Access to and quality of sexual and reproductive health services in Britain during the early stages of the COVID-19 pandemic: a qualitative interview study of patient experiences.
Access to and quality of sexual and reproductive health services in Britain during the early stages of the COVID-19 pandemic: a qualitative interview study of patient experiences.
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DOI：
10.1136/bmjsrh-2021-201413
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发表时间：
2023-01
影响因子：
3.3
通讯作者：
Mitchell, Kirstin R.
中科院分区：
文献类型：
--
作者：
Perez, Raquel Boso;Reid, David;Maxwell, Karen J.;Gibbs, Jo;Dema, Emily;Bonell, Christopher;Mercer, Catherine H.;Sonnenberg, Pam;Field, Nigel;Mitchell, Kirstin R.
关键词：
即使在大流行期间，获得优质性与生殖健康（SRH）服务仍然至关重要。我们的目标是了解英国在 COVID-19 大流行的早期阶段延迟或不成功获得 SRH 服务的经历。 2020 年 10 月和 11 月，我们对 14 名女性和 6 名男性进行了半结构化电话采访，他们在 Natsal-COVID 调查中报告了对性健康和生殖健康服务的需求未得到满足，该调查是一项针对 COVID-19 期间性健康和行为的大规模准代表性网络小组调查 (n=6654)。我们有目的地使用社会人口学配额对符合条件的参与者进行了抽样。归纳主题分析用于探索服务的获取和质量，并为未来提供性健康和生殖健康服务找出经验教训。 20 名与会者讨论了 10 项性健康和生殖健康服务的经验，包括避孕和产前/产妇护理。参与者报告了犹豫和自我审查的需要。获得远程医疗和“社交距离”服务需要坚韧。挑战包括应对不断变化的信息和程序；认为看门人阻碍通行；和不灵活的任命制度。对重新配置的服务的担忧包括隐私减少；与专业人士互动的质量下降；减少非正式支持；预防性性健康和生殖健康实践较少。然而，一些参与者还描述了为弥补中断而采取的更精简的服务和员工工作。许多人对远程医疗与面对面护理的持续融合持积极态度。 COVID-19 大流行影响了性健康和生殖健康服务的获取和质量。参与者的账户揭示了需求的自我审查、改变服务配置的困难以及感知到的质量下降。如果远程医疗与现场护理巧妙地结合起来，那么远程医疗将具有潜力。我们提供初步的基于证据的建议，以促进服务的公平恢复和未来调整。
Access to quality sexual and reproductive health (SRH) services remains imperative even during a pandemic. Our objective was to understand experiences of delayed or unsuccessful access to SRH services in Britain during the early stages of the COVID-19 pandemic. In October and November 2020 we conducted semi-structured telephone interviews with 14 women and six men reporting an unmet need for SRH services in the Natsal-COVID survey, a large-scale quasi-representative web-panel survey of sexual health and behaviour during COVID-19 (n=6654). We purposively sampled eligible participants using sociodemographic quotas. Inductive thematic analysis was used to explore service access and quality and to identify lessons for future SRH service delivery. Twenty participants discussed experiences spanning 10 SRH services including contraception and antenatal/maternity care. Participants reported hesitancy and self-censorship of need. Accessing telemedicine and ‘socially-distanced’ services required tenacity. Challenges included navigating changing information and procedures; perceptions of gatekeepers as obstructing access; and inflexible appointment systems. Concerns about reconfigured services included reduced privacy; decreased quality of interactions with professionals; reduced informal support; and fewer preventive SRH practices. However, some participants also described more streamlined services and staff efforts to compensate for disruptions. Many viewed positively the ongoing blending of telemedicine with in-person care. The COVID-19 pandemic impacted access and quality of SRH services. Participants’ accounts revealed self-censorship of need, difficulty navigating shifting service configurations and perceived quality reductions. Telemedicine offers potential if intelligently combined with in-person care. We offer initial evidence-based recommendations for promoting an equitable restoration and future adaption of services.
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影响因子：
1.4
作者：
Lunt A;Llewellyn C;Bayley J;Nadarzynski T
通讯作者：
Nadarzynski T
DOI：
10.1016/j.socscimed.2020.113610
发表时间：
2021-03
期刊：
Social science & medicine (1982)
影响因子：
--
作者：
Nellums LB;Powis J;Jones L;Miller A;Rustage K;Russell N;Friedland JS;Hargreaves S
通讯作者：
Hargreaves S
DOI：
10.1111/1471-0528.16813
发表时间：
2021-10
期刊：
BJOG : an international journal of obstetrics and gynaecology
影响因子：
--
作者：
Boydell N;Reynolds-Wright JJ;Cameron ST;Harden J
通讯作者：
Harden J
DOI：
10.1111/1471-0528.16668
发表时间：
2021-08
期刊：
BJOG : an international journal of obstetrics and gynaecology
影响因子：
--
作者：
Aiken A;Lohr PA;Lord J;Ghosh N;Starling J
通讯作者：
Starling J
影响因子：
3.6
作者：
Howarth AR;Saunders J;Reid D;Kelly I;Wayal S;Weatherburn P;Hughes G;Mercer CH
通讯作者：
Mercer CH