"I know my body better than you:" patient focus groups to inform a decision aid on oral corticosteroid use during pregnancy.
"I know my body better than you:" patient focus groups to inform a decision aid on oral corticosteroid use during pregnancy.
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DOI：
10.1002/pds.5183
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发表时间：
2021-04
影响因子：
2.6
通讯作者：
Kharbanda EO
中科院分区：
文献类型：
--
作者：
Palmsten K;Bredesen D;JaKa MM;Kumar PC;Ziegenfuss JY;Kharbanda EO
关于妊娠期间药物使用的决策支持需求尚未得到满足。我们的目的是通过焦点小组为妊娠期间口服皮质类固醇（OCS）使用决策辅助的发展提供信息。我们邀请了来自一个卫生系统的患者，他们最近有过活产，并且有可能开出OCS的条件（即，哮喘或其他自身免疫性疾病）参加焦点小组。我们使用归纳编码对焦点小组的逐字记录进行了传统的定性内容分析。2019年5月至6月，共有30名参与者参加了五个焦点小组。妇女赞同有必要在怀孕期间就OCS的使用进行患者-提供者讨论，其中提供者分享风险和益处，患者做出决定。此外，妇女普遍表示支持以患者为中心的关于怀孕期间使用OCS的讲义，提供者与患者讨论。当考虑是否在怀孕期间服用OCS时，女性担心：药物对婴儿的影响（例如，流产、出生缺陷、长期影响），自身（例如，对情绪、睡眠、体重增加的影响），妊娠并发症（例如，早产、血压升高）和哺乳。妇女希望获得有关OCS的信息（例如，适应症、治疗时间和费用）、替代治疗和不服用OCS的风险。我们确定了患者对妊娠期间使用OCS的决策辅助的需求，提供者可以与患者讨论。为了解决患者的担忧，援助应至少描述药物对婴儿的影响，包括长期影响，孕产妇健康，妊娠并发症和哺乳。
There is unmet need for decision support regarding medication use during pregnancy. We aimed to inform the development of a decision aid on oral corticosteroid (OCS) use during pregnancy through focus groups. We invited patients from one health system who had a recent live birth and a condition for which OCSs may be prescribed (i.e., asthma or other autoimmune disease) to participate in focus groups. We conducted conventional qualitative content analysis of verbatim transcripts of the focus groups using inductive coding. There were 30 participants across five focus groups from May-June 2019. Women endorsed the need for patient-provider discussions about OCS use during pregnancy in which the provider shares risks and benefits and the patient makes her decision. Furthermore, women generally expressed support for patient-centered handouts about OCS use during pregnancy that the provider discusses with the patient. When considering whether to take OCSs in pregnancy, women had concerns about: the medication’s impact on their baby (e.g., miscarriage, birth defects, long-term effects), themselves (e.g., effects on mood, sleep, weight gain), pregnancy complications (e.g., preterm birth, increased blood pressure), and lactation. Women wanted information on OCSs (e.g., indications, length of treatment, and cost), alternative treatments, and risks of not taking OCSs. We established patient need for a decision aid on OCS use during pregnancy that providers can discuss with patients. To address patient concerns, the aid should at a minimum describe the medication’s impact on baby, including long-term effects, maternal health, pregnancy complications, and lactation.
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影响因子：
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作者：
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