Interventions for and experiences of shared decision-making underpinning reproductive health, family planning options and pregnancy for women with or at high risk of kidney disease: a systematic review and qualitative framework synthesis.
Interventions for and experiences of shared decision-making underpinning reproductive health, family planning options and pregnancy for women with or at high risk of kidney disease: a systematic review and qualitative framework synthesis.
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DOI：
10.1136/bmjopen-2022-062392
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发表时间：
2022-08-08
期刊：
影响因子：
2.9
通讯作者：
Noyes, Jane
中科院分区：
文献类型：
--
作者：
Mc Laughlin, Leah;Neukirchinger, Barbara;Noyes, Jane
确定干预效果并综合定性研究，探讨患有或处于肾病高风险的妇女在生殖健康、计划生育选择和怀孕方面共同决策的经历。干预措施的系统回顾和定性证据综合。我们检索了Cochrane、CINAHL、MEDLINE、Scopus、ProQuest、Elsevier、PubMed、ScienceDirect和Web of Science。从1980年至2021年1月以英文发表的涉及患有或处于肾病高风险的妇女的生殖健康的共同决策干预措施和定性研究（临床环境，全球视角）。根据纳入标准筛选标题，并由整个团队对全文文章进行审查。进行了框架综合。我们筛选了1898项研究。未发现循证干预措施。包括18项定性研究，11项肾脏疾病特异性研究和7项肾脏疾病为常见合并症的研究。妇女经常对她们的生育选择感到措手不及和不知情。与医疗保健专业人员的对话通常被描述为令人沮丧和无益的，通常是由于感知到自主权的丧失以及偏好和生活目标的不匹配。共同决策的例子很少。肾病加剧了社会对传统性别角色（如妻子、母亲、照料者）的期望，包括生育能力和相关因素，例如养育子女、（性）关系、身体形象和独立生活（包括组建家庭的经济障碍）。地方干预仅限于各种咨询。开发了一种新的卫生系统模式，以支持新的干预措施。显然需要建立新的干预措施，对已经在开发中的干预措施进行试验，并为管理患有或处于肾病高风险的妇女的生殖健康制定新的临床指导，包括早期保持生育能力的各种选择。其他已建立个性化生殖保健方案的健康状况，例如癌症，可以与这里开发的新模型一起用于基准肾脏实践。
To determine intervention effects and synthesise qualitative research that explored women with or at high risk of kidney disease experiences of shared decision-making in relation to their reproductive health, family planning options and pregnancy. A systematic review of interventions and a qualitative evidence synthesis. We searched Cochrane, CINAHL, MEDLINE, Scopus, ProQuest, Elsevier, PubMed, ScienceDirect and Web of Science. Shared decision-making interventions and qualitative studies related to reproductive health involving women with or at high risk of kidney disease published from 1980 until January 2021 in English (clinical settings, global perspective). Titles were screened against the inclusion criteria and full-text articles were reviewed by the whole team. Framework synthesis was undertaken. We screened 1898 studies. No evidence-based interventions were identified. 18 qualitative studies were included, 11 kidney disease-specific studies and 7 where kidney disease was a common comorbidity. Women frequently felt unprepared and uninformed about their reproductive options. Conversations with healthcare professionals were commonly described as frustrating and unhelpful, often due to a perceived loss of autonomy and a mismatch in preferences and life goals. Examples of shared decision-making were rare. Kidney disease exacerbated societal expectations of traditional gender roles (eg, wife, mother, carer) including capability to have children and associated factors, for example, parenting, (sexual) relationships, body image and independent living (including financial barriers to starting a family). Local interventions were limited to types of counselling. A new health system model was developed to support new interventions. There is a clear need to establish new interventions, test those already in development and develop new clinical guidance for the management of women with or at high risk of kidney disease in relation to their reproductive health, including options to preserve fertility earlier. Other health conditions with established personalised reproductive care packages, for example, cancer, could be used to benchmark kidney practice alongside the new model developed here.
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影响因子：
168.9
作者：
Devuyst, Olivier;Knoers, Nine V. A. M.;Remuzzi, Giuseppe;Schaefer, Franz
通讯作者：
Schaefer, Franz
影响因子：
5.4
作者：
Clarke, Angus;Sarangi, Srikant;Verrier-Jones, Kate
通讯作者：
Verrier-Jones, Kate
影响因子：
2.3
作者：
Chuang CH;Velott DL;Weisman CS
通讯作者：
Weisman CS
影响因子：
--
作者：
Charles, C;Whelan, T;Gafni, A
通讯作者：
Gafni, A
DOI：
10.2147/ijwh.s76819
发表时间：
2016
期刊：
International journal of women's health
影响因子：
--
作者：
Fitzpatrick A;Mohammadi F;Jesudason S
通讯作者：
Jesudason S