Traci M Kazmerski1, Sonya Borrero2, Gregory S Sawicki3, Kaleab Z Abebe4, Kelley A Jones5, Lisa K Tuchman6, Daniel J Weiner5, Joseph M Pilewski7, David M Orenstein5, Elizabeth Miller8. 1. Division of Respiratory Diseases, Department of Medicine, Boston Children's Hospital, Boston, Massachusetts. Electronic address: traci.kazmerski@childrens.harvard.edu. 2. Center for Women's Health Research and Innovation, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania; VA Pittsburgh Center for Health Equity Research and Promotion, Pittsburgh, Pennsylvania; Department of Medicine, University of Pittsburgh Medical Center, University of Pittsburgh, Pittsburgh, Pennsylvania. 3. Division of Respiratory Diseases, Department of Medicine, Boston Children's Hospital, Boston, Massachusetts. 4. Department of Medicine, University of Pittsburgh Medical Center, University of Pittsburgh, Pittsburgh, Pennsylvania; Center for Research on Health Care Data Center, Division of General Internal Medicine, University of Pittsburgh, Pittsburgh, Pennsylvania. 5. Children's Hospital of Pittsburgh of UPMC, Department of Pediatrics, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania. 6. Division of Adolescent and Young Adult Medicine, Children's National Health System, Washington, District of Columbia. 7. Department of Medicine, University of Pittsburgh Medical Center, University of Pittsburgh, Pittsburgh, Pennsylvania. 8. Center for Women's Health Research and Innovation, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania; Children's Hospital of Pittsburgh of UPMC, Department of Pediatrics, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania.
Abstract
STUDY OBJECTIVE: To investigate the attitudes and practices of cystic fibrosis (CF) providers toward sexual and reproductive health (SRH) care in young women with CF. DESIGN, SETTING, PARTICIPANTS, AND INTERVENTIONS: Adult and pediatric US CF providers were sent an online survey exploring their attitudes toward SRH importance, SRH care practices, and barriers/facilitators to SRH care in adolescent and/or young adult women. Descriptive statistics and logistic regression were used to analyze results. MAIN OUTCOME MEASURES: Attitudes toward the importance of SRH care in patients with CF and self-report of practice patterns of SRH discussion. RESULTS: Respondents (n = 196) were 57% pediatric (111/196) and 24% adult physicians (48/196) and 19% nurse practitioners (NPs)/physician assistants (PAs) (37/196). Ninety-four percent of respondents believed SRH was important for female patients with CF (184/196). More than 75% believed SRH care should be standardized within the CF care model (147/196) and 41% believed the CF team should have the primary role in SRH discussion and care (80/196). For many CF-specific SRH topics, discrepancies emerged between how important respondents believed these were to address and how often they reported discussing these topics in practice. Significant differences in SRH attitudes and practices were present between adult and pediatric physicians. The most significant barriers to SRH care identified were lack of time (70%, 137/196) and the presence of family in clinic room (54%, 106/196). Potential facilitators included training materials for providers (68%, 133/196) and written (71%, 139/196) or online (76%, 149/196) educational resources for patients. CONCLUSION: CF providers perceive SRH topics as important to discuss, but identify barriers to routine discussion in current practice. Providers endorsed provider training and patient educational resources as means to improve SRH delivery.
STUDY OBJECTIVE: To investigate the attitudes and practices of cystic fibrosis (CF) providers toward sexual and reproductive health (SRH) care in young women with CF. DESIGN, SETTING, PARTICIPANTS, AND INTERVENTIONS: Adult and pediatric US CF providers were sent an online survey exploring their attitudes toward SRH importance, SRH care practices, and barriers/facilitators to SRH care in adolescent and/or young adult women. Descriptive statistics and logistic regression were used to analyze results. MAIN OUTCOME MEASURES: Attitudes toward the importance of SRH care in patients with CF and self-report of practice patterns of SRH discussion. RESULTS: Respondents (n = 196) were 57% pediatric (111/196) and 24% adult physicians (48/196) and 19% nurse practitioners (NPs)/physician assistants (PAs) (37/196). Ninety-four percent of respondents believed SRH was important for female patients with CF (184/196). More than 75% believed SRH care should be standardized within the CF care model (147/196) and 41% believed the CF team should have the primary role in SRH discussion and care (80/196). For many CF-specific SRH topics, discrepancies emerged between how important respondents believed these were to address and how often they reported discussing these topics in practice. Significant differences in SRH attitudes and practices were present between adult and pediatric physicians. The most significant barriers to SRH care identified were lack of time (70%, 137/196) and the presence of family in clinic room (54%, 106/196). Potential facilitators included training materials for providers (68%, 133/196) and written (71%, 139/196) or online (76%, 149/196) educational resources for patients. CONCLUSION: CF providers perceive SRH topics as important to discuss, but identify barriers to routine discussion in current practice. Providers endorsed provider training and patient educational resources as means to improve SRH delivery.
Authors: Traci M Kazmerski; Elizabeth Miller; Gregory S Sawicki; Phaedra Thomas; Olga Prushinskaya; Eliza Nelson; Kelsey Hill; Anna Miller; S Jean Emans Journal: Patient Date: 2019-04 Impact factor: 3.883
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