Information needs and experiences from pregnancies complicated by hypertensive disorders: a qualitative analysis of narrative responses.
Information needs and experiences from pregnancies complicated by hypertensive disorders: a qualitative analysis of narrative responses.
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DOI：
10.1186/s12884-021-04219-0
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发表时间：
2021-11-02
影响因子：
3.1
通讯作者：
Vidler M
中科院分区：
文献类型：
--
作者：
Shree R;Hatfield-Timajchy K;Brewer A;Tsigas E;Vidler M
在广泛的医疗保健环境中迫切需要纳入患者的声音，但在产科文献中尤其缺乏。系统地获取有关妊娠期高血压疾病 (HDP)（尤其是先兆子痫）患者经历的信息对于改善医患沟通并最终为以患者为中心的护理和研究提供信息是必要的。我们试图调查妊娠合并高血压疾病的患者的信息需求和经历。我们对先兆子痫登记处 (TPR) 的一个开放式问题的叙述反应进行了定性内容分析，该登记处是先兆子痫基金会主办的在线登记处。邀请个人通过社交媒体、网络搜索和时事通讯注册 TPR。我们的分析仅限于那些自我报告 HDP 病史的参与者，并回答了开放式问题：“您在这次怀孕时可以获得任何有用的信息吗？”。包括 2013 年 7 月至 2017 年 3 月的可用答复。多个编码员使用归纳方法对叙述性响应进行编码、协调和主题分析。我们的主要结果指标包括参与者表达的需求以及对其 HDP 妊娠的其他担忧。在 3202 名登记参与者中，有 1850 人完成了调查并自我报告至少有一次妊娠并发 HDP，其中 895 人 (48.4%) 回答了开放式问题。参与者在美国 (83%) 和其他 27 个国家交付。与无应答者相比，应答者报告了更严重的 HDP 表型和不良后代结果。我们从回复中确定了三个主要主题：患者确定的需求、管理和咨询以及潜在的行动。反馈显示，参与者对 HDP 的基本了解，包括症状、管理、治疗策略和产后并发症，明显缺乏。应答者强烈希望改善咨询服务，以便他们和他们的提供者能够协作诊断、适当管理以及强有力和持续的沟通，以促进合作伙伴关系来解决任何 HDP 并发症。参与者对其 HDP 经历的回答为了解患者的观点提供了不可或缺的见解。我们的研究表明，需要改进有关可能的 HDP 并发症的教育，以及在评估过程中考虑 HDP 及其相关结果的透明度，并应努力实施这些策略。先兆子痫登记处：NCT02020174
Incorporation of the patient voice is urgently needed in a broad array of health care settings, but it is particularly lacking in the obstetrical literature. Systematically derived information about patients’ experience with hypertensive disorders of pregnancy (HDP), most notably preeclampsia, is necessary to improve patient-provider communication and ultimately inform patient-centered care and research. We sought to examine the information needs and experiences of individuals with pregnancies complicated by hypertensive disorders. We conducted a qualitative content analysis of narrative-responses to an open-ended question from the Preeclampsia Registry (TPR), an online registry hosted by the Preeclampsia Foundation. Individuals were invited to enroll in TPR via social media, web searches, and newsletters. We restricted our analysis to participants who self-reported a history of HDP and responded to the open-ended question, “Is there any information that you could have had at the time of this pregnancy that would have been helpful?”. Available responses from July 2013 to March 2017 were included. Narrative responses were coded, reconciled, and thematically analyzed by multiple coders using an inductive approach. Our main outcome measures included participants’ expressed needs and additional concerns with respect to their HDP pregnancy. Of 3202 enrolled participants, 1850 completed the survey and self-reported having at least one pregnancy complicated by HDP, of which 895 (48.4%) responded to the open-ended question. Participants delivered in the United States (83%) and 27 other countries. Compared to non-responders, responders reported more severe HDP phenotypes and adverse offspring outcomes. We identified three principal themes from responses: patient-identified needs, management and counseling, and potential action. Responses revealed that participants’ baseline understanding of HDP, including symptoms, management, therapeutic strategies, and postpartum complications, was demonstrably lacking. Responders strongly desired improved counseling so that both they and their providers could collaboratively diagnose, appropriately manage, and robustly and continuously communicate to facilitate a partnership to address any HDP complications. Participants’ responses regarding their HDP experience provide indispensable insight into the patient’s perspectives. Our study suggests that improved education regarding possible HDP complications and transparency about the consideration of HDP and its associated outcomes during an evaluation are needed, and efforts to implement these strategies should be sought. The Preeclampsia Registry: NCT02020174
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影响因子：
7.2
作者：
通讯作者：
--
DOI：
10.1136/bmj.f6564
发表时间：
2013-11-07
期刊：
BMJ (Clinical research ed.)
影响因子：
--
作者：
Ananth CV;Keyes KM;Wapner RJ
通讯作者：
Wapner RJ
DOI：
10.1016/j.jamcollsurg.2016.10.032
发表时间：
2017-02-01
影响因子：
5.2
作者：
Pellegrini, Carlos A.
通讯作者：
Pellegrini, Carlos A.
DOI：
10.1111/j.1471-0528.1992.tb13818.x
发表时间：
1992-07-01
期刊：
BRITISH JOURNAL OF OBSTETRICS AND GYNAECOLOGY
影响因子：
--
作者：
DULEY, L
通讯作者：
DULEY, L
DOI：
10.1161/cir.0b013e31820faaf8
发表时间：
2011-03-22
影响因子：
24
作者：
Mosca, Lori;Benjamin, Emelia J.;Zhao, Dong
通讯作者：
Zhao, Dong