Response to Commentaries: Applying the Theory of Planned Behavior to Female Genital Cutting and Deinfibulation.
Response to Commentaries: Applying the Theory of Planned Behavior to Female Genital Cutting and Deinfibulation.
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DOI：
10.1007/s10508-021-02067-9
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发表时间：
2021-07
影响因子：
3.8
通讯作者：
Robinson BBE
中科院分区：
文献类型：
--
作者：
Brady SS;Connor JJ;Chaisson N;Sharif Mohamed F;Robinson BBE
我们感谢针对我们的 Target 文章（Brady 等人，2019 年）撰写的深思熟虑的评论。我们欢迎有机会与同事就理论和概念模型在经历过女性生殖器切割 (FGC) 的妇女的研究和实践中的应用进行对话。我们的几位同事赞扬我们引入了一个理论上丰富的概念模型，以指导未来关于 FGC 和与经历过 FGC 的女性及其伴侣和家人进行去阴术的临床对话。 Meremikwu（待出版）指出，我们提出的“基于理论的研究，旨在进行有效的、以客户为中心的沟通，以提高经历过女性生殖器切割的妇女和女孩的护理质量”，这是“合理的、重要的和及时的”。 1 Meremikwu 观察到，关于去阴部咨询有效性的研究证据很少，需要实用的指南来提供“尊重的护理和有效的医患沟通，对受 FGC 影响的妇女和女孩的价值观和社会文化规范敏感”。 Johnsdotter 和 Essén（2020）将我们的模型描述为一种针对经历过 FGC 的女性进行研究和临床实践的“令人耳目一新的非评判方法”。他们赞赏我们“建议对女性生殖器切割的女性采取真正敏感和尊重的态度”，并且我们“强调了解可能影响女性选择的更广泛背景的紧迫性，以促进临床遭遇中的共同决策。”同样，Johansen（2020）认为我们的概念论文“为女性生殖器切割研究带来了新鲜空气”。约翰森认可我们“制定一种工具，支持提供者为女孩和妇女提供更好的医疗保健”的努力。约翰森特别赞赏在感知规范中添加“个人态度”和“对权力的看法”，并指出需要扩大“女性生殖器切割作为社会习俗的一维理论”的研究范围，该理论“将个人和家庭描绘成完全由社会文化背景决定的”。约翰森发现计划行为理论（TPB）非常适合当今不断变化的女性生殖器切割话语和实践的背景，特别是在考虑散居国外的去阴锁术时。约翰森赞赏我们的模型不仅包括对去阴锁术的积极或消极态度，而且还包括对一般女性生殖器切割实践的态度；锁阴术，FGC 的一种特殊类型；以及去阴锁术的时间、程度和维持。约翰森还认识到，对社区的归属感也包含在态度评估中。除了赞扬之外，我们的同事还对我们的概念模型和我们为将 TPB 应用到定性研究和临床对话而开发的脚本提出了建设性的批评。我们对评论的回应结构如下。首先，我们解决了评论中提出的三个首要问题：(1) TPB 是否是关于去阴锁术的研究和临床对话的合适模型？(2) 谁最适合遵循我们开发的脚本，将 TPB 应用到定性研究和临床对话中，以及谁应该在此类遭遇中在场？(3) 确保我们开发的脚本以文化敏感和道德的方式进行管理的最佳方法是什么？接下来，我们回顾了评论员认为我们为指导研究和临床对话而开发的概念模型和脚本中缺失或欠发达的因素。我们强调了我们最初的概念模型可以扩展到的方法
We are grateful for the thoughtful commentaries written in response to our Target Article (Brady et al., 2019). We welcome the opportunity to engage in a dialogue with colleagues about the application of theory and conceptual models to research and practice with women who have experienced female genital cutting (FGC). Several of our colleagues commended our introduction of a theoretically informed conceptual model to guide future research and clinical conversations about FGC and deinfibulation with women who have undergone FGC, as well as their partners and families. Meremikwu (in press) noted that our proposal for “theory-based research on effective, client-sensitive communication towards improved quality of care for women and girls” who have experienced FGC is “justifiable, crucial, and timely.” 1 Meremikwu observed that research evidence on the effectiveness of counseling for deinfibulation is sparse and that practical guidelines are needed for providing “respectful care and effective physician–patient communication that is sensitive to the values and sociocultural norms of women and girls” affected by FGC. Johnsdotter and Essén (2020) described our model as a “refreshingly nonjudgmental approach” to research and clinical practice with women who have experienced FGC. They appreciated that we “recommend a truly sensitive and respectful attitude toward women with female genital cutting” and that we “highlight the urgency of seeing the wider context that may impact women’s choices in order to promote shared decision-making in clinical encounters.” Similarly, Johansen (2020) found our conceptual paper to be a “breath of fresh air into research on female genital cutting.” Johansen approved of our efforts to “formulate a tool that supports providers in offering improved health care for girls and women.” Johansen particularly appreciated the addition of “personal attitudes” and “perception of power” to perceived norms, noting the need to broaden research from the “one-dimensional theory of FGC as a social convention,” which “portrays individuals and families as totally determined by sociocultural context.” Johansen found the theory of planned behavior (TPB) to be well suited to today’s contexts of changing FGC discourses and practices, particularly when considering deinfibulation in diaspora. Johansen appreciated that our model not only included positive or negative attitudes toward deinfibulation, but also toward the practice of FGC in general; infibulation, a specific type of FGC; and the timing, extent, and maintenance of deinfibulation. Johansen also appreciated that a sense of belonging to one’s communities is included in the assessment of attitudes. In addition to praise, our colleagues offered constructive criticism of our conceptual model and the script that we developed to apply the TPB to qualitative research and clinical conversations. Our response to commentaries is structured as follows. First, we address three overarching questions posed across commentaries:(1) Is the TPB an appropriate model for research and clinical conversations about deinfibulation?(2) Who is in the best position to follow the script that we developed to apply the TPB to qualitative research and clinical conversations, and who should be present during such encounters?(3) What is the best way to ensure that the script we developed is administered in a culturally sensitive and ethical manner? Next, we review factors that commentators identified as missing or underdeveloped from the conceptual model and script that we developed to guide research and clinical conversations. We highlight ways in which our original conceptual model could be expanded to
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影响因子：
3.8
作者：
Johnsdotter S;Essén B
通讯作者：
Essén B
影响因子：
3.8
作者：
Johansen REB
通讯作者：
Johansen REB
影响因子：
1.9
作者：
Brady SS;Brubaker L;Fok CS;Gahagan S;Lewis CE;Lewis J;Lowder JL;Nodora J;Stapleton A;Palmer MH;Prevention of Lower Urinary Tract Symptoms (PLUS) Research Consortium
通讯作者：
Prevention of Lower Urinary Tract Symptoms (PLUS) Research Consortium
影响因子：
2.4
作者：
EARP, JA;ENNETT, ST
通讯作者：
ENNETT, ST
影响因子：
2.1
作者：
Foronda, Cynthia L.
通讯作者：
Foronda, Cynthia L.