Knowledge, interest, and motivations surrounding self-managed medication abortion among patients at three Texas clinics
Knowledge, interest, and motivations surrounding self-managed medication abortion among patients at three Texas clinics
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DOI：
10.1016/j.ajog.2020.02.026
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发表时间：
2020-08-01
影响因子：
9.8
通讯作者：
Scott, James G.
中科院分区：
文献类型：
--
作者：
Aiken, Abigail R. A.;Broussard, Kathleen;Scott, James G.
背景技术背景：美国限制性堕胎立法的迅速增加重新引起了人们对自我管理堕胎的兴趣，以此作为对诊所准入障碍的回应。然而，鲜为人知的是知识，兴趣，和经验的自我管理的药物流产的患者谁获得流产护理在clinic. admintives：我们研究了患者的知识，兴趣，和经验的自我管理的药物流产之前，提出到诊所。我们描述了与这些措施相关的临床和个人层面的因素。最后，我们研究的原因，为什么病人表示有兴趣或考虑自我管理之前参加clinic.MATERIALS和METHODS：我们调查了1502例堕胎患者在3个得克萨斯州的诊所在麦卡伦，圣安东尼奥，和沃斯堡。所有能够用英语或西班牙语完成调查的寻求堕胎护理的个人都被邀请参加使用iPad进行的匿名调查。总有效率为90%。我们检查了4个结果变量的患病率，包括整体和单独的站点：（1）自我管理药物流产的知识;（2）在去诊所之前考虑过使用药物进行自我管理;（3）对药物自我管理作为在诊所获得护理的替代方案的兴趣;（4）在去诊所之前寻求或尝试过任何自我管理方法。我们使用二元逻辑回归模型来探讨与这些结果变量相关的临床和患者水平因素。最后，我们分析了那些在参加诊所之前考虑过药物自我管理的人所报告的原因，以及那些对药物自我管理感兴趣的人所报告的原因，作为诊所护理的替代方案。在所有受访者中，30%的人知道在诊所外可以获得堕胎药物（沃斯堡为37%，麦卡伦为33%，圣安东尼奥为19%，P <0.001），在那些事先知道的人中，28%在来诊所之前考虑过使用这种选择（麦卡伦为36%，沃斯堡为25%，圣安东尼奥为21%，P = 0.028）。在那些事先没有自我管理知识的人中，39%的人表示对这种选择感兴趣，而不是来诊所（圣安东尼奥为54%，麦卡伦为30%，沃斯堡为29%，P
BACKGROUND: A rapid increase in restrictive abortion legislation in the United States has sparked renewed interest in self-managed abortion as a response to clinic access barriers. Yet little is known about knowledge of, interest in, and experiences of self-managed medication abortion among patients who obtain abortion care in a clinic.OBJECTIVES: We examined patients' knowledge of, interest in, and experience with self-managed medication abortion before presenting to the clinic. We characterized the clinic- and person-level factors associated with these measures. Finally, we examined the reasons why patients express an interest in or consider self-management before attending the clinic.MATERIALS AND METHODS: We surveyed 1502 abortion patients at 3 Texas clinics in McAllen, San Antonio, and Fort Worth. All individuals seeking abortion care who could complete the survey in English or Spanish were invited to participate in an anonymous survey conducted using iPads. The overall response rate was 90%. We examined the prevalence of 4 outcome variables, both overall and separately by site: (1) knowledge of self-managed medication abortion; (2) having considered self-managing using medications before attending the clinic; (3) interest in medication self-management as an alternative to accessing care at the clinic; and (4) having sought or tried any method of self-management before attending the clinic. We used binary logistic regression models to explore the clinic- and patient-level factors associated with these outcome variables. Finally, we analyzed the reasons reported by those who had considered medication self-management before attending the clinic, as well as the reasons reported by those who would be interested in medication self-management as an alternative to in-clinic care.RESULTS: Among all respondents, 30% knew about abortion medications available outside the clinic setting (37% in Fort Worth, 33% in McAllen, 19% in San Antonio, P < .001), and among those with prior knowledge, 28% had considered using this option before coming to the clinic (36% in McAllen, 25% in Fort Worth, 21% in San Antonio, P = .028). Among those without prior knowledge of self-management, 39% expressed interest in this option instead of coming to the clinic (54% in San Antonio, 30% in McAllen, 29% in Fort Worth, P