Ross P E, Landis S E
Mountain Area Health Education Center Family Practice Residency, Asheville, NC.
Fam Med. 1994 May;26(5):293-8.
Primary care physicians need to assess their patients' sexual behaviors to help prevent, diagnose, and treat sexually transmitted diseases. However, few physicians take sexual histories. We developed an educational curriculum aimed at increasing the frequency with which our residents take sexual histories from patients.
Residents were observed for 5 months through video monitoring of patient encounters to document the precurriculum rate of taking sexual histories. Residents also completed a sexuality questionnaire about the likelihood of encountering certain patient problems and the residents' degree of comfort and competence with these problems. They then completed the educational curriculum and were monitored for 3 months for any change in taking sexual histories. We added follow-up telephone interviews with the residents to determine the effect of the curriculum and the extent of taking sexual histories.
Due to insufficient data collected with video monitoring in the postcurriculum phase, we used telephone interviews to evaluate the curriculum. Prior to the curriculum, only 7% of the residents reported routinely asking patients about their sexual history, compared to 36% of residents 6 months after implementation of the curriculum.
The sexual history-taking curriculum improved the frequency with which residents collected information from patients on sexual activity. In addition, this article addresses the development of the curriculum based on a needs assessment, and the difficulties in and possible solutions to evaluating curricular changes within family practice residency programs.
初级保健医生需要评估患者的性行为，以帮助预防、诊断和治疗性传播疾病。然而，很少有医生询问性病史。我们制定了一项教育课程，旨在提高住院医师询问患者性病史的频率。
通过对患者诊疗过程的视频监控，对住院医师进行了5个月的观察，以记录课程前询问性病史的比例。住院医师还完成了一份关于遇到特定患者问题可能性以及他们对这些问题的舒适度和处理能力的性取向问卷。然后，他们完成了教育课程，并在3个月内接受监控，观察询问性病史方面是否有任何变化。我们还对住院医师进行了后续电话访谈，以确定课程的效果以及询问性病史的程度。
由于课程后阶段视频监控收集的数据不足，我们使用电话访谈来评估课程。在课程之前，只有7%的住院医师报告说会常规询问患者的性病史，而在课程实施6个月后，这一比例为36%。
性病史询问课程提高了住院医师从患者那里收集性活动信息的频率。此外，本文还讨论了基于需求评估的课程开发，以及在家庭医学住院医师培训项目中评估课程变化时遇到的困难和可能的解决方案。
