Contraceptive Use in Females With Advanced CKD: A Qualitative Study.
Contraceptive Use in Females With Advanced CKD: A Qualitative Study.
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DOI：
10.1016/j.xkme.2023.100738
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发表时间：
2023-12
期刊：
影响因子：
3.9
通讯作者：
Pensak, Meredith
中科院分区：
文献类型：
--
作者：
Shah, Silvi;Katz-Greenberg, Goni;Gudsoorkar, Priyanka;Vyas, Prema;Barhorst, Sunshine;Verma, Prasoon;Pensak, Meredith
患有肾脏疾病的女性怀孕并不少见，并且与不良的母体和胎儿结局相关。患有慢性肾病的女性使用避孕措施的比例仍然很低。我们试图描述患有晚期慢性肾病的女性患者对避孕措施的看法。定性研究。我们进行了 5 次焦点小组访谈，涉及美国 16 名晚期慢性肾病成年女性患者（n = 3 名非透析非移植慢性肾病，n = 9 名肾移植患者，n = 4 名接受透析的肾衰竭患者），随后达到主题饱和。对访谈记录进行了主题分析。我们确定了以下 5 个主题：1）有关肾病生殖健康的知识参差不齐，2）避孕药具使用咨询不足，3）避孕药具使用缺乏跨学科协调，4）可用于指导避孕药具讨论的教育资源不足，5）需要进行研究以更好地了解肾病女性的生殖需求。患者来自美国的一个中心，该研究受到研究结果向其他环境的可转移性的限制。慢性肾病患者报告称，他们在生殖健康方面面临情感挑战，缺乏咨询和护理协调，以及避孕资源不足。加强这些因素的策略可能会提高生殖保健的质量，并增加患有慢性肾病的女性的避孕措施的使用。患有肾脏疾病的女性怀孕很常见，并且与母体和胎儿不良结局的风险较高相关，但避孕措施的使用率仍然很低。人们对女性患者避孕的经历知之甚少，这可能是导致这一高危人群避孕措施使用率较低的原因。在本研究中，采用焦点小组访谈的方式，慢性肾病患者报告了生殖健康方面的情绪挑战、缺乏咨询和护理协调以及避孕使用资源不足。需要采取干预措施来加强这些因素，以提高生殖保健的质量并增加患有慢性肾病的女性的避孕药具的使用。
Pregnancy in females with kidney disease is not uncommon and is associated with adverse maternal and fetal outcomes. The use of contraception in females with chronic kidney disease remains low. We sought to describe the perspectives of female patients with advanced chronic kidney disease on the use of contraception. Qualitative study. We conducted 5 focus group interviews involving 16 adult female patients with advanced chronic kidney disease (n = 3 nondialysis nontransplant chronic kidney disease, n = 9 kidney transplant, and n = 4 kidney failure receiving dialysis) in the United States, following which thematic saturation was reached. Interview transcripts were analyzed thematically. We identified the following 5 themes: 1) variable knowledge regarding reproductive health with kidney disease, 2) inadequate counseling about contraceptive use, 3) lack of interdisciplinary coordination regarding contraceptive use, 4) insufficient educational resources available to guide the contraceptive discussion, and 5) need for research to better understand reproductive needs in females with kidney disease. Patients were from a single center in the United States, and the study is limited by the transferability of findings to other settings. Patients with chronic kidney disease report emotional challenges with reproductive health, lack of counseling and care coordination, and insufficient resources for contraceptive use. Strategies to strengthen these factors may improve the quality of reproductive care and increase contraceptive use for females with chronic kidney disease. Pregnancy in females with kidney disease is common and associated with a higher risk of adverse maternal and fetal outcomes, but the use of contraception remains low. Little is known about female patients’ experiences in contraceptive use that may contribute to low contraceptive use in this high-risk population. In the present study using focus group interviews, patients with chronic kidney disease reported emotional challenges with reproductive health, lack of counseling and care coordination, and insufficient resources for contraceptive use. Interventions are needed to strengthen these factors to improve the quality of reproductive care and increase contraceptive use for females with chronic kidney disease.
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