Women's beliefs about the purpose and value of routine pelvic examinations.
Women's beliefs about the purpose and value of routine pelvic examinations.
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DOI：
10.1016/j.ajog.2016.12.031
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发表时间：
2017-07
影响因子：
9.8
通讯作者：
Sawaya GF
中科院分区：
文献类型：
--
作者：
Norrell LL;Kuppermann M;Moghadassi MN;Sawaya GF
美国妇产科医师大会建议，在与提供者进行知情讨论后，为无症状的妇女提供盆腔检查。虽然没有描述检查避免的不良健康结果，但该组织表示，它有助于在患者和医生之间建立开放的沟通。最近的调查集中在妇产科医生对检查的态度和信念，但妇女的观点没有得到很好的表征。为了更好地了解妇女对常规盆腔检查的目的和价值的信念。我们对264名年龄在21至65岁之间的妇女进行了结构化访谈，她们同意参加50分钟的宫颈癌筛查访谈。招募在加州旧金山弗朗西斯科的一家公立医院和一家学术医疗中心的门诊妇女诊所进行。研究人员向女性展示了一张双手盆腔检查的图片，并询问了一系列封闭式问题：她们是否知道为什么要进行这项检查，是否能让她们对自己的健康放心，以及是否能帮助她们与提供者建立开放的沟通。女性被问到一个关于她们对考试目的的看法的开放式问题。多变量逻辑回归分析用于确定反应的人口统计学预测因素。大约一半（56%）的参与者表示他们知道考试的目的。最常提到的理由是保证正常。大多数参与者（82%）认为检查可以保证他们的健康。不到三分之二（62%）的人认为考试有助于与他们的供应商建立开放的沟通。在多变量分析中，年龄较大（45岁以上）的独立预测更高的可能性，相信他们知道检查的目的[比值比（OR）2.9，95%置信区间（CI）1.5-5.6]和相信它有助于开放的沟通（OR 2.1，95%CI 1.1-3.9）。非白人也与认为检查有助于促进患者和提供者之间的开放式沟通有关（OR 1.9，95%CI 1.1-3.1）。参与我们研究的女性中约有一半报告说不知道盆腔检查的目的，但大多数人认为它有一定的价值，特别是对健康的保证。为了实现共享，明智的决策，临床医生将需要更好地与他们的病人沟通检查的目的。
The American Congress of Obstetricians and Gynecologists recommends that a pelvic examination be offered to asymptomatic women after an informed discussion with their provider. While the adverse health outcomes the examination averts were not delineated, the organization stated that it helps establish open communication between patients and physicians. Recent surveys have focused on obstetrician-gynecologists’ attitudes and beliefs about the examination, but the perspectives of women have not been well characterized. To better understand women’s beliefs about the purpose and value of routine pelvic examinations. We conducted structured interviews with 264 women aged 21 to 65 years who agreed to participate in a 50-minute interview about cervical cancer screening. Recruitment took place in outpatient women’s clinics at a public hospital and an academic medical center in San Francisco, California. Women were shown an illustration of a bimanual pelvic exam and asked a series of closed-ended questions: if they knew why it was performed, if it reassured them of their health and if they felt it helped establish open communication with their provider. Women were asked an open-ended question about their perception of the examination’s purpose. Multivariable logistic regression analysis was used to identify demographic predictors of responses. About half (56%) of the participants stated that they knew the examination’s purpose. The most frequently cited reason was assurance of normalcy. The majority of participants (82%) believed the examination reassured them of their health. Just under two-thirds (62%) believed that the examination helps establish open communication with their provider. In multivariate analyses, older age (45+ years) independently predicted a higher likelihood of a belief that they knew the examination’s purpose [odds ratio (OR) 2.9, 95% confidence interval (CI) 1.5–5.6] and a belief that it facilitates open communication (OR 2.1, 95%CI 1.1–3.9). Non-white race also was associated with a belief that the examination helps facilitate open communication between patients and providers (OR 1.9, 95%CI 1.1–3.1). About half of the women who participated in our study reported not knowing the purpose of the pelvic examination, yet most believed it to be of some value, especially reassurance of health. To achieve shared, informed decision making, clinicians will need to better communicate to their patients the examination’s purpose.
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影响因子：
5.1
作者：
Henderson, Jillian T.;Yu, Jean M.;Sawaya, George F.
通讯作者：
Sawaya, George F.
影响因子：
9.8
作者：
Henderson, Jillian T.;Harper, Cynthia C.;Sawaya, George F.
通讯作者：
Sawaya, George F.
影响因子：
7.2
作者：
Conry, Jeanne A.;Brown, Haywood
通讯作者：
Brown, Haywood
影响因子：
7.2
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通讯作者：
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影响因子：
3.5
作者：
Westhoff, Carolyn L.;Jones, Heidi E.;Guiahi, Maryam
通讯作者：
Guiahi, Maryam