Primary Care Physicians' Perceptions of Barriers To Preventive Reproductive Health Care In Rural Communities
Primary Care Physicians' Perceptions of Barriers To Preventive Reproductive Health Care In Rural Communities
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DOI：
10.1363/4407812
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发表时间：
2012-06-01
影响因子：
5.8
通讯作者：
Weisman, Carol S.
中科院分区：
文献类型：
--
作者：
Chuang, Cynthia H.;Hwang, Sandra W.;Weisman, Carol S.
背景：居住在农村地区的妇女获得预防性生殖保健的可能性低于城市妇女，但造成这种差异的原因基本上仍未得到探讨。方法：在2010年，半结构化的采访进行了19个农村初级保健医生在宾夕法尼亚州中部的经验，在两个领域的预防性生殖健康避孕保健和孕前保健。主要主题确定使用修改扎根理论的方法。研究结果：医生认为，他们在提供避孕保健方面比非农村医生发挥更大的作用，而且他们所在社区的病人可以广泛获得避孕药具;然而，他们提供的避孕服务范围差异很大。参与者意识到怀孕前最佳健康的重要性，但大多数人并没有定期启动孕前咨询。医生认为，农村社区规范的意外怀孕，大家庭，对年轻女性的职业和教育目标的冷漠，避孕和孕前保健的最大障碍，因为这些态度导致缺乏病人的兴趣在计划生育。缺乏时间和资源被确定为提供孕前保健的额外障碍。结论：农村妇女很少使用避孕药具和孕前保健服务，这可能反映出预防性生殖保健不是农村社区的优先事项，而不是无法获得。鼓励农村妇女参与生殖生活规划的努力，包括服务提供者提供更积极主动的咨询，值得加以审查，以改善服务的利用。
CONTEXT: Women residing in rural areas are less likely than urban women to receive preventive reproductive health care, but reasons for this disparity remain largely unexplored. METHODS: In 2010, semistructured interviews were conducted with 19 rural primary care physicians in central Pennsylvania regarding their experiences in two domains of preventive reproductive healthcontraceptive care and preconception care. Major themes were identified using a modified grounded theory approach. RESULTS: Physicians perceived that they had a greater role in providing contraceptive care than did nonrural physicians and that contraceptives were widely accessible to patients in their communities; however, the scope of contraceptive services they provided varied widely. Participants were aware of the importance of optimal health prior to pregnancy, but most did not routinely initiate preconception counseling. Physicians perceived rural community norms of unintended pregnancies, large families, and indifference toward career and educational goals for young women as the biggest barriers to both contraceptive and preconception care, as these attitudes resulted in a lack of patient interest in family planning. Lack of time and resources were identified as additional barriers to providing preconception care. CONCLUSIONS: Rural womens low use of contraceptive and preconception care services may reflect that preventive reproductive health care is not a priority in rural communities, rather than that it is inaccessible. Efforts to motivate rural women to engage in reproductive life planning, including more proactive counseling by providers, merit examination as ways to improve use of services.