Quality of care

护理质量
  • 文章类型: Journal Article
    医疗保健专业人员在临床实践中拥有与患者的第一手经验以及医疗保健系统的动态,这在设计中很有价值,实施,数据分析和传播研究结果。初级保健专业人员特别重要,因为他们提供第一次接触,可访问,协调,全面和持续的以人为本的护理。然而,深入审查卫生专业人员参与卫生系统研究和规划活动的情况——专业人员是如何参与的,以及这在不同国家的背景下是如何变化的——是有限的,特别是在国际倡议中。有必要查明参与活动规划中的差距,以便为设计和成功实施未来国际努力提供信息,以提高卫生系统对患者和专业人员不断变化的需求的反应能力。这项研究的目的是探讨初级保健专业人员如何参与由经济合作与发展组织(OECD)领导的国际卫生政策研究的设计和实施计划。OECD的国际PaRIS调查衡量并传播有关在初级保健中管理的慢性病患者的患者报告结果和经验措施(PROM和PREM)的信息。2023年1月至6月间对17项书面国家实施计划(国家路线图)进行了文献分析。两名审阅者独立进行了筛选和数据抽象,并通过讨论解决了分歧。我们报告了预定的目标初级保健专业人员,研究阶段,参与渠道,参与程度,和参与的目的。所有17个国家的目标都是让初级保健专业人员参与国际PaRIS调查的执行计划。虽然初级保健专业人员的组织,尤其是家庭医生,是最常见的目标群体,在研究的不同阶段,参与活动的时间和参与水平都存在差异,从共同发展(一半的国家与初级保健专业人员共同开发了调查)到与谁进行一次性协商。国际指导促进了初级保健专业人员的参与。国际和国家两级的持续合作努力可以促进与初级保健组织和个人专业人员的参与文化,并增强初级保健专业人员的有意义的参与。
    Healthcare professionals have first-hand experience with patients in clinical practice and the dynamics in the healthcare system, which can be of great value in the design, implementation, data analysis and dissemination of research study results. Primary care professionals are particularly important as they provide first contact, accessible, coordinated, comprehensive and continuous people-focused care. However, in-depth examination of the engagement of health professionals in health system research and planning activities-how professionals are engaged and how this varies across national contexts- is limited, particularly in international initiatives. There is a need to identify gaps in the planning of engagement activities to inform the design and successful implementation of future international efforts to improve the responsiveness of health systems to the changing needs of patients and professionals. The aim of this study was to explore how primary care professionals were engaged in the design and implementation plans of an international health policy study led by the Organisation for Economic Co-operation and Development (OECD). The OECD\'s international PaRIS survey measures and disseminates information on patient-reported outcome and experience measures (PROMs and PREMs) of people living with chronic conditions who are managed in primary care. A documentary analysis of 17 written national implementation plans (country roadmaps) was conducted between January and June 2023. Two reviewers independently performed the screening and data abstraction and resolved disagreements by discussion. We reported the intended target primary care professionals, phase of the study, channel of engagement, level of engagement, and purpose of engagement. All 17 countries aimed to engage primary care professionals in the execution plans for the international PaRIS survey. While organisations of primary care professionals, particularly of family doctors, were the most commonly targeted group, variation was found in the timing of engagement activities during the different phases of the study and in the level of engagement, ranging from co-development (half of the countries co-developed the survey together with primary care professionals) to one-off consultations with whom. International guidance facilitated the participation of primary care professionals. Continuous collaborative efforts at the international and national levels can foster a culture of engagement with primary care organisations and individual professionals and enhance meaningful engagement of primary care professionals.
    导出

    更多引用

    收藏

    翻译标题摘要

    我要上传

    求助全文

  • 文章类型: Journal Article
    目的:我们描述了在COVID-19大流行的背景下,从临床注射肌内注射醋酸甲羟孕酮(DMPA-IM)转为自我注射皮下DMPA(DMPA-SC)的女性的经验和偏好。
    方法:我们采访了加利福尼亚州和华盛顿州的女性,了解她们使用自给DMPA-SC的经历。我们采访了第一次或第二次自我给药DMPA-SC注射后的女性,并在第三次或第四次注射后进行了随访。我们进行了主题和描述性内容分析。
    结果:我们完成了对15名女性的29次访谈。大多数参与者(n=10)年龄在20至39岁之间,大多数(n=12)主要使用DMPA避孕。大多数(n=13)将自我管理的DMPA-SC描述为“非常容易”或“有点容易”使用,并报告了更大的便利性,疼痛减轻,更少的后勤和财务挑战,增加隐私,与DMPA-IM相比,提高了注射舒适性。参与者确定了从药房获得DMPA-SC的困难和安全的针头处置是障碍。大多数(n=13)会向朋友推荐DMPA-SC,并希望在COVID-19大流行之后继续自我给药。参与者建议向所有患者咨询此选项以及其他避孕方法,并提供临床医生监督,如果需要的话。
    结论:在COVID-19大流行期间从临床DMPA-IM转为自我给药DMPA-SC的女性更喜欢后者,并打算继续自我给药。应常规提供DMPA-SC的自我给药,并易于患者使用。
    OBJECTIVE: We describe the experiences and preferences of women who switched from clinic-administered intramuscular depot medroxyprogesterone acetate (DMPA-IM) to self-administered subcutaneous DMPA (DMPA-SC) in the context of the COVID-19 pandemic.
    METHODS: We conducted interviews with women in California and Washington about their experiences with self-administered DMPA-SC. We interviewed women after their first or second self-administered DMPA-SC injection and conducted follow-up interviews after their third or fourth injection. We performed both thematic and descriptive content analyses.
    RESULTS: We completed 29 interviews with 15 women. Most participants (n = 10) were between the ages of 20 and 39 and the majority (n = 12) used DMPA primarily for contraception. Most (n = 13) described self-administered DMPA-SC as \"very easy\" or \"somewhat easy\" to use and reported greater convenience, decreased pain, fewer logistical and financial challenges, increased privacy, and improved comfort with injection compared to DMPA-IM. Participants identified difficulties obtaining DMPA-SC from pharmacies and safe needle disposal as barriers. Most (n = 13) would recommend DMPA-SC to a friend and desired to continue self-administration beyond the COVID-19 pandemic. Participants recommended counseling all patients about this option alongside other contraceptive methods, and offering clinician supervision, if desired.
    CONCLUSIONS: Women who switched from in-clinic DMPA-IM to self-administered DMPA-SC during the COVID-19 pandemic preferred the latter and intended to continue self-administration. Self-administration of DMPA-SC should be routinely offered and easily accessible to patients.
    导出

    更多引用

    收藏

    翻译标题摘要

    我要上传

    求助全文

  • 文章类型: Journal Article
    背景:癌症幸存者面临身体,生活方式,心理,和心理社会挑战。尽管有后续服务,幸存者仍然有未满足的需求。数字善后计划可能会提供支持,但是它们的使用是有限的。这项研究旨在研究提高这些计划的吸收和采用所需的条件。此外,它探讨了可能影响这些需求的社会人口统计学和临床变量。
    方法:使用混合方法方法,涉及定性访谈和问卷。这项研究以COM-B行为模型为指导,考虑到能力,机会,和动机对行为至关重要。使用框架方法进行定性分析。统计分析包括描述性统计和回归分析。
    结果:采访了14名癌症幸存者,213名参与者填写了问卷。调查结果表明,大多数受访者对数字善后计划持积极或中立的态度,相信这些可以解决他们与癌症相关的挑战。尽管如此,只有一小部分人有经验,大多数人都不知道他们的存在。许多人表示希望了解他们。有些人不确定其有效性。其他人则担心缺乏报销。没有发现社会人口统计学和临床变量的显着影响。
    结论:癌症幸存者通常对数字护理计划持积极态度,但通常不知道其可用性。提高认识,阐明其价值,提供支持和偿还可以加强吸收和采用。
    结论:当前的见解可以帮助提高数字善后计划的参与度,最终促进健康,幸福,和癌症幸存者的生活质量。
    BACKGROUND: Cancer survivors face physical, lifestyle, psychological, and psychosocial challenges. Despite the availability of aftercare services, survivors still have unmet needs. Digital aftercare programs may offer support, but their use is limited. This study aimed to examine what is needed to improve uptake and adoption of these programs. Additionally, it explored sociodemographic and clinical variables that may influence these needs.
    METHODS: A mixed-methods approach was used, involving qualitative interviews and a questionnaire. The research was guided by the COM-B model of behaviour, which considers capability, opportunity, and motivation crucial for behaviour. Qualitative analysis was performed using the framework method. Statistical analyses involved descriptive statistics and regression analysis.
    RESULTS: Fourteen cancer survivors were interviewed, and 213 participants completed the questionnaire. Findings indicated that most respondents had a positive or neutral attitude towards digital aftercare programs, believing these could address their cancer-related challenges. Still, only a small percentage had experience with them, and most were unaware of their existence. Many expressed a desire to be informed about them. Some were uncertain about their effectiveness. Others were concerned about a lack of reimbursement. No significant influence of the sociodemographic and clinical variables was found.
    CONCLUSIONS: Cancer survivors are generally positive about digital aftercare programs but are often unaware of their availability. Raising awareness, clarifying their value, and providing support and reimbursement could enhance uptake and adoption.
    CONCLUSIONS: The current insights can help improve participation in digital aftercare programs, ultimately fostering health, well-being, and quality of life of cancer survivors.
    导出

    更多引用

    收藏

    翻译标题摘要

    我要上传

    求助全文

  • 文章类型: Journal Article
    全球许多国家提供物理治疗的直接途径。这项范围审查的目的是从不同的角度综合有关初级保健肌肉骨骼理疗质量的可用证据。
    截至2022年9月,在三个数据库中进行了系统搜索。在评估以下至少一种观点时,纳入了研究:患者(生活质量,患者满意度,疼痛,功能,不良事件),提供者(治疗依从性,责任,责任,status,声望,工作满意度),和社会(推荐人数,医学成像的数量,药物使用,康复所需的课程数量,以及总成本和成本效益)。进行了系统评价的选择和方法学质量评估。对于系统评价和个别主要研究,分别进行数据提取和分析。
    纳入了5项系统综述和17项主要研究。从病人的角度来看,没有发现直接接触对疼痛的显著影响,并且发现了有利于直接接触的生活质量的趋势,功能,和幸福。关于提供者,在直接接受物理治疗时发现治疗依从性更高,决策更准确.从社会的角度来看,在等待时间上发现了支持直接进入物理治疗的显著差异,处方药,和医学成像。此外,有降低医疗保健成本的趋势。
    新的证据表明,直接获得物理治疗可以为患者提供至少同等质量的护理,并为提供者和社会提供更好的选择结果机会。
    UNASSIGNED: Worldwide many countries provide direct access in physiotherapy. The aim of this scoping review was to synthesize the available evidence on the quality of primary care musculoskeletal physiotherapy from different perspectives.
    UNASSIGNED: Systematic searches were conducted in three databases up to September 2022. Studies were included when regarding assessment of at least one of the following perspectives: patient (quality of Life, patient satisfaction, pain, functioning, adverse events), provider (treatment compliance, responsibility, liability, status, prestige, job satisfaction), and society (number of referrals, amount of medical imaging, medication use, number of sessions needed for rehabilitation, and overall costs and cost-effectiveness). Selection and methodological quality assessment of systematic reviews were performed. Data extraction and analysis were performed separately for systematic reviews and individual primary studies.
    UNASSIGNED: Five systematic reviews as well as 17 primary studies were included. From a patient perspective, no significant effect of direct access was found for pain and a tendency in favour of direct access was found for quality of life, functioning, and well-being. Concerning providers, higher treatment compliance was found in direct access to physiotherapy and decision-making was more accurate. From a societal perspective, significant differences in favour of direct access physiotherapy were found for waiting time, prescribed medication, and medical imaging. In addition, there was a tendency towards lower health care costs.
    UNASSIGNED: Emerging evidence suggests that direct access physiotherapy could provide at least equal quality of care for patients and better opportunities for providers and the society on selected outcomes.
    导出

    更多引用

    收藏

    翻译标题摘要

    我要上传

       PDF(Pubmed)

  • 文章类型: Journal Article
    背景:肌萎缩侧索硬化症(ALS)是一种不可避免的致命疾病,会导致身体功能逐渐丧失,这导致了与医疗保健相关的高社会心理负担和组织挑战。建议多维度和多专业护理,以满足患者及其家人的复杂需求。许多医疗保健系统,包括德国,可能无法满足这些需求,因为心理支持或社会咨询等非医疗服务不经常包括在ALS患者的护理中(pwALS)。专门的神经姑息治疗没有常规实施,也没有广泛使用。pwALS的看护者也负担很大,但是仍然缺乏对他们的支持服务。
    方法:该项目旨在评估pwALS及其护理人员对德国ALS护理的看法和满意度。这将通过横截面来实现,多中心调查。考试将评估,将患者的需求扩展到身体的六个领域,心理,社会,精神,当前的护理结构满足了实用和信息化的需求。这项评估将与心理健康联系在一起,主观生活质量,对维持生命措施和医生协助自杀的态度,和照顾者的负担。该研究旨在从全国ALS中心招募500名参与者,以便为德国得出全面的结论。共有29个中心,主要通过德国运动神经元疾病临床和科学网络(MND-NET)获得,将参与这个项目,其中25人已经开始招聘。
    结论:旨在提供基于数据的起点,说明德国当前的护理实践如何感知pwALS及其护理人员,以及如何根据他们的需求进行改进。研究的规划和启动已经完成。
    背景:该研究在ClinicalTrails.gov;NCT06418646注册。
    BACKGROUND: Amyotrophic lateral sclerosis (ALS) is an inevitably fatal condition that leads to a progressive loss of physical functioning, which results in a high psychosocial burden and organizational challenges related to medical care. Multidimensional and multiprofessional care is advised to meet the complex needs of patients and their families. Many healthcare systems, including Germany, may not be able to meet these needs because non-medical services such as psychological support or social counselling are not regularly included in the care of patients with ALS (pwALS). Specialised neuropalliative care is not routinely implemented nor widely available. Caregivers of pwALS are also highly burdened, but there is still a lack of support services for them.
    METHODS: This project aims to assess the perceptions and satisfaction with ALS care in Germany in pwALS and their caregivers. This will be achieved by means of a cross-sectional, multicentre survey. The examination will assess, to which extend the patients\' needs in the six domains of physical, psychological, social, spiritual, practical and informational are being met by current care structures. This assessment will be linked to mental well-being, subjective quality of life, attitudes toward life-sustaining measures and physician-assisted suicide, and caregiver burden. The study aims to recruit 500 participants from nationwide ALS centres in order to draw comprehensive conclusions for Germany. A total of 29 centres, mostly acquired via the clinical and scientific German Network for Motor Neuron Diseases (MND-NET), will take part in the project, 25 of which have already started recruitment.
    CONCLUSIONS: It is intended to provide data-based starting points on how current practice of care in Germany is perceived pwALS and their caregivers and how it can be improved according to their needs. Planning and initiation of the study has been completed.
    BACKGROUND: The study is registered at ClinicalTrails.gov; NCT06418646.
    导出

    更多引用

    收藏

    翻译标题摘要

    我要上传

       PDF(Pubmed)

  • 文章类型: Journal Article
    压力损伤是老年人常见的慢性伤口。压力伤的护理是一项跨行业的工作,涉及医生,护士,注册营养师,康复治疗师,和外科亚专科。存在许多治疗方式,但有不同的证据证明其疗效。所有初级护理提供者和其他护理提供者,尤其是老年儿科医生,需要了解当前基于证据的预防和治疗标准。当无法治愈时,应考虑姑息治疗,以避免徒劳的程序,并保持尊严和生活质量。
    Pressure injuries are a common chronic wound in the older adult. Care of pressure injuries is an interprofessional effort and involves physicians, nurses, registered dieticians, rehabilitation therapists, and surgical subspecialties. Numerous treatment modalities exist but have varying evidence to substantiate their efficacy. All primary and other care providers, particularly geriatricians, need to be aware of current evidence-based prevention and treatment standards. When healing is not expected, palliative care should be considered to avoid futile procedures and preserve dignity and quality of life.
    导出

    更多引用

    收藏

    翻译标题摘要

    我要上传

    求助全文

  • 文章类型: Journal Article
    非传染性疾病(NCDs)是全球死亡的主要原因,糖尿病(DM)是第四大主要原因。通过高质量的护理和良好的血糖控制,可以降低其并发症的发生率。治疗满意度是护理质量的重要方面,特别是在治疗慢性疾病,如糖尿病。这项研究旨在确定糖尿病患者对其护理的满意度,并确定患者满意度与糖尿病控制以及其他相关因素之间的关系。
    这项研究是描述性的横截面,以医院为基础的研究。根据纳入标准将受访者纳入研究,并使用系统随机抽样技术进行选择。收集空腹血浆葡萄糖和总胆固醇的血样。使用糖尿病治疗满意度问卷和患者满意度问卷评估治疗满意度。采用SPSS21.0版进行数据分析,采用线性回归确定满意度影响因素。显著性水平设定为0.05。
    平均糖尿病治疗总满意度评分为33.8±8.2,平均短期患者总满意度评分为16.8±3.6。糖尿病治疗的平均满意度得分与年龄组之间存在统计学上的显着差异(p<0.001)。DM治疗满意度与口服抗糖尿病药的使用(p=0.043)和并发症的存在之间也存在统计学上的显着关联(P<0.001)。
    患者满意度评分与可及性和便利性等其他因素之间存在显着相关性,和医生在一起的时间,等等。总之,该研究确定了口服抗糖尿病药的使用,以及并发症的存在,影响患者满意度的因素之一。这项研究,因此,建议通过解决这些因素来提高患者满意度,从而改善以患者为中心的医学实践。
    UNASSIGNED: Non-communicable diseases (NCDs) are the leading cause of death globally and diabetes mellitus (DM) is the fourth main contributor. The incidence of its complications could be reduced with high-quality care and good glycaemic control. Treatment satisfaction is an important aspect of quality of care, especially in treating chronic diseases like DM. This study sought to determine the satisfaction of diabetics with their care and to identify the relationship between patients\' satisfaction and diabetic control alongside other associated factors.
    UNASSIGNED: The study was a descriptive cross-sectional, hospital-based study. Respondents were admitted into the study based on inclusion criteria and selected using a systematic random sampling technique. Blood samples for fasting plasma glucose and total cholesterol were collected. Diabetic Treatment Satisfaction Questionnaire and the Patient Satisfaction Questionnaire were used to assess treatment satisfaction. The SPSS version 21.0 was used for data analysis and linear regression was used to determine the factors influencing satisfaction. The level of significance was set at 0.05.
    UNASSIGNED: The mean total Diabetes Treatment Satisfaction score was 33.8 ± 8.2 and the mean total Short-Form Patient Satisfaction score was found to be 16.8 ± 3.6. There was a statistically significant difference between the mean satisfaction scores with treatment of diabetes mellitus and age groups (p < 0.001). There was also a statistically significant association between DM treatment satisfaction with the use of oral antidiabetic agents (p = 0.043) and the presence of complications (P < 0.001).
    UNASSIGNED: There was a significant correlation between patient satisfaction scores and other factors like accessibility and convenience, time spent with doctors, and so on. In conclusion, the study identified the use of oral anti-diabetic agents, and the presence of complications, among others as factors affecting patient satisfaction. This study, therefore, suggests improving the practice of patient-centered medicine by increasing patient satisfaction through addressing these factors.
    导出

    更多引用

    收藏

    翻译标题摘要

    我要上传

       PDF(Pubmed)

  • 文章类型: Journal Article
    背景:创新推动了骨科关节成形术从住院到门诊的转变。鉴于这种转变,了解哪些因素有助于为相同手术的特定患者分配护理设置变得势在必行.虽然患者的合并症是重要的考虑因素,最近的研究可能指向更复杂的决定。各种保险状态下的报销结构和患者特征的差异可能会影响这些决定。
    方法:对奥尔巴尼医学中心2018年至2022年的去识别住院和门诊骨科置换术数据进行回顾性二元逻辑和普通最小二乘(OLS)回归分析。数据元素包括手术设置(住院患者与门诊病人),协变量(年龄,性别,种族,肥胖,吸烟状况),Elixhauser合并症指数,和保险状况。
    结果:由Medicare承保的患者更有可能被安置在住院护理环境中,膝盖,与他们的私人保险同行相比,即使在医疗保险和医疗补助服务中心(CMS)从其住院患者名单中删除了每个单独的手术(1.65(p<0.05),1.27(p<0.05),和12.93(p<0.05)倍更可能)。与其他付款人投保的患者相比,医疗保险患者没有最多的合并症(p<0.05)。
    结论:Medicare患者更有可能接受髋部住院护理,膝盖,和踝关节成形术.然而,医疗补助患者的合并症最多。值得注意的是,为门诊服务开具账单的Medicare患者的共同保险费率更高。
    方法:III.
    BACKGROUND: Innovation has fueled the shift from inpatient to outpatient care for orthopaedic joint arthroplasty. Given this transformation, it becomes imperative to understand what factors help assign care-settings to specific patients for the same procedure. While the comorbidities suffered by patients are important considerations, recent research may point to a more complex determination. Differences in reimbursement structures and patient characteristics across various insurance statuses could potentially influence these decisions.
    METHODS: Retrospective binary logistic and ordinary least square (OLS) regression analyses were employed on de-identified inpatient and outpatient orthopaedic arthroplasty data from Albany Medical Center from 2018 to 2022. Data elements included surgical setting (inpatient vs. outpatient), covariates (age, sex, race, obesity, smoking status), Elixhauser comorbidity indices, and insurance status.
    RESULTS: Patients insured by Medicare were significantly more likely to be placed in inpatient care-settings for total hip, knee, and ankle arthroplasty when compared to their privately insured counterparts even after Centers for Medicare and Medicaid Services (CMS) removed each individual surgery from its inpatient-only-list (1.65 (p < 0.05), 1.27 (p < 0.05), and 12.93 (p < 0.05) times more likely respectively). When compared to patients insured by the other payers, Medicare patients did not have the most comorbidities (p < 0.05).
    CONCLUSIONS: Medicare patients were more likely to be placed in inpatient care-settings for hip, knee, and ankle arthroplasty. However, Medicaid patients were shown to have the most comorbidities. It is of value to note Medicare patients billed for outpatient services experience higher coinsurance rates.
    METHODS: III.
    导出

    更多引用

    收藏

    翻译标题摘要

    我要上传

       PDF(Pubmed)

  • 文章类型: Journal Article
    背景:招聘调查一直是一个巨大的挑战,尤其是在一般实践中。
    方法:这里,我们报告了招聘策略,数据收集,PRICOV-19研究的参与率(PR)和代表性,国际比较,横截面,在37个欧洲国家和以色列的一般做法(GP做法)中进行在线调查。
    结果:9个(24%)国家报告了已发布的邀请;19个(50%)与所有GP/GP实践有直接联系;19个(50%)联系了GP/GP实践样本;7个(18%)使用了另一种邀请策略。中位参与率为22%(IQR=10%,28%)。多种邀请策略(P值0.93)和多种增加PR的策略(P值0.64)与PR无关。在(半)农村地区的GP实践,GP实践服务于10,000多名患者,和小组实践的代表性过高(P值<0.001)。PR与初级保健(PC)系统强度之间没有显着相关性[Spearmanr0.13,95%CI(-0.24,0.46);P值0.49];COVID-19发病率[Spearmanr0.19,95%CI(-0.14,0.49);P值0.24],或COVID-19死亡率[Spearmanr0.19,95%CI(-0.02,0.58);P值0.06]在特定国家研究开始前的三个月内。
    结论:我们的主要贡献是描述了PRICOV-19的调查招募和代表性,这是一项重要而新颖的研究。
    BACKGROUND: Recruitment for surveys has been a great challenge, especially in general practice.
    METHODS: Here, we reported recruitment strategies, data collection, participation rates (PR) and representativeness of the PRICOV-19 study, an international comparative, cross-sectional, online survey among general practices (GP practices) in 37 European countries and Israel.
    RESULTS: Nine (24%) countries reported a published invitation; 19 (50%) had direct contact with all GPs/GP practices; 19 (50%) contacted a sample of GPs /GP practices; and 7 (18%) used another invitation strategy. The median participation rate was 22% (IQR = 10%, 28%). Multiple invitation strategies (P-value 0.93) and multiple strategies to increase PR (P-value 0.64) were not correlated with the PR. GP practices in (semi-) rural areas, GP practices serving more than 10,000 patients, and group practices were over-represented (P-value < 0.001). There was no significant correlation between the PR and strength of the primary care (PC) system [Spearman\'s r 0.13, 95% CI (-0.24, 0.46); P-value 0.49]; the COVID-19 morbidity [Spearman\'s r 0.19, 95% CI (-0.14, 0.49); P-value 0.24], or COVID-19 mortality [Spearman\'s r 0.19, 95% CI (-0.02, 0.58); P-value 0.06] during the three months before country-specific study commencement.
    CONCLUSIONS: Our main contribution here was to describe the survey recruitment and representativeness of PRICOV-19, an important and novel study.
    导出

    更多引用

    收藏

    翻译标题摘要

    我要上传

       PDF(Pubmed)

  • 文章类型: Journal Article
    尽管人们越来越担心避孕方面的胁迫,很少有研究描述了它的频率和表现。Further,没有确定的定量方法来测量这种结构。我们开始通过详细说明避孕胁迫经历的细微差别并测试一种新颖的措施来填补这一空白:避孕护理清单中的胁迫。在2023年初,我们调查了美国生育年龄的人,他们在出生时被分配给女性,了解他们的避孕护理。我们在样本中描述了避孕胁迫的频率(N=1197),并使用开放式描述来证明这些经验中的细微差别。最后,我们首次发布了检查表,并提供了心理测试结果。在曾经与医疗保健提供者谈论避孕的人中,超过六分之一(18.46%)的参与者报告说,在他们上次的避孕咨询中经历了胁迫,超过三分之一(42.27%)的人在他们一生的某个时候报告了这一情况。使用或继续使用避孕药是患者报告的最常见的胁迫形式(终生频率为14.62%)。因子分析支持避孕护理清单中强制的双因素维度。项目间相关性有统计学意义(p<0.001),提供可靠性的证据。该清单还与计划生育护理的质量指标有关(向下胁迫:t[1194]=7.54,p<0.001;向上胁迫:t[1194]=14.76,p<0.001)和医疗保健中的歧视(向下胁迫:t[1160]=-14.77,p<0.001;向上胁迫:t[1160]=-18.27,p<0.001),提供结构效度的证据。研究结果提供了有关避孕胁迫的频率和表现的关键信息。心理测试揭示了避孕护理清单中强制性有效性的证据,可靠性,和维度,同时也为未来的测试和改进提供了途径。
    Despite growing concerns over coercion in contraceptive care, few studies have described its frequency and manifestations. Further, there is no established quantitative method of measuring this construct. We begin to fill this gap by detailing nuance in contraceptive coercion experiences and testing a novel measure: the Coercion in Contraceptive Care Checklist. In early 2023, we surveyed reproductive-aged people in the United States who were assigned female at birth about their contraceptive care. We describe the frequency of contraceptive coercion in our sample (N = 1197) and use open-ended descriptions to demonstrate nuances in these experiences. Finally, we debut our checklist and present psychometric testing results. Among people who had ever talked to a healthcare provider about contraception, over one in six participants (18.46%) reported experiencing coercion during their last contraceptive counseling, and over one in three (42.27%) reported it at some point in their lifetime. Being made to use or keep using birth control pills was the most common form of coercion reported by patients (14.62% lifetime frequency). Factor analysis supported the two-factor dimensionality of the Coercion in Contraceptive Care Checklist. Inter-item correlations were statistically significant (p < 0.001), providing evidence of reliability. The checklist was also related to measures of quality in family planning care (downward coercion: t[1194] = 7.54, p < 0.001; upward coercion: t[1194] = 14.76, p < 0.001) and discrimination in healthcare (downward coercion: t[1160] = -14.77, p < 0.001; upward coercion: t[1160] = -18.27, p < 0.001), providing evidence of construct validity. Findings provide critical information about the frequency and manifestations of contraceptive coercion. Psychometric tests reveal evidence of the Coercion in Contraceptive Care Checklist\'s validity, reliability, and dimensionality while also suggesting avenues for future testing and refinement.
    导出

    更多引用

    收藏

    翻译标题摘要

    我要上传

       PDF(Pubmed)

公众号