变性和非二元成人在初级保健中的经历:系统回顾。

IF 2.3 4区 医学 Q2 MEDICINE, GENERAL & INTERNAL European Journal of General Practice Pub Date : 2024-12-01 Epub Date: 2024-01-10 DOI:10.1080/13814788.2023.2296571
Daisy Holland, Luka C J White, Marija Pantelic, Carrie Llewellyn
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引用次数: 0

摘要

背景:变性人和非二元人(TNB)在初级医疗服务中面临障碍,而初级医疗服务仍是英国人获得性别确认医疗服务的主要切入点:本系统性综述旨在总结有关变性人和非二元性(TNB)人群在初级医疗服务中的经历的证据,为改善服务和患者疗效提供参考:本综述遵循系统综述和荟萃分析首选报告项目(PRISMA)报告指南。我们使用与性别认同、初级保健和经历相关的既定关键词,在 Ovid Medline、Ovid Embase 和 PsychInfo 上对 2005 年至 2023 年 4 月期间的文章进行了系统性文献检索。对定性数据进行了专题分析,并使用描述性叙述对定量数据进行了汇编:根据资格标准,16 篇文章被纳入本综述。本综述确定了TNB人群在初级医疗服务提供者知识、患者与提供者的关系以及医疗环境等方面遇到的促进因素、限制因素和障碍。定量研究结果显示,多达54.4%的参与者在与医生讨论TNB问题时感到不自在。总体研究结果表明,TNB人群在使用初级医疗服务时面临着系统性歧视,但也有报道称他们在当地遇到了积极的医疗服务。受访者表示,希望在当地TNB社区的参与下,提供以初级医疗为主导的性别平等医疗服务:本综述展示了TNB人群对初级医疗服务的不同体验,以及他们对改善服务的建议。这是首次对该主题的证据进行系统回顾,强调了临床医生和政策制定者在服务设计和改进过程中以TNB群体的声音为中心的必要性。
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The experiences of transgender and nonbinary adults in primary care: A systematic review.

Background: Transgender and nonbinary (TNB) people face barriers to primary care, which remains the main entry point for accessing gender-affirming healthcare in the UK.

Objectives: This systematic review aims to summarise the evidence regarding TNB people's experiences of primary care to inform improvements in service and patient outcomes.

Methods: This review followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) reporting guidelines. A systematic literature search was conducted across articles from 2005 to April 2023 across Ovid Medline, Ovid Embase and PsychInfo using established keywords relating to gender identity, primary care and experiences. Qualitative data were thematically analysed and quantitative data were compiled using a descriptive narrative.

Results: Following eligibility criteria, 16 articles were included in this review. This review identified both facilitators and limitations and barriers experienced by TNB people related to primary care provider knowledge; the patient-provider relationship, and healthcare settings. Quantitative findings reported up to 54.4% of participants were uncomfortable discussing TNB issues with their physician. Overall findings suggest TNB people face discrimination on a systemic level utilising primary care services, though positive healthcare encounters at a local level were reported. Participants expressed a desire for primary care-led gender-affirming healthcare services, with involvement from local TNB communities.

Conclusion: This review demonstrates TNB people's mixed experiences of primary care alongside their recommendations for service improvement. This is the first systematically reviewed evidence on the topic, emphasising the need for clinicians and policymakers to centre the voices of the TNB community in service design and improvement.

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来源期刊
European Journal of General Practice
European Journal of General Practice PRIMARY HEALTH CARE-MEDICINE, GENERAL & INTERNAL
CiteScore
5.10
自引率
5.90%
发文量
31
审稿时长
>12 weeks
期刊介绍: The EJGP aims to: foster scientific research in primary care medicine (family medicine, general practice) in Europe stimulate education and debate, relevant for the development of primary care medicine in Europe. Scope The EJGP publishes original research papers, review articles and clinical case reports on all aspects of primary care medicine (family medicine, general practice), providing new knowledge on medical decision-making, healthcare delivery, medical education, and research methodology. Areas covered include primary care epidemiology, prevention, diagnosis, pharmacotherapy, non-drug interventions, multi- and comorbidity, palliative care, shared decision making, inter-professional collaboration, quality and safety, training and teaching, and quantitative and qualitative research methods.
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