Barriers Pediatric PCP's Identify To Providing Gender-Affirming Care For Adolescents.
Barriers Pediatric PCP's Identify To Providing Gender-Affirming Care For Adolescents.
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儿科 PCP 为青少年提供性别肯定护理的障碍。
DOI：
10.1016/j.jadohealth.2023.04.007
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发表时间：
2023
期刊：
影响因子：
--
通讯作者：
Richardson,LauraP
中科院分区：
文献类型：
--
作者：
Sequeira,GinaM;Kahn,NicoleF;Ricklefs,Colbey;Collin,Arin;Asante,PeterG;Pratt,Wanda;Christakis,Dimitri;Richardson,LauraP
目的肯定的环境和获得性别肯定的医疗保健对跨性别和性别多样性（TGD）青年的心理健康有积极的影响，然而，许多TGD青年在获得这种护理方面遇到障碍。儿科初级保健提供者（PCP）可以发挥重要作用，扩大获得性别肯定的照顾TGD青年;然而，目前很少提供这种照顾。本研究的目的是探讨儿科PCP的观点，他们的经验，以提供性别肯定的护理在初级保健setting.MethodsPediatric PCP谁寻求了支持，从西雅图儿童性别诊所通过电子邮件招募参加半结构化，一个小时的变焦采访的障碍。所有的采访被转录，然后在Dedoose定性分析软件使用自反性专题分析framework.ResultsProvider参与者（n = 15）进行了分析，代表了广泛的经验，多年来在实践中，TGD青年看到的数量，和实践的位置（城市，农村，郊区）。项目协调员查明了卫生系统和社区一级在向过渡、转型和发展青年提供肯定性别观点的护理方面存在的障碍。卫生系统一级的障碍包括：（1）缺乏基本知识和技能，（2）临床决策支持有限，（3）卫生系统设计的局限性。社区层面的障碍包括（1）社区和机构的偏见，（2）供应商的态度，对性别肯定的护理提供，和（3）挑战，确定社区资源，以支持TGD youth.DiscussionA众多的卫生系统和社区层面的障碍，必须克服在儿科初级保健设置，以确保TGD青年得到及时，有效，更公平的性别肯定的护理。
PurposeBoth affirming environments and access to gender-affirming medical care have a positive impact on the mental health of transgender and gender diverse (TGD) youth, however, many TGD youth experience barriers in accessing this care. Pediatric primary care providers (PCPs) can play an important role in expanding access to gender-affirming care for TGD youth; however, few currently provide this care. The purpose of this study was to explore pediatric PCPs' perspectives regarding barriers they experience to providing gender-affirming care in the primary care setting.MethodsPediatric PCPs who had sought out support from the Seattle Children's Gender Clinic were recruited via email to participate in semistructured, one-hour Zoom interviews. All interviews were transcribed and then subsequently analyzed in Dedoose qualitative analysis software using a reflexive thematic analysis framework.ResultsProvider participants (n = 15) represented a wide range of experiences with respect to years in practice, number of TGD youth seen, and practice location (urban, rural, suburban). PCPs identified both health system and community-level barriers to providing gender-affirming care to TGD youth. Health system-level barriers included: (1) lack of foundational knowledge and skills, (2) limited clinical decision-making support, and (3) health system design limitations. Community-level barriers included (1) community and institutional biases, (2) provider attitudes regarding gender-affirming care provision, and (3) challenges identifying community resources to support TGD youth.DiscussionA multitude of health system and community-level barriers must be overcome in the pediatric primary care setting to ensure that TGD youth receive timely, effective, and more equitable gender-affirming care.
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DOI：
--
发表时间：
2011
期刊：
Issue brief
影响因子：
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