背景:澳大利亚大都市三级医院全面堕胎护理的障碍研究不足。以前的工作表明,消极的从业者态度和缺乏培训可能会起到很大的作用;然而,这一点仍然知之甚少。
目的:目的是调查妇产科医生,以更好地了解他们的观点,培训经验和对堕胎护理的信心。
方法:该方法涉及通过匿名调查对墨尔本一家未提供实质性堕胎服务的大都市三级医院进行的横断面研究,澳大利亚。纳入标准是在该医院工作的妇产科医务人员。收集了有关观点的数据,在妊娠早期药物和手术流产方面的培训经验和信心,和孕中期手术流产。根据培训水平分析数据,归类为RANZCOG(澳大利亚和新西兰皇家妇产科学院)研究员,职业/职业培训生和全科医生专家。
结果:90名符合条件的参与者收到了61份有效回复(回复率68%)。绝大多数(96%)支持堕胎服务。大多数RANZCOG研究员对进行孕早期手术流产(89%)和孕早期药物流产(71%)充满信心;但是,只有一半的人认为有信心进行孕中期手术流产(50%).职业/职业培训生总体上信心不足,但绝大多数人表示有兴趣获得更多的堕胎经验。
结论:医生通常有信心在大都市三级环境中提供妊娠早期流产服务(医疗或手术)。然而,需要进一步的工作来了解全面堕胎护理的持续障碍。孕中期手术流产也可能存在技能短缺,需要显著改善堕胎培训。
BACKGROUND: The barriers to comprehensive
abortion care in Australian metropolitan tertiary hospitals are under-researched. Previous work has suggested that negative practitioner attitudes and lack of training may play a large role; however, this remains poorly understood.
OBJECTIVE: The aim was to survey doctors practicing obstetrics and gynaecology to better understand their views, training experience and confidence in abortion care.
METHODS: The method involved a cross-sectional study via an anonymous survey at a single metropolitan tertiary hospital not providing substantive abortion services in Melbourne, Australia. Inclusion criterion was obstetric and gynaecology medical staff working at that hospital. Data were collected regarding views, training experiences and confidence in first-trimester medical and surgical abortion, and second-trimester surgical
abortion. Data were analysed according to levels of training, categorised as RANZCOG (Royal Australian and New Zealand College of Obstetricians and Gynaecologists) Fellows, prevocational/vocational trainees and general practitioner specialists.
RESULTS: Sixty-one valid responses were received from 90 eligible participants (response rate 68%). An overwhelming majority (96%) supported
abortion services. The majority of RANZCOG Fellows felt confident performing first-trimester surgical abortion (89%) and first-trimester medical abortion (71%); however, only half felt confident performing second-trimester surgical
abortion (50%). Prevocational/vocational trainees were overall less confident but overwhelmingly expressed interest in gaining further experience in abortion.
CONCLUSIONS: Doctors are generally confident in providing first-trimester abortion services (medical or surgical) in the metropolitan tertiary setting. However, further work is required to understand ongoing barriers to comprehensive abortion care. There may also be a skills shortage for second-trimester surgical abortion, requiring significant improvements in
abortion training.