BMJ Sexual & Reproductive Health最新文献_第4页

Nurse practitioner medication abortion providers in Canada: results from a national survey. 加拿大执业护士药物流产提供者：全国调查结果。

IF 3.4 3区医学

BMJ Sexual & Reproductive Health Pub Date : 2024-12-30 DOI: 10.1136/bmjsrh-2024-202379

Emma Stirling-Cameron, Andrea Carson, Abdul-Fatawu Abdulai, Ruth Martin-Misener, Regina Renner, Madeleine Ennis, Wendy V Norman

{"title":"Nurse practitioner medication abortion providers in Canada: results from a national survey.","authors":"Emma Stirling-Cameron, Andrea Carson, Abdul-Fatawu Abdulai, Ruth Martin-Misener, Regina Renner, Madeleine Ennis, Wendy V Norman","doi":"10.1136/bmjsrh-2024-202379","DOIUrl":"10.1136/bmjsrh-2024-202379","url":null,"abstract":"Background: In 2017, nurse practitioners (NPs) became the first non-physician healthcare providers authorised to independently provide medication abortion (MA) in Canada. We aimed to report on demographic and clinical characteristics of NPs providing mifepristone/misoprostol MA in Canada and to identify context-specific barriers and enablers to NP provision of mifepristone/misoprostol MA in Canada among MA providers and non-providers.Methods: From August 2020 to February 2021, we invited Canadian NPs to complete a national, web-based, bilingual (English/French) survey. The survey was distributed through national and provincial nursing associations and national abortion health professional organisations. We collected demographic and clinical care characteristics and present descriptive statistics and bivariate analyses to compare the experiences of NP providers and non-providers of MA.Results: The 181 respondents represented all Canadian provinces and territories. Sixty-five NPs (36%) had provided MA at the time of the survey and 116 (64%) had not. Nearly half (47%) of respondents worked in rural or remote communities and 81% in primary care clinics. Significant barriers impacting non-providers' abilities to provide MA included limited proximity to a pharmacy that dispensed mifepristone/misoprostol, few experienced abortion providers in their community of practice, poor access to procedural abortion services, policy restrictions in NPs' places of employment, and no access to clinical mentorship. Some 98% of NPs providing MA services had never encountered anti-choice protest activity.Conclusions: NPs appear prepared and able to provide MA, yet barriers remain, particularly for NPs in smaller, lower-resourced communities. Our findings inform the development of supports for NPs in this new practice to improve abortion access in Canada.","PeriodicalId":9219,"journal":{"name":"BMJ Sexual & Reproductive Health","volume":" ","pages":""},"PeriodicalIF":3.4,"publicationDate":"2024-12-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142458416","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Providers' perspectives on the barriers to post-20-week Ground C abortion in Scotland. 苏格兰医疗服务提供者对 20 周后 Ground C 人工流产障碍的看法。

IF 3.4 3区医学

BMJ Sexual & Reproductive Health Pub Date : 2024-12-30 DOI: 10.1136/bmjsrh-2024-202529

Lucy Grieve, Jeni Harden, Nicola Boydell

引用次数: 0

Seeking abortion accompaniment: experiences and self-managed abortion preferences of hotline callers after abortion legalisation in Argentina. 寻求堕胎陪伴：阿根廷堕胎合法化后热线来电者的经历和自我管理堕胎的偏好。

IF 3.4 3区医学

BMJ Sexual & Reproductive Health Pub Date : 2024-12-30 DOI: 10.1136/bmjsrh-2023-202209

Brianna Keefe-Oates, Sofia Filippa, Elizabeth Janiak, Ruth Zurbriggen, Belén Grosso, Jarvis T Chen, Caitlin Gerdts, Barbara Gottlieb

{"title":"Seeking abortion accompaniment: experiences and self-managed abortion preferences of hotline callers after abortion legalisation in Argentina.","authors":"Brianna Keefe-Oates, Sofia Filippa, Elizabeth Janiak, Ruth Zurbriggen, Belén Grosso, Jarvis T Chen, Caitlin Gerdts, Barbara Gottlieb","doi":"10.1136/bmjsrh-2023-202209","DOIUrl":"10.1136/bmjsrh-2023-202209","url":null,"abstract":"Background: Until the legalisation of abortion in Argentina in 2021, the Socorristas en Red, a network of feminist collectives, provided support and information ('accompaniment') to people self-managing their abortion with medications. Following legalisation, the Socorristas continued accompanying people self-managing or accessing abortion through the healthcare system. We conducted a cross-sectional study to understand preferences, experiences and choices about abortion when contacting a Socorristas hotline after legalisation of abortion in Argentina.Methods: We surveyed callers to the Socorristas' hotline in Neuquén, Argentina about their demographics, pregnancy history, reasons for calling, and experiences seeking abortion through the hotline and the healthcare system. We assessed overall prevalence of these experiences, and analysed differences between people who contacted the health system before calling the hotline and those who first called the hotline for services.Results: Of the 755 callers in the study, the majority (63.3%) contacted the Socorristas because they trusted them, and 21.7% called because they both trusted the Socorristas and did not want to go to the healthcare system. At the end of the call, most people (95.4%) chose to self-manage their abortion with accompaniment outside the healthcare system. People who called the healthcare system prior to contacting the hotline frequently reported being referred to the Socorristas, as well as challenges scheduling appointments.Conclusions: After legalisation of abortion in Argentina there is continued demand for accompaniment. Globally, ensuring that accompaniment and self-management of abortion is legal and protected will provide individuals with the support and facilitated access to the abortion care they desire.","PeriodicalId":9219,"journal":{"name":"BMJ Sexual & Reproductive Health","volume":" ","pages":""},"PeriodicalIF":3.4,"publicationDate":"2024-12-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141417829","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

What do Australian primary care clinicians need to provide long-acting reversible contraception and early medical abortion? A content analysis of a virtual community of practice. 澳大利亚初级保健临床医生在提供长效可逆避孕药具和早期药物流产时需要什么？对虚拟实践社区的内容分析。

IF 3.4 3区医学

BMJ Sexual & Reproductive Health Pub Date : 2024-12-30 DOI: 10.1136/bmjsrh-2024-202330

Sonia Srinivasan, Sharon Maree James, Joly Kwek, Kirsten Black, Angela J Taft, Deborah Bateson, Wendy V Norman, Danielle Mazza

{"title":"What do Australian primary care clinicians need to provide long-acting reversible contraception and early medical abortion? A content analysis of a virtual community of practice.","authors":"Sonia Srinivasan, Sharon Maree James, Joly Kwek, Kirsten Black, Angela J Taft, Deborah Bateson, Wendy V Norman, Danielle Mazza","doi":"10.1136/bmjsrh-2024-202330","DOIUrl":"10.1136/bmjsrh-2024-202330","url":null,"abstract":"Background: Uptake of long-acting reversible contraception (LARC) is lower in Australia compared with other high-income countries, and access to early medical abortion (EMA) is variable with only 11% of general practitioners (GPs) providing EMA. The AusCAPPS (Australian Contraception and Abortion Primary Care Practitioner Support) Network is a virtual community of practice established to support GPs, nurses and pharmacists to provide LARC and EMA in primary care. Evaluating participant engagement with AusCAPPS presents an opportunity to understand clinician needs in relation to LARC and EMA care.Methods: Data were collected from July 2021 until July 2023. Numbers of online resource views on AusCAPPS were analysed descriptively and text from participant posts underwent qualitative content analysis.Results: In mid-2023 AusCAPPS had 1911 members: 1133 (59%) GPs, 439 (23%) pharmacists and 272 (14%) nurses. Concise point-of-care documents were the most frequently viewed resource type. Of the 655 posts, most were created by GPs (532, 81.2%), followed by nurses (88, 13.4%) then pharmacists (16, 2.4%). GPs most commonly posted about clinical issues (263, 49% of GP posts). Nurses posted most frequently about service implementation (24, 27% of nurse posts). Pharmacists posted most about health system and regulatory issues (7, 44% of pharmacist posts).Conclusions: GPs, nurses and pharmacists each have professional needs for peer support and resources to initiate or continue LARC and EMA care, with GPs in particular seeking further clinical education and upskilling. Development of resources, training and implementation support may improve LARC and EMA provision in Australian primary care.","PeriodicalId":9219,"journal":{"name":"BMJ Sexual & Reproductive Health","volume":" ","pages":""},"PeriodicalIF":3.4,"publicationDate":"2024-12-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141497182","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Expectations and experiences of pain during medical abortion at home: a secondary, mixed-methods analysis of a patient survey in England and Wales. 对家庭药物流产期间疼痛的期望和经历：对英格兰和威尔士一项患者调查的二级混合方法分析。

IF 3.4 3区医学

BMJ Sexual & Reproductive Health Pub Date : 2024-12-30 DOI: 10.1136/bmjsrh-2024-202533

Hannah McCulloch, Danielle Perro, Neda Taghinejadi, Katherine C Whitehouse, Patricia A Lohr

{"title":"Expectations and experiences of pain during medical abortion at home: a secondary, mixed-methods analysis of a patient survey in England and Wales.","authors":"Hannah McCulloch, Danielle Perro, Neda Taghinejadi, Katherine C Whitehouse, Patricia A Lohr","doi":"10.1136/bmjsrh-2024-202533","DOIUrl":"10.1136/bmjsrh-2024-202533","url":null,"abstract":"Objective: To explore experiences of pain during medical abortion and provide patient-centred recommendations for improving abortion experience and pain counselling.Methods: We invited patients of British Pregnancy Advisory Service who underwent medical abortion up to 10 weeks' gestation to participate in an online, English language questionnaire from November 2021 to March 2022. Participants answered questions about pain, method preference, abortion experience, advice, and how they would describe pain experienced to a friend. In this secondary analysis, we analysed free-text responses using reflexive thematic analysis techniques. We used descriptive statistics and parametric tests to analyse quantitative responses.Results: Of 11 906 patients invited to participate, 1596 (13.4%) completed the questionnaire, including at least one free-text comment. Participants used a range of descriptors for medical abortion pain across three broad themes: pain severity, pain quality and comparisons to other reproductive pain. Some found the commonly used analogy to period pain misleading. Many felt unprepared for the level of pain they experienced, which they attributed to provider comparisons to period pain, as well as a lack of detailed, realistic anticipatory pain counselling. Qualitative and quantitative results suggest pain experiences impact method preference. Participants recommended better counselling for pain and abortion preparation, including first-hand accounts of medical abortion at home and a wide and accessible range of descriptions of pain.Conclusions: Abortion providers should use patient-centred recommendations to better prepare patients for pain during medical abortion. Setting realistic expectations can improve abortion experience and support informed method choice. Further research is needed to develop and test patient-centred counselling materials.","PeriodicalId":9219,"journal":{"name":"BMJ Sexual & Reproductive Health","volume":" ","pages":""},"PeriodicalIF":3.4,"publicationDate":"2024-12-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142852816","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Celebrating 50 years of our Journal. 庆祝本刊创刊 50 周年。

IF 3.4 3区医学

BMJ Sexual & Reproductive Health Pub Date : 2024-12-30 DOI: 10.1136/bmjsrh-2024-202394

Sam Rowlands

引用次数: 0

General practice preconception care invitations: a qualitative study of women's acceptability and preferences. 全科孕前保健邀请：关于妇女接受程度和偏好的定性研究。

IF 3.4 3区医学

BMJ Sexual & Reproductive Health Pub Date : 2024-12-30 DOI: 10.1136/bmjsrh-2024-202432

Nishadi Nethmini Withanage, Sharon James, Jessica Botfield, Kirsten Black, Jeana Wong, Danielle Mazza

{"title":"General practice preconception care invitations: a qualitative study of women's acceptability and preferences.","authors":"Nishadi Nethmini Withanage, Sharon James, Jessica Botfield, Kirsten Black, Jeana Wong, Danielle Mazza","doi":"10.1136/bmjsrh-2024-202432","DOIUrl":"10.1136/bmjsrh-2024-202432","url":null,"abstract":"Background: In general practice, primary care providers can potentially use electronic medical records (EMRs) to identify and invite reproductive-aged women with preconception health risk factors to increase their engagement in preconception care (PCC). However, the acceptability of receiving PCC invitations and women's preferences about the invitation process are poorly understood. This study aims to investigate women's acceptability and preferences for receiving PCC invitations from general practice settings.Methods: Participants were recruited via convenience, purposive and snowball sampling. Semi-structured interviews were conducted via Zoom from August until November 2023. Interviews were transcribed verbatim and inductive reflexive thematic analysis was undertaken.Results: PCC invitations sent from general practice are acceptable if the language is sensitive and non-stigmatising. Text or email invitations detailing the importance and scope of the PCC consultation were preferred, after discussing reproductive intentions with a general practitioner or practice nurse. Women with preconception health risk factors or those actively trying to conceive were more likely to engage in PCC. Key strategies to enhance PCC engagement include advertising in waiting rooms, introducing PCC in new patient registration forms, and integrating PCC into holistic care.Conclusion: Using EMRs to identify and invite women with preconception health risk factors to increase their engagement in PCC is generally acceptable. Invitations sent via text messages or emails are preferred. It is crucial to use respectful and appropriate language to avoid stigmatising or offending women, particularly those with infertility issues, those who have completed their families, or those who do not wish to have children.","PeriodicalId":9219,"journal":{"name":"BMJ Sexual & Reproductive Health","volume":" ","pages":""},"PeriodicalIF":3.4,"publicationDate":"2024-12-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142341957","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Shifting discourses, changing interests? How the language of sexual and reproductive health has evolved in the past 50 years. 话语在变，利益在变？性健康与生殖健康的语言在过去 50 年是如何演变的。

IF 3.4 3区医学

BMJ Sexual & Reproductive Health Pub Date : 2024-12-30 DOI: 10.1136/bmjsrh-2024-202456

Aideen O'Shaughnessy, Carrie Purcell

引用次数: 0

Health care professionals' views on a new postpartum contraception audiovisual animation: a survey. 医护人员对新型产后避孕视听动画的看法调查

IF 3.4 3区医学

BMJ Sexual & Reproductive Health Pub Date : 2024-12-30 DOI: 10.1136/bmjsrh-2024-202422

Janine Simpson, Michelle Cooper, Sharon Cameron

{"title":"Health care professionals' views on a new postpartum contraception audiovisual animation: a survey.","authors":"Janine Simpson, Michelle Cooper, Sharon Cameron","doi":"10.1136/bmjsrh-2024-202422","DOIUrl":"10.1136/bmjsrh-2024-202422","url":null,"abstract":"Background: The postpartum period is a high-risk time for unintended pregnancy. We developed a 2-minute audiovisual animation on postpartum contraception (PPC) including the return of fertility after birth for patients. The aim of our study was to determine the views of healthcare professionals (HCPs) involved in pregnancy care on the animation and to identify facilitators and barriers to its implementation into routine pregnancy care pathways.Methods: An anonymous online questionnaire was circulated to 100 HCPs (midwives, doctors, health visitors) in Glasgow, Scotland, UK who provide antenatal and/or postnatal care. The aim was to collect 50 responses. The questionnaire contained 12 questions including fixed responses, categorical Likert rating scale questions and open-ended questions. Content analysis was used for the free-text responses.Results: Forty-four responses were obtained. HCPs rated the animation positively for information and inclusivity (95%), accessibility for those with a disability (81.8%) and non-English speaking (59%), and usefulness for HCPs (88.6%) and pregnant individuals (97%). Some felt the animation should contain more information or could be displayed on digital screens in clinical waiting areas. Suggestions were made as to the optimal time to view the animation in pregnancy and the importance of choice of whether/how to view and considerations on trauma-informed care. Accessibly for HCPs was mentioned, with considerations on how the resource could alleviate perceived service and financial pressures.Conclusions: The animation was felt to be an engaging, inclusive and informative knowledge tool for patients. Consideration needs to be given to allow choice to view, timing and the appropriate digital media for delivering it.","PeriodicalId":9219,"journal":{"name":"BMJ Sexual & Reproductive Health","volume":" ","pages":""},"PeriodicalIF":3.4,"publicationDate":"2024-12-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142876128","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

The state of sexual health services in England. 英格兰性健康服务状况。

IF 3.4 3区医学

BMJ Sexual & Reproductive Health Pub Date : 2024-12-30 DOI: 10.1136/bmjsrh-2024-202450

Sarah Harris

引用次数: 0