一项定性研究，探讨患者在远程医疗和诊室药物流产方面的体验：耻辱感、隐私和支持

IF 2.8 2区医学 Q1 OBSTETRICS & GYNECOLOGY

Contraception Pub Date : 2024-10-07 DOI:10.1016/j.contraception.2024.110621

M Barnes, E Piqueiras, L Gutierrez-Palominos, R Patil

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引用次数: 0

摘要

方法我们采用半结构化远程会议访谈的方式进行了一项探索性定性研究，访谈对象为 2018 年 6 月至 2022 年 12 月期间接受药物流产的 23 名（9 名远程医疗药物流产患者和 14 名门诊药物流产患者）孕龄不超过 77 天的患者。在加利福尼亚州的一个学术中心招募参与者时采用了有目的的抽样。所有访谈均由作者记录、转录和编码，通过主题分析产生突出主题。结果参与者讨论了社会和社交网络对人工流产污名化的影响，从而导致对隐私、支持和预约时间紧迫性的渴望增加。定性分析显示，远程医疗药物流产参与者更喜欢通过远程医疗增加隐私。门诊药物流产参与者强调，门诊环境更容易侵犯他们的隐私，往往需要更多的人知道他们的流产情况，这增加了他们的不安感。许多参与者表示不确定是否要与社交网络分享堕胎信息，因为他们（1）不想在做决定时引入他人的意见，（2）不清楚自己会有什么感觉或反应。这项研究还表明，尽管美国各州都有保护堕胎的法律，但堕胎耻辱感（包括实际耻辱感和感知耻辱感）会严重影响患者的体验，而提高可及性和隐私性可以抵消与堕胎护理相关的耻辱感。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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A QUALITATIVE STUDY EXPLORING PATIENT EXPERIENCES WITH TELEHEALTH AND IN-CLINIC MEDICATION ABORTION: STIGMA, PRIVACY, AND SUPPORT

Objectives

We aimed to explore the experiences of people obtaining medication abortion through telemedicine medication abortion and clinic-based medication abortion at a single academic center.

Methods

We conducted an exploratory qualitative study utilizing semi-structured teleconference interviews with 23 (9 telemedicine medication abortion and 14 clinic-based medication abortion) patients with a gestational age up to 77 days who obtained a medication abortion between June 2018 and December 2022. Purposive sampling was adopted for the recruitment of participants at a single academic center in California. All interviews were recorded, transcribed, and coded by the authors to generate salient themes via thematic analysis.

Results

Participants discussed the effects of abortion stigma from society and social networks, leading to an increased desire for privacy, support, and urgency with time to appointment. Qualitative analysis indicates that telemedicine medication abortion participants preferred the increased privacy afforded via telemedicine. Clinic-based medication abortion participants highlighted the in-clinic environment as more invasive to their privacy, often requiring more people to know about their abortion which increased feelings of unease. Many participants described uncertainty about sharing abortion information with social networks because they (1) did not want to introduce others' opinions into their decision-making and (2) were unclear about how they might feel or react.

Conclusions

The results suggest that telemedicine abortion is an important tool to counteract pervasive societal stigma as well as improve accessibility. This study also suggests that abortion stigma (both actual and perceived) significantly impacts patient experiences despite being in a state with protective abortion laws, and improving accessibility and privacy can counteract the stigma associated with abortion care.

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来源期刊

Contraception 医学-妇产科学

CiteScore

4.70

自引率

17.20%

发文量

211

审稿时长

69 days

期刊介绍： Contraception has an open access mirror journal Contraception: X, sharing the same aims and scope, editorial team, submission system and rigorous peer review. The journal Contraception wishes to advance reproductive health through the rapid publication of the best and most interesting new scholarship regarding contraception and related fields such as abortion. The journal welcomes manuscripts from investigators working in the laboratory, clinical and social sciences, as well as public health and health professions education.