Saving time, signaling trust: Using the PROMOTE self-report screening instrument to enhance prenatal care quality and therapeutic relationships.
Saving time, signaling trust: Using the PROMOTE self-report screening instrument to enhance prenatal care quality and therapeutic relationships.
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DOI：
10.1016/j.pecinn.2022.100030
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发表时间：
2022-12-01
期刊：
影响因子：
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通讯作者：
Lobel, Marci
中科院分区：
文献类型：
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作者：
Preis, Heidi;Whitney, Clare;Lobel, Marci
目的：在产前护理中全面筛查心理社会脆弱性和药物使用情况，对于促进孕妇的健康和福祉至关重要。有效实施新的筛查程序和工具应伴随着深入的调查，以评估其可行性和对护理提供的影响。方法：在2020年，在实施孕产妇和产科治疗效果简介（PROMOTE）后，这是一种为美国门诊产前诊所开发的创新自我报告筛查工具，我们对22名助产士、执业护士和产科住院医师进行了个别访谈和焦点小组讨论，重点关注PROMOTE及其对护理提供的影响。我们使用解释性描述对访谈进行定性分析。结果：确定了五个主题：有效引导时间：“我没有的时间”、防止错过护理、发出可信度信号、建立创伤知情基金会以及促进“诚实”的患者披露。结论：访谈表明，患者在医疗接触前完成PROMOTE有助于减少先前报告的障碍，更具时效性，让历史记录更容易创新：研究结果提供了对PROMOTE产生的临床影响的广度和深度的洞察，并为实施此类工具以优化健康结果提供指导。
Objectives: Comprehensive screening of psychosocial vulnerabilities and substance use in prenatal care is critical to promote the health and well-being of pregnant patients. Effective implementation of new screening procedures and instruments should be accompanied by an in-depth investigation to assess their feasibility and impact on care delivery.Methods: In 2020, following implementation of the Profile for Maternal and Obstetric Treatment Effectiveness (PROMOTE) an innovative self-report screening instrument developed for outpatient prenatal clinics in the U.S., we conducted individual interviews and focus groups with twenty-two midwives, nurse practitioners, and obstetric residents focused on the PROMOTE and its impacts on care delivery. We used interpretive description for the qualitative analysis of the interviews.Results: Five themes were identified: Guiding Time Efficiently: "The Time I Don't Have," Preventing Missed Care, Signaling Trustworthiness, Establishing Trauma-Informed Foundations, and Promoting "Honest" Patient Disclosure.Conclusion: Interviews suggest that patient completion of the PROMOTE before the medical encounter helps reduce previously reported barriers, is more time-effective, and makes history-taking easier. It also facilitates the patient-provider relationship.Innovation: Findings offer insight into the breadth and depth of clinical impact resulting from the PROMOTE, and provide guidance for the implementation of such tools to optimize health outcomes.