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Assessing Trust in Physician and Vaccine Hesitancy Among Hispanic/Latinx Parents. 评估西班牙裔/拉美裔家长对医生的信任度和对疫苗的犹豫不决。
Pub Date : 2024-06-01 Epub Date: 2023-07-12 DOI: 10.1177/15404153231187379
Hector Gonzalez, Mona S Patel, Marieta Pehlivanova, Rita V Burke

Introduction: Representing the USA's largest ethnic/racial group, Hispanic/Latinx (HL) experience health challenges of proportional magnitude. This study investigates the prevalence of vaccine hesitancy among HL adults and trust in their child's pediatrician. Methods: HL parents of children who receive medical care at one of the largest Federally Qualified Health Centers in the United States completed a survey examining associations between physician trust, vaccine hesitancy, and demographics. Data were subjected to ANOVA via SAS9 version 9.0 (Cary, NC) and SPSS version 27 (Chicago, IL) software. Results: With a total of 500 surveys completed (51% response rate; 81% completion rate), the prevalence of vaccine hesitancy amounted to 15.4% (n = 77). Parents with university-level education displayed higher levels of trust and perceptions in favor of routine vaccination practices (p < .01). When medical visits were conducted in Spanish, parents exhibited lower levels of trust and were more vaccine-hesitant (p < .01). Conclusions: Vaccine literacy must be prioritized in early education to reach parents who may not achieve college degrees. Ensuring language concordance within patient-physician dyads may maximize the potential for vaccine uptake and physician trust.

导言:作为美国最大的民族/种族群体,西班牙裔/拉丁裔(HL)在健康方面面临着巨大的挑战。本研究调查了 HL 成年人对疫苗犹豫不决的普遍程度及其对子女儿科医生的信任度。方法:在美国最大的联邦合格医疗中心之一接受医疗服务的 HL 儿童家长完成了一项调查,研究了医生信任、疫苗犹豫和人口统计学之间的关联。数据通过 SAS9 9.0 版(北卡罗来纳州凯里)和 SPSS 27 版(伊利诺伊州芝加哥)软件进行方差分析。结果共完成了 500 份调查问卷(回复率为 51%;完成率为 81%),疫苗接种犹豫率为 15.4%(n = 77)。受过大学教育的家长对常规疫苗接种做法的信任度和支持度较高(p p 结论:疫苗知识必须在早期教育中得到优先考虑,以帮助那些可能未达到大学学历的家长。确保患者与医生之间语言的一致性可最大限度地提高疫苗接种率和医生信任度。
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引用次数: 0
Barriers and Challenges Experienced by Latina Nurse Leaders. 拉丁裔护士领导面临的障碍和挑战。
Pub Date : 2024-06-01 Epub Date: 2023-09-20 DOI: 10.1177/15404153231199175
Ursula Canli, Elizabeth Aquino

Introduction: Leadership reflecting and representing the diversity of the workforce and patient population has been an ongoing challenge for healthcare institutions. As hospitals strategically plan to improve diversity, equity, and inclusion within their intuitions, especially in executive and other leadership roles, it must be acknowledged that only about 5.3% of the nursing workforce is Latinx and few serve in leadership positions. This study aims to learn about the barriers and challenges Latina nurse leaders have experienced in their ascension into leadership roles. Methods: Using a qualitative descriptive study approach, Latina nurse leaders were interviewed one-on-one about their nursing journey and the challenges experienced. A conventional thematic content analysis approach was used to identify common themes. Results: Seventeen Latina nurse leaders shared their experiences. The themes that emerged included: imposter syndrome being the only one, the need to work harder to be seen, age discrimination, racism and racial discrimination, lack of mentorship, and motherhood. Conclusion: Findings from this study help to highlight barriers to leadership development and success of Latina nurses. The findings can be used to encourage, mentor, and support Latina nurses throughout their careers, so they are provided with opportunities for advancement and nurtured as they become leaders.

引言:反映和代表劳动力和患者群体多样性的领导力一直是医疗机构面临的挑战。随着医院战略性地计划在其直觉中提高多样性、公平性和包容性,特别是在执行和其他领导角色中,必须承认,只有约5.3%的护理人员是拉丁裔,很少有人担任领导职位。本研究旨在了解拉丁裔护士领导者在晋升为领导角色过程中所经历的障碍和挑战。方法:采用定性描述性研究方法,对拉丁裔护士领导进行一对一访谈,了解他们的护理历程和所经历的挑战。采用传统的主题内容分析方法来确定共同主题。结果:17位拉丁裔护士领导分享了他们的经历。出现的主题包括:冒名顶替综合症是唯一的一种,需要更加努力地工作才能被看到,年龄歧视,种族主义和种族歧视,缺乏指导,以及做母亲。结论:这项研究的结果有助于突出拉丁裔护士领导能力发展和成功的障碍。研究结果可用于鼓励、指导和支持拉丁裔护士的整个职业生涯,从而为他们提供晋升机会,并在他们成为领导者时得到培养。
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引用次数: 0
Hazard and Injury Experiences of Latino Day Laborers in Houston, Texas. 得克萨斯州休斯敦拉丁裔日工的危险和伤害经历。
Pub Date : 2024-06-01 Epub Date: 2023-10-30 DOI: 10.1177/15404153231210454
Celeste Monforton, Maria Eugenia Fernandez-Esquer, Maria Lizette Rangel, Mariana Arevalo

Latino day laborers in the United States provide skilled labor to businesses and homeowners through informal work arrangements. We conducted exploratory qualitative research with Latino day laborers in Houston, Texas, to investigate their perceptions of safety risks and circumstances related to work-related injuries. We conducted focus groups with 34 participants and used risk mapping and body mapping activities to elicit greater engagement by the Latino day laborers in the conversations. Participants described physical, occupational, and psychosocial hazards that affected their risk for workplace injuries. They indicated a significant risk for injury was employers failing to provide proper tools or equipment for the job being done. The themes that emerged from the analysis were lack of control over employment conditions and the risk of performing unsafe work in order to meet financial needs. This formative qualitative research informed a pilot test and subsequent clinical trial of injury risk reduction strategies for Latino day laborers. Interventions to protect day laborers from work-related injuries should be informed by recognizing the employment and social dilemmas they confront.

美国的拉丁裔日工通过非正式的工作安排为企业和房主提供技术劳动力。我们对德克萨斯州休斯顿的拉丁裔日工进行了探索性的定性研究,以调查他们对安全风险和工伤相关情况的看法。我们进行了34名参与者的焦点小组,并使用风险图和身体图活动来吸引拉丁裔日工更多地参与对话。参与者描述了影响他们工伤风险的身体、职业和心理社会危害。他们表示,雇主未能为正在进行的工作提供适当的工具或设备是造成伤害的重大风险。分析得出的主题是对就业条件缺乏控制,以及为满足经济需求而从事不安全工作的风险。这项形成性的定性研究为拉丁美洲日工减少伤害风险策略的试点测试和随后的临床试验提供了信息。应认识到日工面临的就业和社会困境,从而采取干预措施保护他们免受工伤。
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引用次数: 0
Health and Demographic Factors for Chronic Obstructive Pulmonary Disease Among Hispanic Adults in the United States: Analysis of Behavioral Risk Factor Surveillance System Survey Data. 美国西班牙裔成年人慢性阻塞性肺病的健康和人口因素:行为危险因素监测系统调查数据分析。
Pub Date : 2024-06-01 Epub Date: 2023-10-29 DOI: 10.1177/15404153231210863
Brandon Workman, Laura Nabors

Introduction: Appropriate diagnosis and regular primary care appointments are markers of quality chronic obstructive pulmonary disease (COPD) care. Underdiagnosis of COPD has been associated with an absence of health insurance, lower socioeconomic status, and race and ethnicity. Methods: This study examined predictors of COPD using data from the Behavioral Risk Factor Surveillance System (BRFSS, 2021) to provide information for prevention messaging and interventions. Participants included Hispanic adults (n = 17,782) aged 45 years and older. Chi-square tests and a multinomial logistic regression analysis (adjusted with the BRFSS weighting variable) were used to understand how sex, income, health status, smoking behaviors, asthma morbidity, and health insurance coverage were related to having COPD. Results: Patients with poor health, lower income level, current smokers, former smokers, or asthma were more likely to report COPD. Females were more likely to report COPD than males. Patients with COPD were more likely to be without health insurance when compared to those who did not have COPD, indicating unmet medical needs. Conclusion: Studies such as this one, aiming to evaluate the relationship between COPD prevalence and predictors of health and outcomes among Hispanic patients in the United States will remain important for developing health messaging to attenuate disease progression.

引言:适当的诊断和定期的初级保健预约是高质量慢性阻塞性肺病(COPD)护理的标志。COPD的诊断不足与缺乏医疗保险、社会经济地位低下以及种族和民族有关。方法:本研究使用行为危险因素监测系统(BRFSS,2021)的数据检查了COPD的预测因素,为预防信息和干预措施提供信息。参与者包括西班牙裔成年人(n = 17782),年龄在45岁及以上。卡方检验和多项逻辑回归分析(用BRFSS加权变量调整)用于了解性别、收入、健康状况、吸烟行为、哮喘发病率和健康保险覆盖率与COPD的关系。结果:健康状况不佳、收入水平较低、目前吸烟、以前吸烟或哮喘的患者更有可能报告COPD。女性比男性更有可能报告COPD。与没有COPD的患者相比,COPD患者更有可能没有医疗保险,这表明医疗需求没有得到满足。结论:这类旨在评估美国西班牙裔患者COPD患病率与健康和预后预测因素之间关系的研究,对于开发健康信息以减轻疾病进展仍然很重要。
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引用次数: 0
HIV-Related Stigma and Multidimensional Frailty Among Older Latinos With HIV. 感染艾滋病毒的拉丁美洲老年人中与艾滋病毒相关的污名和多维脆弱性。
Pub Date : 2024-06-01 Epub Date: 2023-10-19 DOI: 10.1177/15404153231208130
Evelyn Iriarte, Rosina Cianelli, Joseph P De Santis, Natalia Villegas, Lisette Irarrazabal, Catherine Jankowski, Elias Provencio-Vasquez

Introduction: Frailty is a geriatric syndrome of increased vulnerability to stressors marked by a higher risk for poor health outcomes. HIV-related stigma is a stressor for Latino people with HIV (PWH) and an important barrier to HIV care. This study examines the association between HIV-related stigma and multidimensional frailty among older Latino PWH. Methods: A cross-sectional design with 120 Latino PWH aged 50 and older was used. Self-reported questionnaires were administered to assess multidimensional frailty (Tilburg Frailty Indicator) and HIV-related stigma (HIV stigma scale). Results: Participants were 59.1 ± 7.0 years old, primarily White-Hispanic (85.00%, n = 102), single (48.33%, n = 58), and male (73.30%, n = 88). Nearly half of the participants were frail (45.85%, n = 55). Compared to non-frail, frail individuals had significantly higher scores in the total HIV-related stigma (M = 98.5 ± 24.7 vs. M = 85.3 ± 25.6, p = .020) and all subscales. The odds of multidimensional frailty were 1.021 times higher for people with higher HIV-related stigma scores (p = .007). This association remained significant after adjustment for income and comorbidities (p = .049). Conclusions: HIV-related stigma among older Latino PWH was significantly associated with their odds of being frail. Efforts to prevent multidimensional frailty should consider addressing HIV-related stigma through age-appropriate and culturally tailored resources for this group.

简介:虚弱是一种老年综合征,易受压力源的影响,其特征是健康状况不佳的风险更高。与艾滋病毒相关的污名是拉丁裔艾滋病毒感染者的压力源,也是艾滋病毒护理的重要障碍。这项研究调查了老年拉丁裔PWH中与艾滋病毒相关的污名与多层面虚弱之间的关系。方法:对120名50岁及以上的拉丁裔PWH进行横断面设计 已使用。自我报告问卷用于评估多维度虚弱(Tilburg虚弱指标)和HIV相关污名(HIV污名量表)。结果:参与者为59.1 ± 7.0岁,主要为西班牙裔白人(85.00%,n = 102),单个(48.33%,n = 58)和男性(73.30% = 88)。近一半的参与者身体虚弱(45.85% = 55)。与非体弱者相比,体弱者在总的HIV相关污名中的得分显著更高(M = 98.5 ± 24.7 vs.M = 85.3 ± 25.6,p = .020)和所有分量表。HIV相关污名评分较高的人出现多维虚弱的几率高出1.021倍(p = .007)。在对收入和合并症进行调整后,这种相关性仍然显著(p = .049)。结论:老年拉丁裔PWH中与HIV相关的污名与他们虚弱的几率显著相关。预防多层面虚弱的努力应考虑通过针对这一群体的适龄和文化定制资源来解决与艾滋病毒相关的污名化问题。
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引用次数: 0
Implementing Strategies to Recruit and Retain a Diverse Sample of Heart Failure Patients. 实施策略,招募并留住多样化的心衰患者样本。
Lila de Tantillo, Brian E. McCabe, Martin Zdanowicz, Johis Ortega, Juan M. Gonzalez, Sandra Chaparro
Introduction: The increased prevalence, severity, and mortality of heart disease and specifically heart failure among Hispanic and Black populations are a concern for clinicians and researchers. Additionally, patients of poor socioeconomic status also have worse outcomes for cardiovascular disease. To address disparities, it is necessary to address the persistent lack of representation in clinical research of diverse populations, including the Hispanic and Black populations and individuals who are of low socioeconomic status. Method: This study was a pilot randomized trial of a medication adherence intervention for heart failure patients conducted at a safety net hospital and affiliated pharmacy with a diverse patient population. Using an evidence-based multifactorial approach, this investigation implemented and adapted best practices to support the inclusion of Hispanic, Black, and socioeconomically diverse participants. Results: A total of 40 participants were recruited, 58% were Hispanic, 38% Black, and 5% White. A total of 40% reported the need for socioeconomic assistance. At 30 days after discharge, follow-up data were obtained for 37 of 40 (93%) of participants either by interview, electronic record, or both. Conclusion: Findings suggest that a combination of strategies used in this trial can be applied to recruit and retain ethnically and socioeconomically diverse participants.
导言:拉美裔和黑人心脏病,特别是心力衰竭的发病率、严重程度和死亡率的增加引起了临床医生和研究人员的关注。此外,社会经济地位较低的患者心血管疾病的治疗效果也较差。为了解决差异问题,有必要解决在临床研究中长期缺乏不同人群代表的问题,包括西班牙裔和黑人人群以及社会经济地位低下的个人。研究方法本研究是一项针对心力衰竭患者的用药依从性干预试点随机试验,在一家安全网医院及其附属药房进行,该医院的患者群体具有多样性。这项调查采用循证多因素方法,实施并调整了最佳实践,以支持纳入西班牙裔、黑人和社会经济地位不同的参与者。结果:共招募了 40 名参与者,其中 58% 为西班牙裔,38% 为黑人,5% 为白人。共有 40% 的人表示需要社会经济援助。出院后 30 天,通过访谈、电子记录或两种方式获得了 40 名参与者中 37 人(93%)的随访数据。结论研究结果表明,该试验中使用的策略组合可用于招募和留住不同种族和社会经济背景的参与者。
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引用次数: 0
Botánicas Function as Health Care Safety Nets Among Hispanic American Immigrants: A Brief Report. 植物园在西班牙裔美国移民中发挥着医疗安全网的作用:简要报告。
F. Brenes, Evan V. Goldstein, Ernesto Lázaro Sarduy, Richard Lazarus, Gabriela Fernandez, Federico A. Henriquez, Dariel Asgarali
As the U.S. population becomes more racially/ethnically diverse, the Hispanic American immigrant population has slowly grown in recent years. In the face of anti-immigrant policies, limited access to care, fear of deportation, discrimination, stigmatization, poverty, and other stressors, Hispanic American immigrants seek services from botánicas for religious, spiritual, medical, and psychosocial health reasons, including the accessibility and affordability of services from folk practitioners in these herbal dispensaries. Hispanics are the primary consumers of herbal remedies and complementary and alternative medicines in the United States. The purpose of this article is to emphasize the critical role of botánicas in the health and wellness of Hispanic American immigrants. Recommendations for health professionals are provided in the care of Hispanic Americans who utilize folk, traditional, and herbal medicines for health and healing.
随着美国人口的种族/族裔日益多元化,西班牙裔美国移民人口近年来也在缓慢增长。面对反移民政策、有限的医疗服务、对驱逐出境的恐惧、歧视、污名化、贫困和其他压力,西语裔美国移民出于宗教、精神、医疗和社会心理健康等原因,寻求草药药房的服务,包括这些草药药房的民间医师提供的服务的可及性和可负担性。在美国,西班牙裔是草药疗法以及补充和替代药物的主要消费者。本文旨在强调植物药房在美国西语裔移民的健康和保健方面发挥的关键作用。文章还为保健专业人员提供了一些建议,以帮助他们照顾那些利用民间、传统和草药来促进健康和治疗的西班牙裔美国人。
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引用次数: 0
Influence of Medical Interpreters on the Healthcare Experiences of Hospitalized Spanish-Speaking Patients. 医疗翻译对住院西班牙语患者医疗体验的影响。
Christian Arce Guzman, Catherin Morocho, Kristen Lentsch, Ashley D Meagher
Introduction: The perspective of hospitalized patients with limited English proficiency (LEP) in US hospitals interacting with language-discordant healthcare providers remains understudied. Our goal is to examine the inpatient experiences of Spanish-speaking patients and offer suggestions to improve patient satisfaction. Methods: A survey was administered to Spanish-speaking patients using interpreters during their admission to medicine at an urban, academic hospital. Qualitative thematic analysis of responses was conducted. Results: Thirty-six patients completed the survey. Despite limited use of interpreters, the majority of patients rated interpretation services as excellent, reported high level of involvement in care and respect of their opinions, and preferred video remote interpreting and in-person interpreters. Language barrier and cost affected patients' comfort level requesting health care services. The mean patient satisfaction score was 9.64. Patients suggested an increase in bilingual personnel, improved access to interpreters, specifically in-person. Conclusion: Although highly satisfied, patients reported inconsistent use of interpretation services in the inpatient setting and suboptimal access. Hospitals should strive to provide language-concordant care and patient-centered interpretation. Patients' understanding of their health care rights needs better assessment to ease the inpatient experience. Further research is needed to estimate the regard for autonomy by Spanish-speaking patients in their own care.
介绍:美国医院中英语水平有限(LEP)的住院病人在与语言不通的医疗服务提供者互动时的视角仍未得到充分研究。我们的目标是研究西班牙语患者的住院体验,并为提高患者满意度提供建议。调查方法我们对在一家城市学术医院就医期间使用翻译的西班牙语患者进行了一项调查。对回答进行了定性专题分析。结果:36 名患者完成了调查:36 名患者完成了调查。尽管对口译员的使用有限,但大多数患者将口译服务评为 "优秀",表示高度参与护理并尊重他们的意见,他们更喜欢视频远程口译和面对面口译。语言障碍和费用影响了患者申请医疗服务的舒适度。患者的平均满意度为 9.64 分。患者建议增加双语人员,改善获得口译服务的途径,特别是当面口译服务。结论:尽管患者的满意度很高,但他们表示在住院环境中使用口译服务的情况并不一致,而且获得口译服务的机会也不理想。医院应努力提供语言一致的医疗服务和以患者为中心的口译服务。需要更好地评估患者对其医疗保健权利的理解,以减轻住院患者的痛苦。需要进一步开展研究,以评估讲西班牙语的患者在其自身护理中对自主权的重视程度。
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引用次数: 0
Roe v. Wade Overturned: The Association of Acculturation with Interest in and Awareness of Hospital Services for Family Planning Among Hispanic Women. 罗伊诉韦德案被推翻:西语裔妇女的文化程度与对医院计划生育服务的兴趣和认识之间的关系》(The Association of Acculturation with Interest in and Awareness of Hospital Services for Family Planning Among Hispanic Women)。
Deborah Lee, Joshua Fogel, Linda Arce, Mohab Idriss, Madilyn Thomas, Mary Fatehi
Introduction: The overturning of Roe v. Wade impacted family planning services in many areas of the United States (US). Our study investigates the association of acculturation with interest in and awareness of family planning hospital services of contraception and elective termination of pregnancy among Hispanic women. Methods: We surveyed 306 Hispanic women at a public hospital in a Long Island suburb of New York City. Predictor variables were acculturation (language, media, ethnic social relations) measured by the Short Acculturation Scale for Hispanics and years lived in the US. Outcome variables were interest in and awareness of hospital services of family planning for elective abortion and non-elective non-abortion family planning methods. Results: For interest in hospital services, both language and ethnic social relations acculturation were significantly positively associated with almost all family planning methods whether abortion or non-abortion. However, media acculturation and years lived in the US were significantly positively associated with abortion but not the non-abortion methods. For awareness of hospital services, only language acculturation was significantly positively associated with abortion and some nonelective non-abortion family planning methods. Conclusion: We recommend that healthcare providers and hospitals should be aware of acculturation levels when providing counseling and information about family planning methods to Hispanic women.
导言:罗伊诉韦德案的推翻对美国许多地区的计划生育服务产生了影响。我们的研究调查了西语裔妇女的文化程度与对计划生育医院避孕和选择性终止妊娠服务的兴趣和认识之间的关系。研究方法:我们对纽约市长岛郊区一家公立医院的 306 名西班牙裔妇女进行了调查。预测变量为文化适应度(语言、媒体、种族社会关系),由西班牙裔文化适应度简易量表和在美居住年限测量。结果变量是对医院提供的选择性流产和非选择性非流产计划生育方法服务的兴趣和认识。结果:就对医院服务的兴趣而言,语言和种族社会关系文化程度与几乎所有的计划生育方法(无论是人工流产还是非人工流产)都呈显著正相关。然而,媒体文化程度和在美国生活的年数与堕胎有明显的正相关,但与非堕胎方法没有关系。在对医院服务的认识方面,只有语言文化程度与人工流产和一些非选择性的非人工流产计划生育方法呈显著正相关。结论:我们建议,医疗服务提供者和医院在为西班牙裔女性提供计划生育方法的咨询和信息时,应注意其文化程度。
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引用次数: 0
Internet-Based Access to Sexual and Reproductive Health Services Among Colombian Youth: A Cross-Sectional Study. 哥伦比亚青年通过互联网获得性健康和生殖健康服务的情况:一项横断面研究。
J. Brisson, Karena D. Volesky-Avellaneda
Introduction: Sexual and reproductive health (SRH) is a sensitive subject, and young people may be unfamiliar with how to access SRH services. In this cross-sectional study, we examined young people's internet use to understand how they accessed SRH clinics in Colombia. This study also explored Colombian youth's interest in online material teaching how to access SRH services. Methods: During August 2019-February 2020, patients aged 10-24 years old presenting at two SRH clinics in Colombia were invited to answer a survey. Chi-square tests were performed to assess possible differences in how participants inquired how to access the clinic according to sociodemographic characteristics. Results: Among the 812 patients who participated, 91.4% were female and the median age was 19 years. To inquire how to access the SRH clinic, 30.7% of participants asked their parent(s) and 24.0% used the internet. Participants aged 20-24 years old were more likely to use the internet compared to younger participants (p < .001). Most respondents (81.5%) were interested in the availability of online material explaining how to access SRH services. Conclusions: While Colombian youth learned about how to access SRH clinics from several different sources, the vast majority indicated their interest in having access to online materials explaining how to access SRH services.
导言:性与生殖健康(SRH)是一个敏感话题,年轻人可能不熟悉如何获得性与生殖健康服务。在这项横断面研究中,我们调查了哥伦比亚年轻人使用互联网的情况,以了解他们如何获得性与生殖健康诊所的服务。本研究还探讨了哥伦比亚青少年对教授如何获得性健康和生殖健康服务的在线资料的兴趣。研究方法在 2019 年 8 月至 2020 年 2 月期间,哥伦比亚两家性健康和生殖健康诊所邀请 10-24 岁的患者回答调查问卷。进行了卡方检验,以评估不同社会人口特征的参与者在询问如何就诊时可能存在的差异。结果显示在参与调查的 812 名患者中,91.4% 为女性,年龄中位数为 19 岁。在询问如何前往性健康和生殖健康诊所时,30.7%的参与者询问其父母,24.0%的参与者使用互联网。与年龄较小的参与者相比,20-24 岁的参与者更倾向于使用互联网(p < .001)。大多数受访者(81.5%)对提供解释如何获得性健康和生殖健康服务的在线资料感兴趣。结论:虽然哥伦比亚青年从多个不同渠道了解了如何获得性健康和生殖健康诊所的服务,但绝大多数人表示他们有兴趣获得解释如何获得性健康和生殖健康服务的在线资料。
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引用次数: 0
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Hispanic health care international : the official journal of the National Association of Hispanic Nurses
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