Perspectives of midwives and doctors on adolescent sexuality and abortion care in Vietnam
Perspectives of midwives and doctors on adolescent sexuality and abortion care in Vietnam
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DOI：
10.1080/14034940500429046
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发表时间：
2006-08-01
影响因子：
3.4
通讯作者：
Johansson, Annika
中科院分区：
文献类型：
--
作者：
Klingberg-Allvin, Marie;Nga, Nguyen Thu;Johansson, Annika
背景资料：越南是世界上堕胎率最高的国家之一，青少年堕胎被认为至少占所有堕胎病例的三分之一。对青少年缺乏均衡的生殖健康信息和服务，以及社会对青少年性行为的消极态度，都是造成堕胎率高的因素。保健提供者在指导和咨询青少年如何保护其生殖健康方面发挥重要作用。缺乏关于保健提供者对其在青少年生殖保健方面工作的看法的研究。目的：探讨助产士和医生对青少年性行为和堕胎的看法，以及他们认为对青少年的优质堕胎护理和障碍，以及他们自己的培训需求。方法：观察堕胎诊所的护理和焦点小组讨论（FGD）收集数据。来自越南北方广宁省三个医疗机构的医生和助产士参加了总共八个FGD。使用潜在内容分析法对数据进行分析。调查结果：确定的主要障碍，高质量的堕胎护理的技术和管理性质。与会者认为，向未婚客户提供有关堕胎的咨询，应侧重于警告他们对堕胎和婚前性关系的风险和危险，因为他们强烈反对这些风险和危险。然而，他们也对未婚少女和前来堕胎的夫妇表示了务实和关心的态度。在越南文化中，青少年性行为和堕胎是道德上敏感的问题。在教育和培训方案中，需要解决文化规范与保健提供者在为未婚青少年提供咨询时所面临的现实之间的矛盾。
Background: Vietnam has one of the highest abortion rates in the world and adolescent abortions are thought to constitute at least one-third of all cases. Lack of balanced reproductive health information and services to adolescents and negative social attitudes towards adolescent sexuality are contributing factors to the high abortion rates. Health providers are important in guiding and counselling adolescents on how to protect their reproductive health. There is a lack of studies on health providers' perspectives on their work in adolescent reproductive health care. Aim: To explore the perspectives of midwives and doctors on adolescent sexuality and abortion, and what they considered to be quality abortion care for adolescents and the barriers to it, as well as to their own training needs. Methods: Observations of care in abortion clinics and focus-group discussions (FGD) were used to collect data. Doctors and midwives from three healthcare facilities in Quang Ninh province in Northern Vietnam participated in a total of eight FGDs. Data were analysed using latent content analysis. Findings: Major barriers identified for quality abortion care were of technical and managerial nature. Participants considered that counselling unmarried clients in connection with abortion should focus on warning against the risks and dangers of abortion and pre-marital sexual relations, which they strongly disapproved of. However, they also expressed a pragmatic and caring attitude towards the unmarried girls and couples coming for abortion. Adolescent sexuality and abortion are morally sensitive issues in the Vietnamese culture. The contradictions between cultural norms and the reality facing health providers while counselling unmarried adolescents need to be addressed in education and training programmes.