sexual and reproductive

  • 文章类型: Journal Article
    这是杂志为自我照顾月和自我照顾日做出贡献的机会,正如世界卫生组织(世卫组织)在努力促进自我保健方面所宣布的那样,自我保健在资源有限的环境中的话语中日益突出,以实现全民健康覆盖。性健康和生殖健康以及权利面临障碍,比如文化障碍,自我护理应在维护隐私的同时促进获得服务。主要限于事先怀孕,现在可以促进医疗流产的自我管理,注射避孕药和性别确认激素的自我给药,除了自我收集样本进行感染检测。
    It is opportune for the Journal to contribute to Self-Care Month and Self-Care Day, as proclaimed by the World Health Organization (WHO) in its efforts to promote self-care which is increasingly prominent in discourses in resource-limited settings for attaining universal health coverage. With sexual and reproductive health and rights facing hindrances, such as cultural barriers, self-care should facilitate access to services whilst maintaining privacy. Largely limited to pregnancy beforehand, self-care can now be promoted for the self-management of medical abortion, self-administration of injectable contraceptives and gender-affirming hormones besides self-collection of samples for infection testing.
    Il est opportun pour le Journal de contribuer au Mois et à la Journée des soins personnels, comme l\'a proclamé l\'Organisation mondiale de la santé dans ses efforts visant à promouvoir les soins personnels, qui occupent une place de plus en plus importante dans les discours dans les contextes à ressources limitées pour atteindre la couverture sanitaire universelle. . La santé et les droits sexuels et reproductifs étant confrontés à des obstacles, tels que des barrières culturelles, les soins personnels devraient faciliter l\'accès aux services tout en préservant la vie privée. Largement limités à la grossesse préalable, les soins personnels peuvent désormais être encouragés pour l\'autogestion de l\'avortement médicamenteux, l\'auto-administration de contraceptifs injectables et d\'hormones d\'affirmation de genre, en plus de l\'auto-collecte d\'échantillons pour les tests d\'infection.
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  • 文章类型: Journal Article
    背景技术青少年的性健康至关重要,因为它为他们一生的性健康奠定了基础。马来西亚卫生部(MOH)主要提供性生殖健康(SRH)服务。除了卫生部,国家人口家庭发展委员会(NPFDB),在妇女部的职权范围内,马来西亚家庭和社区发展和生殖健康协会联合会,与卫生部密切合作,确保提供SRH信息和服务。尽管马来西亚有SRH服务,尚不确定年轻人是否意识到并使用这些服务。这项研究旨在确定影响马来西亚18-24岁青年使用SRH服务的因素。方法论这个基于网络的,横断面研究于2022年3月至2022年6月进行,使用自我管理的预先测试问卷.使用Andersen的卫生服务利用行为模型来识别调查中包含的变量。使用双变量和多变量逻辑回归模型来确定与SRH服务利用显着相关的因素。调整后的比值比(AOR)和95%置信区间(CI),p值<0.05被认为是统计学意义。结果共有617名18~24岁青少年参与调查。只有20.4%(n=126)的青少年一生中曾参观过SRH服务,在过去一年中,只有8.4%(n=52)的年轻人访问了SRH服务。诱发因素如年龄、婚姻状况,接触家庭和政府机构如NPFDB的SRH信息,SRH服务的可用性和舒适性等有利因素,和需求因素,如诊断为SRH相关疾病的年轻人,与SRH利用显著相关。与18-19岁年龄组相比,年龄较大的年龄组(20-24岁)更有可能使用SRH服务(AOR=1.634,95%CI=1.041,2.564,p=0.033)。已婚参与者使用SRH服务的可能性是单身参与者的三倍(AOR=2.910,95%CI=1.356,6.249,p=0.006)。使用电子烟的参与者使用SRH服务的几率更高(AOR=1.793,95%CI=1.014,3.174,p=0.045)暴露于家庭SRH信息的参与者组使用SRH服务的几率高于未从家庭接收SRH信息的参与者(AOR=1.964,95%CI=1.229,3.138,p=0.005)。同样,从政府机构获得SRH信息的参与者更有可能利用SRH服务(AOR=1.929,95%CI=1.202,3.095,p=0.006).与SRH利用率相关的启用因素是服务的可用性,描述为药店自购药(AOR=1.830,95%CI=1.184,2.855,p=0.007),和服务的舒适性(AOR=1.928,95%CI=1.250,2.974,p=0.003)。被诊断为SRH疾病(需求因素)的年轻人使用SRH服务的可能性是其四倍(AOR=4.490,95%CI=1.935,10.410,p<0.001)。结论马来西亚青少年的SRH服务利用率和认知度普遍较差,这是可以改进的。这项研究的结果可用于影响SRH提供者,以提供更多针对年龄的意识计划,以满足年轻人的各种SRH需求。
    Background The sexual well-being of youths is crucial as it establishes the foundation for their sexual health throughout their lives. Malaysia\'s Ministry of Health (MOH) mainly delivers sexual reproductive health (SRH) services. Besides MOH, the National Population Family Development Board (NPFDB), under the purview of the Ministry of Women, Family and Community Development and Federation of Reproductive Health Association Malaysia, works closely with MOH to ensure the delivery of SRH information and services. Despite the availability of SRH services in Malaysia, it is uncertain whether youths are aware of and utilize these services. This study aims to identify factors that affect the utilization of SRH services among youths aged 18-24 years in Malaysia. Methodology This web-based, cross-sectional study was conducted from March 2022 to June 2022 using a self-administered pre-tested questionnaire. Andersen\'s Behavioral Model of Health Service Utilization was used to identify the variables included in the survey. Bivariate and multivariate logistic regression models were used to determine factors significantly associated with the utilization of SRH services. Adjusted odds ratio (AOR) and 95% confidence interval (CI) with a p-value <0.05 were considered to denote statistical significance. Results A total of 617 youths aged 18-24 years participated in the survey. Only 20.4% (n = 126) of youths had visited SRH services in their entire life, and only 8.4% (n = 52) of youths had visited SRH services in the past year. Predisposing factors such as age, marital status, exposure to SRH information from family and governmental agencies such as the NPFDB, enabling factors such as availability and comfort of SRH services, and need factors such as youths diagnosed with SRH-related diseases were significantly associated with SRH utilization. The older age group (20-24 years old) was more likely to utilize SRH services compared to the 18-19-year age group (AOR = 1.634, 95% CI = 1.041, 2.564, p = 0.033). Married participants were three times more likely to utilize SRH services than single participants (AOR = 2.910, 95% CI = 1.356, 6.249, p = 0.006). Participants who vaped had more odds of utilizing SRH services (AOR = 1.793, 95% CI = 1.014, 3.174, p = 0.045) The group of participants exposed to information on SRH from family had more odds of utilizing SRH service than those who did not receive information on SRH from the family (AOR = 1.964, 95% CI = 1.229, 3.138, p = 0.005). Likewise, participants who received SRH information from governmental agencies were more likely to utilize SRH services (AOR = 1.929, 95% CI = 1.202, 3.095, p = 0.006). Enabling factors that were associated with SRH utilization were the availability of services, described as self-buying medicine in pharmacies (AOR = 1.830, 95% CI = 1.184, 2.855, p = 0.007), and the comfortability of services (AOR = 1.928, 95% CI = 1.250, 2.974, p = 0.003). Youths who were diagnosed with SRH diseases (need factor) were four times more likely to utilize SRH services (AOR = 4.490, 95% CI = 1.935, 10.410, p < 0.001). Conclusions There is generally poor SRH service utilization and awareness among youths in Malaysia, which could be improved. The findings of this study can be used to influence SRH providers to offer a more age-targeted awareness program to meet the various SRH needs of youths.
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  • 文章类型: Journal Article
    Trans and gender diverse people are globally recognised as being under-served in clinical services, with significant implications for their health. During a national reorientation of the Australian cervical screening programme - from Papanicolaou smears to human papillomavirus screening - we conducted interviews with 12 key informants in cancer policy, sexual and reproductive health and trans health advocacy to understand how trans people\'s needs and experiences were being accounted for and addressed in health policy and practice. Themes captured the complexities of increasing visibility for trans people, including men and non-binary people with a cervix. These complexities reflect the extensive system and cultural change required in asking policymakers and practitioners to think differently about who is at risk of a disease typically associated with cisgender women. Informants drew on the language of trauma to explain the resistance many trans people feel when engaging with clinical services, particularly relating to sexual and reproductive health. In doing so, they argued for increasing resources and processes to elicit trans people\'s willingness to put their trust in such services. Thinking critically about the relationship between the politics of trans visibilities, trauma and trust can support effective and inclusive approaches to transgender health.
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    文章类型: Case Reports
    背景:成年以下的青少年需要父母同意才能接受治疗,否则治疗医生可能会对侵入和攻击负责。这给一线医生带来了困境,因为让父母参与讨论可能会给青少年在获得医疗保健服务方面的现有障碍增加另一个障碍。
    目的:本文旨在探讨医生在管理有性健康和生殖健康问题的青少年时,未经父母同意而做出的治疗决定。
    方法:基于定性方法,我们对马来西亚各地的25名医生进行了深入访谈.所有音频记录的访谈都是逐字转录的,并使用主题方法进行分析。
    结果:一般来说,医生通过检查所涉及的健康风险和益处来权衡任何决定。虽然对诉讼的恐惧会影响治疗决定,严格遵守“不伤害”的道德义务超过了其他考虑。当所有选择都有风险时,选择被认为是“两个邪恶中的较小者”,\'即,什么被认为是青少年的最大利益,被采纳。
    结论:当法律要求与医生的道德和个人价值观不同步时,与青少年SRH问题相关的医疗决策的复杂性会进一步增加。与父母同意有关的法律应颁布一项规定,允许医生在未经父母同意的情况下在处理特定的SRH问题方面行使酌处权。
    BACKGROUND: Adolescents below the age of majority require parental consent for treatment or else the treating doctor may be liable for trespass and assault. This creates a dilemma for frontline doctors, as involving parents in the discussion could add yet another barrier to the existing barriers for adolescents in terms of access to healthcare services.
    OBJECTIVE: This paper seeks to explore doctors\' treatment decisions made without parental consent when managing adolescents presenting with sexual and reproductive health issues.
    METHODS: Based on a qualitative approach, in-depth interviews with 25 doctors throughout Malaysia were conducted. All audio-recorded interviews were transcribed verbatim and analyzed using a thematic approach.
    RESULTS: Generally, doctors weigh any decision by examining the health risks and benefits involved. While fear of litigation influences treatment decisions, a strong adherence to the ethical duty of \'do no harm\' outweighs other considerations. When all options are risky, choosing what is considered \'the lesser of two evils,\' i.e., what is perceived to be in the best interest of the adolescent, is adopted.
    CONCLUSIONS: The complexity of a medical decision related to adolescent SRH issues is increased further when legal requirements are not in synch with the ethical and personal values of doctors. The laws relating to parental consent should be promulgated with a provision allowing doctors to exercise discretion in terms of treating specific SRH issues without parental consent.
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  • 文章类型: Journal Article
    BACKGROUND: Globally, young people account for 15.5% of the total global disability-adjusted life-years burden for all age groups. They face mental health, nutritional problems, accidental and intentional injuries, sexual and reproductive health problems, and substance abuse. These health challenges have effects on their oral health. This paper discusses the oral health problems adolescents face and suggests approaches for providing integrated oral and general health care for adolescents.
    CONCLUSIONS: Oral health issues linked with adolescent health concerns include: malocclusion and esthetic concerns linked with mental health status; oral and maxillofacial injuries linked with accidental and intentional injuries; oral manifestations of sexually transmitted infections; oral leukoplakia and oral cancers linked with alcohol, tobacco and psychoactive substance abuse; and oral manifestations of anemia resulting from nutritional problems. Training oral health care providers on adolescent health and care could promote prompt diagnosis, management and prevention of complications associated with major health challenges affecting adolescents.
    CONCLUSIONS: Adolescent oral health care needs focused attention: as a possible route for early diagnosis and management of general health problems and for promoting adolescent oral health care. Oral health care should be integrated into adolescent friendly services and oral health care providers should learn how to handle adolescents\' health needs.
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