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在COVID-19大流行的早期阶段，英国性健康和生殖健康服务的可及性和质量：对患者体验的 ...
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在COVID-19大流行的早期阶段，英国性健康和生殖健康服务的可及性和质量：对患者体验的定性访谈研究
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Access to and quality of sexual
and reproductive health services in Britain during the early stages of the
COVID-19 pandemic: a qualitative interview study of patient experiences
——原载《英国医学杂志-性与生殖健康》2023年第49卷第1期
<BMJ Sexual & Reproductive
Health> 2023, 49 (1)
【摘要】引言：即使在大流行期间，获得优质的性健康和生殖健康 (SRH) 服务仍然势在必行。 我们的目标是了解在 COVID-19 大流行的早期阶段英国延迟或不成功获得 SRH 服务的经历。方法：在2020年10月和2020年11月，我们对Natsal-COVID调查中的14名女性和6名男性报告了未满足的SRH服务需求进行了半结构化电话采访，Natsal-COVID 调查是一项针对性健康和性行为的大规模准代表性网络面板调查
COVID-19（n=6654）。我们有目的地使用社会人口配额对符合条件的参与者进行抽样。归纳主题分析用于探索服务获取和质量，并确定未来SRH服务交付的经验教训。结果：20名参与者讨论了10项SRH服务的经验，包括避孕和产前/产科护理。参与者报告了对需求的犹豫和自我审查。获得远程医疗和“保持社交距离”的服务需要坚韧不拔的精神。挑战包括导航不断变化的信息和程序；将看门人视为阻碍通行的看法；和不灵活的任命系统。对重新配置服务的担忧包括减少隐私；与专业人士的互动质量下降；减少非正式支持；以及更少的预防性SRH实践。然而，一些与会者还描述了更精简的服务和工作人员为弥补中断所做的努力。许多人对远程医疗与面对面护理的持续融合持积极态度。结论：COVID-19大流行影响了SRH服务的获取和质量。参与者的账户显示了对需求的自我审查、难以驾驭不断变化的服务配置和感知到的质量下降。如果与面对面护理巧妙结合，远程医疗具有潜力。我们提供初步的基于证据的建议，以促进服务的公平恢复和未来适应。
[Abstract] Introduction: Access
to quality sexual and reproductive health (SRH) services remains imperative
even during a pandemic. Our objective was to understand experiences of delayed
or unsuccessful access to SRH services in Britain during the early stages of
the COVID-19 pandemic. Methods: In
October and November 2020 we conducted semi-structured telephone interviews
with 14 women and six men reporting
an unmet need for SRH services in the Natsal-COVID survey, a large-scale
quasi-representative web-panel survey of sexual health and behaviour during
COVID-19 (n=6654). We purposively sampled eligible participants using
sociodemographic quotas. Inductive thematic analysis was used to explore
service access and quality and to identify lessons for future SRH service
delivery. Results: Twenty participants discussed experiences spanning 10 SRH services
including contraception and antenatal/maternity care. Participants reported
hesitancy and self-censorship of need. Accessing telemedicine and
‘socially-distanced’ services required tenacity. Challenges included navigating
changing information and procedures; perceptions of gatekeepers as obstructing
access; and inflexible appointment systems. Concerns about reconfigured
services included reduced privacy; decreased quality of interactions with
professionals; reduced informal support; and fewer preventive SRH practices.
However, some participants also described more streamlined services and staff
efforts to compensate for disruptions. Many viewed positively the ongoing blending
of telemedicine with in-person care. Conclusion: The COVID-19 pandemic impacted access and quality of SRH services.
Participants’ accounts revealed self-censorship of need, difficulty navigating
shifting service configurations and perceived quality reductions. Telemedicine
offers potential if intelligently combined with in-person care. We offer
initial evidence-based recommendations for promoting an equitable restoration
and future adaption of services.
论文原文：Raquel Bosó Pérez, David Rei, Karen J Maxwell, et al. (2023). Access to
and quality of sexual and reproductive health services in Britain during the
early stages of the COVID-19 pandemic: a qualitative interview study of patient
experiences. BMJ Sexual & Reproductive Health, Volume 49, Issue 1.
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