Trust in provider and stigma during second-trimester abortion

IF 16.4 1区 化学 Q1 CHEMISTRY, MULTIDISCIPLINARY
Arina E. Chesnokova , Divyah Nagendra , Eshani Dixit , Arden McAllister , Allison Schachter , Courtney A. Schreiber , Andrea H. Roe , Sarita Sonalkar
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引用次数: 0

Abstract

Objective

To determine whether trust in the provider and sociodemographics are associated with individual-level abortion stigma.

Methods

We performed a cross sectional and exploratory study design using secondary analysis of a randomized trial that enrolled participants undergoing second trimester abortion. We collected baseline survey data from 70 trial participants to assess stigma (Individual Level of Abortion Stigma scale, ILAS; range 0–4), trust in provider (Trust in Physician scale; range 1–5), anxiety, depression, and sociodemographics. We performed multiple linear regression, for which ILAS score was the outcome of interest. Univariate associations were used to inform the regression model.

Results

The mean abortion stigma score was at the low end of the ILAS at 1.21 (range 0.2–2.8, SD 0.66). Age, race, income, BMI, parity, gestational age at time of abortion, and reasons for ending the pregnancy were not significantly associated with the ILAS score. Higher trust in provider scores were (m 4.0, SD 0.49) and inversely related to the ILAS score, even after adjustment for confounders (β −0.02, CI −0.03 to −0.004, p = 0.013). Screening positive for anxiety or depression was associated with a higher ILAS score ((β 0.48, CI 0.10, 0.90, p = 0.015); (β = 0.27 CI −0.097, 0.643)), while cohabitation was associated with lower ILAS score (β −0.44, CI −0.82 to −0.57, p = 0.025).

Conclusions

Trust in an abortion provider, anxiety, depression, and cohabitation are associated with abortion stigma among people seeking second trimester abortion care. Interventions that improve trust in a provider may be an area of focus for addressing abortion stigma. Future research should confirm these findings in larger populations and across diverse locations and demographics and to conduct qualitative research to understand what patients perceive as trust-promoting behaviors and words during abortion encounters.

妊娠中期流产时对提供者的信任与耻感
目的确定对提供者的信任和社会人口统计学是否与个人层面的堕胎耻辱感有关。方法我们采用了一项横断面探索性研究设计,对一项随机试验进行了二次分析,纳入了妊娠中期流产的参与者。我们收集了来自70名试验参与者的基线调查数据来评估耻辱感(个体流产耻辱感水平量表,ILAS;范围0-4),对提供者的信任(信任医生量表;范围1-5),焦虑,抑郁和社会人口统计学。我们进行了多元线性回归,ILAS评分是我们感兴趣的结果。采用单变量关联来建立回归模型。结果流产污名的平均评分处于ILAS的低端,为1.21(范围0.2 ~ 2.8,SD 0.66)。年龄、种族、收入、体重指数、胎次、流产时胎龄和终止妊娠的原因与ILAS评分无显著相关。即使在调整混杂因素后(β - 0.02, CI - 0.03至- 0.004,p = 0.013),对提供者评分的较高信任度与ILAS评分呈负相关(m = 4.0, SD = 0.49)。焦虑或抑郁筛查阳性与更高的ILAS评分相关((β 0.48, CI 0.10, 0.90, p = 0.015);(β = 0.27 CI−0.097,0.643)),同居与较低的ILAS评分相关(β = 0.44, CI−0.82 ~−0.57,p = 0.025)。结论在寻求中期流产护理的患者中,对流产服务提供者的信任、焦虑、抑郁和同居与流产污名有关。提高对提供者的信任的干预措施可能是解决堕胎耻辱的重点领域。未来的研究应该在更大的人群中,在不同的地区和人口统计数据中证实这些发现,并进行定性研究,以了解患者在堕胎过程中认为促进信任的行为和言语。
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来源期刊
Accounts of Chemical Research
Accounts of Chemical Research 化学-化学综合
CiteScore
31.40
自引率
1.10%
发文量
312
审稿时长
2 months
期刊介绍: Accounts of Chemical Research presents short, concise and critical articles offering easy-to-read overviews of basic research and applications in all areas of chemistry and biochemistry. These short reviews focus on research from the author’s own laboratory and are designed to teach the reader about a research project. In addition, Accounts of Chemical Research publishes commentaries that give an informed opinion on a current research problem. Special Issues online are devoted to a single topic of unusual activity and significance. Accounts of Chemical Research replaces the traditional article abstract with an article "Conspectus." These entries synopsize the research affording the reader a closer look at the content and significance of an article. Through this provision of a more detailed description of the article contents, the Conspectus enhances the article's discoverability by search engines and the exposure for the research.
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