Latina contraceptive decision-making and use: The importance of provider communication and shared decision-making for patient-centered care.
Latina contraceptive decision-making and use: The importance of provider communication and shared decision-making for patient-centered care.
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DOI：
10.1016/j.pec.2021.03.006
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发表时间：
2021-09
影响因子：
3.5
通讯作者：
Barnet B
中科院分区：
文献类型：
--
作者：
Carvajal DN;Klyushnenkova E;Barnet B
除其他原因外，患者与提供者沟通不畅是拉丁美洲人避孕决策的一个显著障碍。以患者为中心的避孕咨询方法，优化沟通与共同决策（SDM）-这是与满意度和持续使用避孕药具的各种人群。研究患者-提供者沟通的关联和SDM原则的重要性与拉丁裔人群中一致的避孕药具使用。本研究的形成性工作包括先前的定性和定量研究与拉丁美洲人谁表示在避孕咨询过程中的患者-提供者沟通的重要性，因此有助于问题的定义。对15-29岁的拉丁美洲人进行了横断面调查。测量并分析了患者-提供者沟通、患者报告的特定SDM原则的重要性以及一致的避孕措施使用的相关性。103名拉丁裔（平均年龄= 21.4岁）参与。33%的< 21岁的参与者持续使用避孕措施，而≥ 21岁的参与者为67%（p = 0.003）。在≥ 21岁的参与者中，一致的用户报告的沟通得分高于不一致的用户和非用户（p = 0.042）。对于< 21岁的参与者，一致的使用者比不一致的使用者和非使用者更有可能报告2个SDM原则（讨论避孕偏好和避免基于种族/民族的判断）是重要的（p = 0.052，0.028，分别）。对于21岁以上的拉丁裔来说，患者与提供者的沟通尤其重要，而21岁以下的拉丁裔则高度重视在咨询期间使用SDM方法。以患者为中心的避孕咨询方法为这一弱势群体提供了优化医疗服务的机会。从这项研究的结果表明，以病人为中心的沟通是高度重视的拉丁研究参与者，是一个重要的考虑因素，在他们的避孕咨询。临床医生应考虑采用技术，如SDM，因为他们试图提供以病人为中心的护理在避孕咨询这一患者群体。
Poor patient-provider communication, among other reasons, is a notable barrier to contraceptive decision-making among Latinas. Patient-centered approaches to contraceptive counseling that optimize communication align with shared decision-making (SDM) –which is associated with satisfaction and continued contraceptive use among various populations. To examine associations of patient-provider communication and importance of SDM tenets with consistent contraceptive use among a population of Latinas. Formative work for this study included prior qualitative and quantitative research with Latinas who expressed the importance of patient-provider communication during contraceptive counseling and therefore were instrumental in problem definition. Cross-sectional surveys were administered to Latinas ages 15–29 years. Patient-provider communication, patient-reported importance of specific SDM tenets, and consistent contraception use were measured and analyzed for associations. 103 Latinas (mean age = 21.4) participated. 33% of participants < 21 years were using contraception consistently vs. 67% for those ≥ 21 (p = 0.003). Among participants ≥ 21, consistent users reported higher communication scores compared to inconsistent users and non-users (p = 0.042). For participants < 21, consistent users were more likely than inconsistent users and non-users to report that 2 SDM tenets (discussion of contraceptive preferences and avoidance of race/ethnic-based judgement) are important (p = 0.052, 0.028, respectively). Patient-provider communication was especially important for Latinas ≥ 21 while using an SDM approach during counseling was highly valued by those < 21. Patient-centered approaches to contraceptive counseling provide opportunities to optimize healthcare delivery for this vulnerable population. Results from this research demonstrate that patient-centered communication is highly valued by Latina study participants and is an important consideration in their contraceptive counseling. Clinicians should consider employing techniques such as SDM as they seek to provide patient-centered care during contraceptive counseling for this patient population.
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