Cargando…

Chlamydia screening practices among physicians and community nurses in Yukon, Canada

BACKGROUND: Yukon, a territory in northern Canada, has one of the highest reported sexually transmitted chlamydia infection rates in the country. OBJECTIVE: We examined screening practices among physicians and community nurses to elucidate factors that may be contributing to the high rates. DESIGN:...

Descripción completa

Detalles Bibliográficos
Autores principales: Machalek, Karolina, Hanley, Brendan E., Kajiwara, Joy N., Pasquali, Paula E., Stannard, Cathy J.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Co-Action Publishing 2013
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3753158/
https://www.ncbi.nlm.nih.gov/pubmed/23984299
http://dx.doi.org/10.3402/ijch.v72i0.21607
_version_ 1782281789509730304
author Machalek, Karolina
Hanley, Brendan E.
Kajiwara, Joy N.
Pasquali, Paula E.
Stannard, Cathy J.
author_facet Machalek, Karolina
Hanley, Brendan E.
Kajiwara, Joy N.
Pasquali, Paula E.
Stannard, Cathy J.
author_sort Machalek, Karolina
collection PubMed
description BACKGROUND: Yukon, a territory in northern Canada, has one of the highest reported sexually transmitted chlamydia infection rates in the country. OBJECTIVE: We examined screening practices among physicians and community nurses to elucidate factors that may be contributing to the high rates. DESIGN: Cross-sectional survey. METHODS: A questionnaire was distributed to all physicians in Yukon and all community nurses in Yukon's communities. We surveyed sexual health assessment frequency, chlamydia testing frequency and barriers to screening. Comparison of physician testing practices was performed to another Canadian jurisdiction, which previously undertook a similar survey. Survey results were compared to the available laboratory data in Yukon. RESULTS: Eligible physicians and nurses, 79% and 77%, respectively, participated in the survey. Physicians tested 15 to 24-year-old females more frequently than 15 to 24-year-old males for chlamydia (p=0.007). Physicians who asked sexual health assessment questions were more likely to test for chlamydia in both females (p<0.001) and males (p=0.032). More physicians screened females based on risk factors compared to males. General practice physicians in Yukon were more likely to test females for chlamydia than general practice physicians in Toronto, Canada (p<0.001). Community nurses had different testing patterns than physicians, with a lower overall frequency of testing, equal frequency of testing males and females, and in applying risk factor-based screening to both males and females. Barriers to screening included testing causing patient discomfort, patients reluctant to discuss screening, health provider uncomfortable conducting sexually transmitted infection tests and sexual health assessments, among others. Laboratory data in Yukon appear to confirm provider screening patterns. CONCLUSIONS: This survey provides valuable information on health provider screening patterns. We have some evidence which suggests that chlamydia testing rates may be higher among patients seen by physicians in Yukon in comparison to another Canadian jurisdiction. However, more consistent application of optimal screening methods with support to “start the conversation” around sexual health may assist in overcoming barriers to screening and in addressing Yukon's high rate of chlamydia.
format Online
Article
Text
id pubmed-3753158
institution National Center for Biotechnology Information
language English
publishDate 2013
publisher Co-Action Publishing
record_format MEDLINE/PubMed
spelling pubmed-37531582013-08-27 Chlamydia screening practices among physicians and community nurses in Yukon, Canada Machalek, Karolina Hanley, Brendan E. Kajiwara, Joy N. Pasquali, Paula E. Stannard, Cathy J. Int J Circumpolar Health Supplement 1, 2013 BACKGROUND: Yukon, a territory in northern Canada, has one of the highest reported sexually transmitted chlamydia infection rates in the country. OBJECTIVE: We examined screening practices among physicians and community nurses to elucidate factors that may be contributing to the high rates. DESIGN: Cross-sectional survey. METHODS: A questionnaire was distributed to all physicians in Yukon and all community nurses in Yukon's communities. We surveyed sexual health assessment frequency, chlamydia testing frequency and barriers to screening. Comparison of physician testing practices was performed to another Canadian jurisdiction, which previously undertook a similar survey. Survey results were compared to the available laboratory data in Yukon. RESULTS: Eligible physicians and nurses, 79% and 77%, respectively, participated in the survey. Physicians tested 15 to 24-year-old females more frequently than 15 to 24-year-old males for chlamydia (p=0.007). Physicians who asked sexual health assessment questions were more likely to test for chlamydia in both females (p<0.001) and males (p=0.032). More physicians screened females based on risk factors compared to males. General practice physicians in Yukon were more likely to test females for chlamydia than general practice physicians in Toronto, Canada (p<0.001). Community nurses had different testing patterns than physicians, with a lower overall frequency of testing, equal frequency of testing males and females, and in applying risk factor-based screening to both males and females. Barriers to screening included testing causing patient discomfort, patients reluctant to discuss screening, health provider uncomfortable conducting sexually transmitted infection tests and sexual health assessments, among others. Laboratory data in Yukon appear to confirm provider screening patterns. CONCLUSIONS: This survey provides valuable information on health provider screening patterns. We have some evidence which suggests that chlamydia testing rates may be higher among patients seen by physicians in Yukon in comparison to another Canadian jurisdiction. However, more consistent application of optimal screening methods with support to “start the conversation” around sexual health may assist in overcoming barriers to screening and in addressing Yukon's high rate of chlamydia. Co-Action Publishing 2013-08-05 /pmc/articles/PMC3753158/ /pubmed/23984299 http://dx.doi.org/10.3402/ijch.v72i0.21607 Text en © 2013 Karolina Machalek et al. http://creativecommons.org/licenses/by/2.0/ This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle Supplement 1, 2013
Machalek, Karolina
Hanley, Brendan E.
Kajiwara, Joy N.
Pasquali, Paula E.
Stannard, Cathy J.
Chlamydia screening practices among physicians and community nurses in Yukon, Canada
title Chlamydia screening practices among physicians and community nurses in Yukon, Canada
title_full Chlamydia screening practices among physicians and community nurses in Yukon, Canada
title_fullStr Chlamydia screening practices among physicians and community nurses in Yukon, Canada
title_full_unstemmed Chlamydia screening practices among physicians and community nurses in Yukon, Canada
title_short Chlamydia screening practices among physicians and community nurses in Yukon, Canada
title_sort chlamydia screening practices among physicians and community nurses in yukon, canada
topic Supplement 1, 2013
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3753158/
https://www.ncbi.nlm.nih.gov/pubmed/23984299
http://dx.doi.org/10.3402/ijch.v72i0.21607
work_keys_str_mv AT machalekkarolina chlamydiascreeningpracticesamongphysiciansandcommunitynursesinyukoncanada
AT hanleybrendane chlamydiascreeningpracticesamongphysiciansandcommunitynursesinyukoncanada
AT kajiwarajoyn chlamydiascreeningpracticesamongphysiciansandcommunitynursesinyukoncanada
AT pasqualipaulae chlamydiascreeningpracticesamongphysiciansandcommunitynursesinyukoncanada
AT stannardcathyj chlamydiascreeningpracticesamongphysiciansandcommunitynursesinyukoncanada