发现血管运动症状管理方面的差距:全国需求评估结果。

IF 1.4 Q2 MEDICINE, GENERAL & INTERNAL
Teresa A Hubka, Andrew Crim, Ju Yong Koh, Chris Larrison, Tom McKeithen, Matthew Fleming, Jennifer Caruso, Martha Prud'homme
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引用次数: 0

摘要

背景:这项全国性需求评估研究探讨了初级保健和妇产科临床医生在与更年期相关的血管运动症状(VMS)方面存在的知识、态度、信念和实践(KABP)差距。更年期血管运动症状对医疗成本、工作效率和患者的社会心理健康有重大影响,但医疗服务提供者与患者之间存在明显的脱节,而医疗服务提供者的缄默和知识差距是造成这种脱节的原因之一:本研究旨在确定并提出消除这些障碍的最佳教育策略,同时关注影响有色人种妇女的健康差异:方法:采用的方法包括文献综述、专家意见、定性访谈、调查、焦点小组和案例研究等多模式方法,确保临床医生的意见多元化。数据收集包括深入的临床医生访谈、全国性的临床医生调查和焦点小组:结果表明,医疗服务提供者对 VMS 的理解和管理存在严重不足,尤其是妇产科住院医生,75% 的人对 VMS 的了解有限。该研究还强调了知识差距对有色人种妇女的影响尤为严重,从而强调了在医学培训和实践中采用文化信息方法的必要性。临床医生在管理 VMS 方面的现有能力与期望能力之间存在明显差异,这表明需要持续的专业发展。VMS的诊断和治疗方法存在很大差异,治疗方案方面的知识差距也很大,这突出表明需要以证据为基础的治疗方案:尽管VMS是衰老的一个正常方面,但它们会严重影响许多女性的生活质量,因此有必要进行干预。除了直接的不适感,VMS 还会影响生活质量,引发失眠和情绪障碍。本研究揭示了医疗服务提供者在 VMS 治疗方案的知识和管理技能方面存在的新的和以前认识到的差距,尤其是在激素和非激素疗法方面。此外,我们的研究结果还凸显了深入了解 VMS 如何对不同背景的女性产生独特影响的必要性。包括 "全美妇女健康研究"(SWAN)在内的研究表明,社会经济地位、种族/民族、体重指数(BMI)和吸烟状况可能会影响 VMS 的经历和严重程度。然而,这些因素之间复杂的相互作用及其相对贡献仍不清楚。进一步的调查对于促进所有妇女公平获得有效治疗至关重要。为了缩小这些差距,从住院医生开始加强教育至关重要。这种教育应针对有关 VMS 及其管理的常见误解。医疗服务提供者必须提高他们讨论 VMS 广泛影响的能力,并采用有效的沟通策略,确保患者充分了解自己的症状和可用的治疗方案。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Uncovering gaps in management of vasomotor symptoms: findings from a national need assessment.

Context: This national needs assessment study explores the knowledge, attitude, beliefs, and practices (KABP) gaps related to vasomotor symptoms (VMS) associated with menopause among primary care and OB/GYN clinicians. VMS significantly impacts healthcare costs, workplace productivity, and patient psychosocial health, but a notable disconnect exists between healthcare providers and patients, with provider reticence and knowledge gaps playing a contributing role.

Objectives: This study aims to identify and propose optimal educational strategies to address these barriers, with attention to health disparities affecting women of color.

Methods: Methods employed include a multimodal approach of literature review, expert opinion, qualitative interviews, surveys, focus groups, and case studies, ensuring diverse clinician input. Data collection involved in-depth clinician interviews, a nationally disseminated clinician survey, and focus groups.

Results: Results indicate a critical deficiency in healthcare providers' understanding and management of VMS, especially among OB/GYN residents, with 75 % showing limited knowledge. The study also highlights the disproportionate impact of knowledge gaps on women of color, emphasizing the need for a culturally informed approach in medical training and practice. There's a notable discrepancy between clinicians' current and desired abilities in managing VMS, indicating a need for ongoing professional development. Significant variability in approaches to diagnosing and treating VMS, as well as substantial knowledge gaps about treatment options, underscore the need for evidence-based protocols.

Conclusions: Although VMS are a normal aspect of aging, they can significantly disrupt quality of life for many women, necessitating intervention. Beyond the immediate discomfort, VMS can impact quality of life and trigger insomnia and mood disturbances. This study exposes both new and previously recognized gaps in healthcare providers' knowledge and management skills concerning VMS treatment options, particularly regarding hormonal and nonhormonal therapies. Furthermore, our findings highlight the need for a deeper understanding of how VMS uniquely impacts women of diverse backgrounds. Research, including the Study of Women's Health Across the Nation (SWAN), suggests that the experience and severity of VMS may be influenced by socioeconomic status, race/ethnicity, body mass index (BMI), and smoking status. However, the complex interplay of these factors and their relative contributions remain unclear. Further investigation is crucial to facilitate equitable access to effective treatment for all women. To bridge these gaps, improved education starting as early as residency is essential. This education should address common misconceptions about VMS and its management. Healthcare providers must enhance their competence in discussing the broad spectrum of VMS impacts and employ effective communication strategies to ensure that patients are well-informed about their symptoms and available treatment options.

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来源期刊
Journal of Osteopathic Medicine
Journal of Osteopathic Medicine Health Professions-Complementary and Manual Therapy
CiteScore
2.20
自引率
13.30%
发文量
118
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