Assessing patient perceptions of cytomegalovirus infection in pregnancy
Assessing patient perceptions of cytomegalovirus infection in pregnancy
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DOI：
10.1002/jmv.25714
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发表时间：
2020-03-05
影响因子：
12.7
通讯作者：
Hughes, Brenna L.
中科院分区：
文献类型：
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作者：
Siegel, Anne M.;Clinton, Chelsea M.;Hughes, Brenna L.
受巨细胞病毒（CMV）影响的孕妇尽管结局不确定，但仍会做出临床决定。不容忍不确定性评分（IUS）是一种有效的衡量个人发现不可接受的负面事件可能发生的倾向的方法。我们调查了患者在怀孕期间对CMV感染的看法，并将IUS和知识与决策相关联。2017年7月至8月向女性发送了电子问卷。该问卷评估了CMV、IUS的知识，以及对CMV风险升高的三种临床情况的管理反应，包括选择不进行进一步检测、超声、子宫穿刺或流产。对于每种情况，使用逻辑回归对IUS响应进行建模。共有815名妇女参加。大多数参与者是白色（63.1%），42%拥有研究生学位。超过70%的人报告说他们以前没有听说过CMV。在只有CMV暴露的情况下，IUS增加的参与者更有可能选择流产（比值比[OR] = 1.04; 95%置信区间[CI]：1.01，1.06），并且不进行进一步检测（OR = 0.97; 95% CI：0.95，0.99）。在CMV暴露背景下轻度超声检查结果的情况下，IUS增加与选择不进行进一步检查的几率较高相关（OR = 0.97; 95%CI，0.94，0.99）。在CMV暴露的情况下，在重度超声异常的情况下，未观察到IUS与缓解之间的显著相关性。大多数患者对CMV一无所知。较高的IUS与低严重程度场景中的更多干预相关，但在严重场景中，IUS与参与者的选择无关。
Pregnant women impacted by cytomegalovirus (CMV) make clinical decisions despite uncertain outcomes. Intolerance of uncertainty score (IUS) is a validated measure of tendency for individuals to find unacceptable that a negative event might occur. We investigated patient perceptions of CMV infection during pregnancy and correlated IUS and knowledge with decision-making. Electronic questionnaire was sent to women from July to August 2017. The questionnaire evaluated knowledge of CMV, IUS, and responses regarding management to three clinical scenarios with escalating risk of CMV including choices for no further testing, ultrasound, amniocentesis, or abortion. For each scenario, logistic regression was used to model IUS on responses. A total of 815 women were included. The majority of participants was white (63.1%) and 42% had a postgraduate degree. Over 70% reported that they had not previously heard of CMV. In the scenario with only CMV exposure, participants with increasing IUS were more likely to choose abortion (odds ratio [OR] = 1.04; 95% confidence interval [CI]: 1.01, 1.06) and no further testing (OR = 0.97; 95% CI: 0.95, 0.99). In the scenario with mild ultrasound findings in setting of CMV exposure, increasing IUS was associated with higher odds of choosing no further testing (OR = 0.97; 95% CI, 0.94, 0.99). No significant association was observed between IUS and responses in the scenario with severe ultrasound abnormalities in setting of CMV exposure. The majority of patients had no knowledge of CMV. Higher IUS was associated more intervention in low severity scenarios, but in severe scenarios, IUS was not associated with participants' choices.