为经历过女性生殖器切割/切割女性生殖器官(FGM/C)的女性提供护理方面发挥着关键作用,尽管在加拿大和美国,关于HCPs对FGM/C的了解的研究有限。研究证据表明,许多经历过FGM/C的女性有负面的护理体验。我们试图调查加拿大和美国HCPs对FGM/C的知识、态度和做法,以及两国女性在FGM/C方面的医疗保健经历。我们在阿克西和奥马利的框架指导下进行了一项范围审查。我们从Embase、全球健康PubMed、Medline和Scopus数据库中导出了4054条同行评审记录。在使用诸如2000年至2023年之间发表、关注FGM/C以及在美国和加拿大进行的研究等纳入标准筛选标题、摘要和全文后,我们在最终审查中纳入了13篇文章。护理提供者研究表明,HCPs表示希望获得更多知识和培训,以便能够为经历过FGM/C的女性提供高质量护理。大多数研究表明,HCPs依靠非正式学习渠道来获取有关FGM/C的知识。研究结果显示,许多经历过FGM/C的女性报告称,HCPs发表了麻木不仁的评论,包括一些护士对与FGM/C相关的产后不适表现出冷漠的行为。在一些研究中,大多数女性觉得她们的医生无法照顾她们,而其他女性指出,羞耻和不适使她们不敢寻求进一步的护理。HCPs在照顾FGM/C患者方面发挥着重要作用。尽管如此,HCPs通常没有接受过关于如何提供高质量、具有文化能力的护理的培训或培训不足(不足以让提供者有信心提供护理),这导致女性的护理体验不佳。这就需要共同努力,为HCPs提供高质量培训,以便更好地照顾经历过FGM/C的女性。