"Opening a can of worms": GP and practice nurse barriers to talking about sexual health in primary care
"Opening a can of worms": GP and practice nurse barriers to talking about sexual health in primary care
复制标题
DOI：
10.1093/fampra/cmh509
复制
发表时间：
2004-10-01
期刊：
影响因子：
2.2
通讯作者：
Elford, H
中科院分区：
文献类型：
--
作者：
Gott, M;Galena, E;Elford, H
背景。有证据表明，保健专业人员在咨询中不像病人希望的那样经常讨论与性有关的问题。虽然初级保健已被确定为寻求性健康问题治疗的首选场所，但对于阻止全科医生和执业护士发起此类讨论的因素，以及他们认为如何改善这一领域的沟通，人们知之甚少。本研究的目的是找出全科医生和执业护士认为在初级保健中阻碍讨论性健康问题的障碍，并探讨改善这方面沟通的策略。对22名全科医生和35名实习护士进行了半结构化访谈，这些护士来自谢菲尔德的不同诊所。“一罐蠕虫”一词概括了参与者的信念，即性相关问题在初级保健中非常成问题，因为它们的敏感性、复杂性以及时间和专业知识的限制。确定了与异性患者、黑人和少数民族患者、中老年患者和非异性恋患者讨论性健康的特殊障碍。在初级保健中改善性健康交流的潜在战略包括培训、提供病人信息和扩大执业护士的作用；然而，这些方法存在一些局限性。全科医生和执业护士没有主动与患者解决性健康问题，如果要满足扩大初级保健在性健康管理中的作用的政策建议，这一领域值得进一步关注。
Background. There is evidence that health professionals do not discuss sexually related issues in consultations as often as patients would like. Although primary care has been identified as the preferred place to seek treatment for sexual health concerns, little is known either of the factors that prevent GPs and practice nurses initiating such discussions or of how they feel communication in this area could be improved.Objective. The purpose of the present study was to identify barriers perceived by GPs and practice nurses to inhibit discussion of sexual health issues in primary care and explore strategies to improve communication in this area.Methods. Semi-structured interviews were conducted with 22 GPs and 35 practice nurses recruited from diverse practices throughout Sheffield.Results. The term 'can of worms' summarized participants' beliefs that sexually related issues are highly problematic within primary care because of their sensitivity, complexity and constraints of time and expertise. Particular barriers were identified to discussing sexual health with patients of the opposite gender, patients from Black and ethnic minority groups, middle-aged and older patients, and non-heterosexual patients. Potential strategies to improve communication about sexual health within primary care included training, providing patient information and expanding the role of the practice nurse; however, several limitations to these approaches were identified.Conclusion. GPs and practice nurses do not address sexual health issues proactively with patients, and this area warrants further attention if policy recommendations to expand the role of primary care within sexual health management are to be met.