Obstetrician-gynecologists and the intrauterine device: A survey of attitudes and practice
Obstetrician-gynecologists and the intrauterine device: A survey of attitudes and practice
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DOI：
10.1016/s0029-7844(01)01726-4
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发表时间：
2002-02-01
影响因子：
7.2
通讯作者：
Konrad, TR
中科院分区：
文献类型：
--
作者：
Stanwood, NL;Garrett, JM;Konrad, TR
目的：评估妇产科医生对宫内节育器（IUD）的临床使用情况、他们对宫内节育器的态度以及他们如何选择宫内节育器的候选人，并检验有限的宫内节育器住院医师培训、对诉讼的恐惧以及认为宫内节育器导致盆腔炎会减少宫内节育器使用的假设。方法：我们对全国811名执业妇产科医生进行了邮寄调查，这些医生来自ACOG会员名单的系统抽样，以评估对宫内节育器的使用和态度。结果：调查回复率为50%。大多数受访者认为铜宫内节育器是安全的（95%）和有效的（98%）。然而，20%的受访者在过去一年中没有植入宫内节育器，而在那些植入了宫内节育器的人中，大多数（79%）报告植入了10个或更少。担心诉讼和认为宫内节育器会导致盆腔炎与宫内节育器使用率较低有关；住院期间植入宫内节育器的数量没有变化。在选择宫内节育器候选人时，受访者对患者一夫一妻制的限制最大。选择宫内节育器候选人的保守标准较低与宫内节育器使用较多有关，具有自由标准的受访者在过去一年中平均插入9个宫内节育器，而具有保守标准的受访者则插入4个。结论：由于大多数妇产科医生很少植入宫内节育器，教育项目应针对这些医生扩大宫内节育器的使用。这样的项目应该强调现代宫内节育器的安全性和诉讼的稀缺性。在住院医师中植入宫内节育器的数量可能不如制定限制性更少、更基于证据的标准来选择宫内节育器候选人重要。(C) 2002年由美国妇产科医师学会发布。
OBJECTIVE: To assess obstetrician-gynecologists' clinical use of the intrauterine device (IUD), their attitudes toward the IUD and how they select IUD candidates, and to test the hypotheses that limited residency training in IUDs, fear of litigation, and a belief that IUDs cause pelvic inflammatory disease decrease IUD use.METHODS: We performed a national mailed survey of 811 practicing obstetrician-gynecologists obtained from systematic sampling of ACOG membership listings to assess use of and attitudes toward the IUD.RESULTS: The survey response rate was 50%. Most respondents agreed that the copper IUD is safe (95%) and effective (98%). However, 20% of respondents had not inserted an IUD in the past year, and of those who had, most (79%) reported inserting 10 or fewer. Fear of litigation and a belief that IUDs cause pelvic inflammatory disease were associated with lower IUD use; the number of IUDs inserted during residency was not. In selecting IUD candidates, respondents were most restrictive about patient monogamy. Having less conservative criteria for selecting IUD candidates was associated with greater IUD use, Respondents with liberal criteria inserted a mean of nine IUDs in the past year, whereas those with conservative criteria inserted four.CONCLUSIONS: Because most obstetrician-gynecologists are inserting few IUDs, educational programs should target these physicians to expand their IUD use. Such programs should highlight modem IUD safety and the rarity of litigation. The number of IUDs inserted in residency may be less important than the development of less restrictive, more evidence-based criteria for selecting IUD candidates. (C) 2002 by the American College of Obstetricians and Gynecologists.