Experiences of Preconception Counseling among Pregnant Women with Preexisting Diabetes: Opportunities to Improve Patient-Centered Care.
Experiences of Preconception Counseling among Pregnant Women with Preexisting Diabetes: Opportunities to Improve Patient-Centered Care.
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DOI：
10.3390/ijerph20042908
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发表时间：
2023-02-07
影响因子：
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通讯作者：
Irani, Roxanna A
中科院分区：
文献类型：
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作者：
Marshall, Cassondra J;Parham, Lindsay;Hubbard, Erin;Irani, Roxanna A
现有的研究表明，糖尿病患者没有定期接受孕前咨询，但有关患者咨询经验的信息很少。我们进行了一项定性研究，涉及2020年10月至2021年2月期间对22名患者进行的半结构化访谈。从北方加州的一个大型学术医学中心的糖尿病和妊娠专科诊所招募了已有糖尿病的妊娠患者。访谈被转录，编码，并使用归纳和演绎内容分析方法进行分析。共有27%的人报告说，他们在怀孕前没有与卫生保健提供者进行任何与怀孕有关的讨论。在那些这样做的人中，许多人寻求咨询;这通常与怀孕的“计划”有关。很少有参与者，几乎所有的1型糖尿病患者，报告有一个正式的孕前保健访问。参与者描述了他们收到的信息主要是关于糖尿病和怀孕的风险。虽然寻求咨询的参与者通常报告他们的提供者支持他们怀孕的愿望，但也有一些例外，特别是所有2型糖尿病患者。参与者的不同经历表明，在向糖尿病患者提供孕前咨询方面存在差距，并建议咨询可能因糖尿病类型而异。有机会改善以病人为中心的咨询。
Available research suggests that patients with diabetes do not regularly receive preconception counseling, but information on patients’ experiences of counseling is scant. We conducted a qualitative study involving semi-structured interviews with 22 patients between October 2020 and February 2021. Pregnant patients with preexisting diabetes were recruited from a specialty diabetes and pregnancy clinic at a large academic medical center in Northern California. Interviews were transcribed, coded, and analyzed using an inductive and deductive content analysis approach. A total of 27% reported they did not have any pregnancy-related discussions with a health care provider before pregnancy. Of those that did, many sought out counseling; this was often connected to how “planned” the pregnancy was. Few participants, nearly all with type 1 diabetes, reported having a formal preconception care visit. Participants described receiving information mostly about the risks associated with diabetes and pregnancy. While participants who sought out counseling generally reported their providers were supportive of their desire for pregnancy, there were a few exceptions, notably all among patients with type 2 diabetes. The varied experiences of participants indicate gaps in the delivery of pre-pregnancy counseling to patients with diabetes and suggest counseling may vary based on diabetes type. There are opportunities to improve the patient-centeredness of counseling.