Julian Hirschbaum, Grace Kung, Diane Tanaka, Roberta Williams, Dana Gal
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引用次数: 0
Abstract
Purpose: Limited data suggest that pediatric cardiology (PC) fellows are unprepared to provide sexual and reproductive health (SRH) care to adolescents and young adults (AYA) with congenital heart disease (CHD), an expanding population. We sought to explore PC fellow training, attitudes, and clinical practices surrounding the provision of SRH care for AYA with CHD.
Methods: This national survey-based study of PC fellows in American College of Graduate Medical Education accredited fellowship programs collected demographic data, data related to participant training program, participants' attitudes, practices, and experiences regarding SRH for AYA with CHD, and participants' knowledge of SRH for these patients. Bivariate logistic regression was performed to assess associations between categorical variables of interest.
Results: There were 97 responses submitted and an estimated 466 PC fellows, resulting in an estimated response rate of 20%. Approximately half of the participants indicated that the training received during fellowship has not prepared them to counsel patients with heart and/or vascular disease on contraceptive options (52%) or provide preconception counseling to their patients (49%). Fewer than half of the participants indicated feeling comfortable discussing SRH with cardiology patients in fellowship (43%), while most participants do not regularly discuss or initiate discussions about SRH with cardiology patients (79%). Nearly all participants indicated that additional training resources for SRH counseling for AYA with CHD would be helpful.
Discussion: Our results demonstrate that PC fellows are inadequately prepared to provide SRH care to AYA with CHD, and there is a need for curricular reform within PC fellowship programs.
目的:有限的数据表明,儿科心脏病学(PC)研究员没有准备好为患有先天性心脏病(CHD)的青少年和年轻人(AYA)提供性和生殖健康(SRH)护理,这是一个不断扩大的人群。我们试图探索PC同事的培训、态度和临床实践,为AYA冠心病患者提供SRH护理。方法:对美国研究生医学教育学院(American College of Graduate Medical Education)认可的奖学金项目的PC研究员进行全国性调查研究,收集了人口统计数据、参与者培训计划相关数据、参与者对AYA合并冠心病患者SRH的态度、实践和经验,以及参与者对这些患者SRH的知识。采用双变量逻辑回归来评估感兴趣的分类变量之间的关联。结果:共收到97份回复,估计有466名PC研究员,估计回复率为20%。大约一半的参与者表示,在奖学金期间接受的培训没有使他们准备好就避孕选择向患有心脏和/或血管疾病的患者提供咨询(52%)或向患者提供孕前咨询(49%)。不到一半的参与者表示与心脏病患者讨论SRH感到舒适(43%),而大多数参与者不定期与心脏病患者讨论或发起SRH讨论(79%)。几乎所有的参与者都表示,为患有冠心病的AYA提供额外的SRH咨询培训资源将会有所帮助。讨论:我们的研究结果表明,PC研究员在为患有冠心病的AYA提供SRH护理方面准备不足,PC研究员项目需要进行课程改革。