de Heer-Koster Merel H, Benedetto Chiara, Bjegović-Mikanović Vesna, Banaitytė-Baleišienė Indre, Perdiou Mary, Gerdts Eva, Kautzky-Willer Alexandra, Mazières Julien, McGregor Alyson, Newman Connie, Price Susanna, Roeters van Lennep Jeanine, Stankevičiūtė Simona, Sommer Iris E, Stadler Gertraud, Thibaut Florence, van 't Land Karine, Wermer Marieke, Wilbur Kerry, Scheele Fedde
Amsterdam Public Health, Amsterdam UMC, Vrije Universiteit, Amsterdam, The Netherlands.
Department of Obstetrics and Gynaecology, University of Torino, Torino, Italy.
BMJ Public Health. 2025 Jan 25;3(1):e001786. doi: 10.1136/bmjph-2024-001786. eCollection 2025.
Over the past few decades, knowledge of women's health regarding sex and gender differences in health has increased but transfer of these new insights into medical education and clinical practice is lagging, resulting in substandard care for women compared with men. This study aimed to reach consensus on what all physicians taking care of women should know about women's health.
A Delphi study was executed involving statements prepared by experts in women's health across 10 medical specialties and a patient advisory board. Participants were recruited from Europe and Northern America through the experts' networks and snowball sampling. Participants voted IN/OUT on each statement based on its perceived relevance and feasibility for general physician knowledge, regardless of specialty. The statements were ranked according to a >80% consensus in the first Delphi round and a 4-point Likert scale in the second Delphi round.
In the first round, 44 participants fully completed the survey. 18 statements progressed to the second round, in which four additional statements were included based on participant suggestions. In the final round, 35 responses on the 22 selected statements resulted in consensus on 18 statements of the highest importance, within the following domains: the societal position of women in health, patient perception of disease and treatment, differences in symptomatology, pharmacological considerations and the impact of the female life cycle on health and disease.
Consensus was reached on the top priority clinical conditions and public health issues in women's health, resulting in a list of 18 statements on women's health that every physician caring for women should know, regardless of specialty. There was also consensus on the importance of incorporating these insights into medical education. The next step involves implementing women's health education in medical schools, postgraduate education and continuing education for medical specialists.
在过去几十年里，关于女性健康方面性与性别差异的知识有所增加，但将这些新见解转化为医学教育和临床实践的工作却滞后了，导致与男性相比，女性获得的医疗服务质量较低。本研究旨在就所有诊治女性的医生应了解的女性健康知识达成共识。
开展了一项德尔菲研究，涉及由10个医学专业的女性健康专家以及一个患者咨询委员会编写的陈述。通过专家网络和滚雪球抽样从欧洲和北美招募参与者。参与者根据每条陈述对普通医生知识的相关性和可行性感知，对其进行“纳入/排除”投票，不考虑专业。在第一轮德尔菲研究中，根据超过80%的共识对陈述进行排序，在第二轮中则使用4点李克特量表进行排序。
在第一轮中，44名参与者完全完成了调查。18条陈述进入第二轮，在此基础上根据参与者的建议又纳入了4条陈述。在最后一轮中，对22条选定陈述的35份回复在以下领域就18条最重要的陈述达成了共识：女性在健康方面的社会地位、患者对疾病和治疗的认知、症状学差异、药理学考量以及女性生命周期对健康和疾病的影响。
就女性健康方面的首要临床情况和公共卫生问题达成了共识，得出了一份18条关于女性健康的陈述清单，每位诊治女性的医生，无论专业如何，都应了解这些内容。对于将这些见解纳入医学教育的重要性也达成了共识。下一步涉及在医学院校、研究生教育以及医学专家的继续教育中实施女性健康教育。
