Missingness patterns in a comprehensive instrument identifying psychosocial and substance use risk in antenatal care.
Missingness patterns in a comprehensive instrument identifying psychosocial and substance use risk in antenatal care.
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DOI：
10.1080/02646838.2021.2004302
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发表时间：
2023-09
影响因子：
2.5
通讯作者：
Marci, Lobel
中科院分区：
文献类型：
--
作者：
Preis, Heidi;Djuric, Petar M.;Ajirak, Marzieh;Mane, Vibha;Garry, David J.;Garretto, Diana;Herrera, Kimberly;Heiselman, Cassandra;Marci, Lobel
关键词：
社会心理脆弱性（例如，社会支助不足、经济无保障、压力）和使用药物增加了围产期不良结果和孕产妇精神健康发病率的风险。然而，各种障碍，包括缺乏有效、简单和可用的综合工具，阻碍了在首次产前保健检查中筛查此类脆弱性的建议的执行。目前的研究提出了一个新实施的自我报告工具，以克服产前门诊筛查障碍的结果。这是对904名妇女的回顾性图表审查，这些妇女在2019年6月至12月的首次产前检查期间完成了孕产妇和产科治疗有效性概况（PROMOTE）。PROMOTE包括4项NIDA快速筛选和15个额外项目，每个项目评估不同的心理社会脆弱性。统计分析包括缺失数据的评价，以及使用单变量相关性和分层聚类对缺失数据模式的探索。四分之三的女性（70.0%）没有丢失物品。在整个样本中，除了四个PROMOTE项目（阿片类药物使用，计划怀孕，教育水平和财务状况）外，所有项目的缺失值均< 5%，表明具有良好的可接受性和可行性。一些受访者相关的特征，如教育程度较低，家庭支持较少，更大的压力与更大的可能性失踪的项目。与缺失值相关的仪器相关特征是用西班牙语完成PROMOTE或在仪器末尾定位问题。在门诊环境中对理论上和临床上有意义的脆弱性进行全面筛查是可行的。研究结果将为PROMOTE的修改和随后的数字化提供信息。
Psychosocial vulnerabilities (e.g., inadequate social support, financial insecurity, stress) and substance use elevate risks for adverse perinatal outcomes and maternal mental health morbidities. However, various barriers, including paucity of validated, simple and usable comprehensive instruments, impede execution of the recommendations to screen for such vulnerabilities in the first antenatal care visit. The current study presents findings from a newly implemented self-report tool created to overcome screening barriers in outpatient antenatal clinics. This was a retrospective chart-review of 904 women who completed the Profile for Maternal & Obstetric Treatment Effectiveness (PROMOTE) during their first antenatal visit between June and December 2019. The PROMOTE includes the 4-item NIDA Quick Screen and 15 additional items that each assess a different psychosocial vulnerability. Statistical analysis included evaluation of missing data, and exploration of missing data patterns using univariate correlations and hierarchical clustering. Three quarters of women (70.0%) had no missing items. In the entire sample, all but four PROMOTE items (opioid use, planned pregnancy, educational level, and financial state) had < 5% missing values, suggesting good acceptability and feasibility. Several respondent-related characteristics such as lower education, less family support, and greater stress were associated with greater likelihood of missing items. Instrument-related characteristics associated with missing values were completing the PROMOTE in Spanish or question positioning at the end of the instrument. Conducting a comprehensive screening of theoretically and clinically meaningful vulnerabilities in an outpatient setting is feasible. Study findings will inform modifications of the PROMOTE and subsequent digitization.
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