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处理患者的性问题:全科医生与妇产科医生的比较研究。

Engagement with patients' sexual problems: a comparative study among general practitioners and obstetrician-gynecologists.

作者信息

Aromaa Anna, Kero Katja, Manninen Sanna-Mari, Vahlberg Tero, Polo-Kantola Päivi

机构信息

Department of Obstetrics and Gynecology, Satasairaala Central Hospital, the Wellbeing Services County of Satakunta, Pori.

Department of Obstetrics and Gynecology, University of Turku.

出版信息

Menopause. 2025 Aug 1;32(8):677-684. doi: 10.1097/GME.0000000000002551.

Abstract

OBJECTIVES

Even though good sexual health is an important part of well-being, the evaluation of patients' sexual problems is not necessarily routine for physicians. We compared engagement (attitudes, barriers to bringing up, and practice patterns) with patients' sexual problems among general practitioners (GPs) and obstetrician-gynecologists (OB/GYNs) with special regard for the sex and age of the physician.

METHODS

A web-based questionnaire was used for data collection from 2 samples of physicians. The completed questionnaires from 402 GPs and 299 OB/GYNs were eligible for analysis. In the statistical analysis, the GPs were compared with the OB/GYNs as entire groups with multivariable binary logistic regression adjusted for sex and age. In addition, interaction and subgroup analysis by sex and age groups were both carried out.

RESULTS

Both GPs and OB/GYNs considered treating sexual problems to be an important health care practice. However, compared with the OB/GYNs, the GPs were less likely to inquire about sexual problems during general medical history-taking [adjusted odds ratio (aOR): 0.23, 95% CI: 0.16-0.33, P < 0.0001] and more likely to consider diagnosing female sexual problems as being difficult (aOR: 2.44, 95% CI: 1.73-3.44, P < 0.0001). Compared with the OB/GYNs, the GPs were more likely to report having barriers-for example, "shortness of the appointment time" (aOR: 2.36, 95% CI: 1.53-3.63, P < 0.0001), "personal attitudes and beliefs" (aOR: 2.07, 95% CI: 1.41-3.67, P = 0.001), and "lack of knowledge about sexual medicine" (aOR: 2.05, 95% CI: 1.36-3.10, P = 0.001).

CONCLUSIONS

Both GPs and OB/GYNs considered the treatment of sexual problems to be an important health care practice; however, the engagement with patients' sexual problems among GPs was less structured.

摘要

目的

尽管良好的性健康是幸福生活的重要组成部分,但对医生来说,评估患者的性问题不一定是常规操作。我们比较了全科医生(GPs)和妇产科医生(OB/GYNs)在处理患者性问题方面的参与度(态度、提出问题的障碍和实践模式),特别关注医生的性别和年龄。

方法

通过基于网络的问卷对两个医生样本进行数据收集。来自402名全科医生和299名妇产科医生的完整问卷符合分析条件。在统计分析中,将全科医生与妇产科医生作为整体进行比较,采用多变量二元逻辑回归,并对性别和年龄进行了调整。此外,还进行了按性别和年龄组的交互作用分析和亚组分析。

结果

全科医生和妇产科医生都认为治疗性问题是一项重要的医疗保健实践。然而,与妇产科医生相比,全科医生在一般病史询问中询问性问题的可能性较小[调整后的优势比(aOR):0.23,95%置信区间(CI):0.16 - 0.33,P < 0.0001],且更倾向于认为诊断女性性问题困难(aOR:2.44,95%CI:1.73 - 3.44,P < 0.0001)。与妇产科医生相比,全科医生更有可能报告存在障碍,例如“预约时间短”(aOR:2.36,95%CI:1.53 - 3.63,P < 0.0001)、“个人态度和信念”(aOR:2.07,95%CI:1.41 - 3.67,P = 0.001)以及“缺乏性医学知识”(aOR:2.05,95%CI:1.36 - 3.10,P = 0.001)。

结论

全科医生和妇产科医生都认为治疗性问题是一项重要的医疗保健实践;然而,全科医生在处理患者性问题方面的参与度缺乏系统性。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2849/12316142/5288bf317152/gme-32-677-g001.jpg

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