Impact of perinatal exposure counseling on patient reported emotional outcomes and decisional empowerment

IF 1.6 4区医学 Q4 DEVELOPMENTAL BIOLOGY

Birth Defects Research Pub Date : 2024-03-23 DOI:10.1002/bdr2.2325

Réka Müller, Madison Lake, Nevena Krstić, Sarah G. Običan, Deborah Cragun

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引用次数: 0

Abstract

Background

Exposures during pregnancy are common and most pregnant patients utilize at least one medication during pregnancy. The lack of reliable information on medication safety during pregnancy available to providers and patients is a stressor and obstacle to decision-making about medication use in pregnancy. Previous studies showed that exposures in pregnancy are associated with guilt, worry, and decisional conflict. Although prior research has evaluated changes in patient knowledge after teratogen counseling, studies have not examined emotional outcomes or patients' decisional empowerment. This quasi-experimental study measured changes in patients' feelings of guilt, anxiety, and decisional empowerment after receiving exposure counseling from trained teratogen information specialists.

Methods

We administered pre- and post-counseling surveys to patients referred to a perinatal exposure clinic in Tampa, Florida. Validated scales were used to measure anxiety and guilt, and the ‘SURE’ measure was used to assess decisional empowerment. Paired samples t-tests evaluated changes in anxiety and guilt and a McNemar test assessed for changes in empowered decision making.

Results

Among the 34 participants who completed both surveys, anxiety, and guilt scores decreased significantly (p < .001). While only 21% felt informed and empowered to make a decision related to their exposure(s) before counseling, this increased to 85% (p < .001) on the post-survey.

Conclusion

Comprehensive counseling with a trained teratogen information specialist improves patient emotional outcomes as well as feelings of empowerment to make an informed decision regarding medication use in pregnancy. This study highlights that patient-centered teratogen counseling goes beyond simple changes in patient knowledge.

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围产期暴露咨询对患者报告的情绪结果和决定权的影响

背景怀孕期间接触药物很常见，大多数孕妇在怀孕期间至少会使用一种药物。医疗服务提供者和患者缺乏有关孕期用药安全的可靠信息，这对孕期用药决策造成了压力和障碍。先前的研究表明，孕期暴露与内疚、担忧和决策冲突有关。虽然之前的研究已经评估了患者在接受畸形儿咨询后对相关知识的了解程度，但还没有研究对情感结果或患者的决策能力进行考察。这项准实验研究测量了患者在接受训练有素的畸形儿信息专家提供的暴露咨询后，内疚感、焦虑感和决策能力的变化。方法我们对转诊到佛罗里达州坦帕市一家围产期暴露诊所的患者进行了咨询前和咨询后调查。我们使用经过验证的量表来测量焦虑和内疚感，并使用 "SURE "量表来评估决策能力。配对样本 t 检验评估了焦虑和内疚感的变化，McNemar 检验评估了决策能力的变化。结果在完成这两项调查的 34 名参与者中，焦虑和内疚的得分都有显著下降（p < .001）。在接受咨询前，只有 21% 的人认为自己掌握了相关信息并有能力做出与所接触的疾病有关的决定，而在接受咨询后的调查中，这一比例上升到了 85% (p <.001)。结论由训练有素的畸形源信息专家提供全面的咨询，可改善患者的情绪结果，并增强其就孕期用药做出知情决定的能力。这项研究强调，以患者为中心的畸变咨询不仅仅是简单地改变患者的知识。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Birth Defects Research Medicine-Embryology

CiteScore

3.60

自引率

9.50%

发文量

153

期刊介绍： The journal Birth Defects Research publishes original research and reviews in areas related to the etiology of adverse developmental and reproductive outcome. In particular the journal is devoted to the publication of original scientific research that contributes to the understanding of the biology of embryonic development and the prenatal causative factors and mechanisms leading to adverse pregnancy outcomes, namely structural and functional birth defects, pregnancy loss, postnatal functional defects in the human population, and to the identification of prenatal factors and biological mechanisms that reduce these risks. Adverse reproductive and developmental outcomes may have genetic, environmental, nutritional or epigenetic causes. Accordingly, the journal Birth Defects Research takes an integrated, multidisciplinary approach in its organization and publication strategy. The journal Birth Defects Research contains separate sections for clinical and molecular teratology, developmental and reproductive toxicology, and reviews in developmental biology to acknowledge and accommodate the integrative nature of research in this field. Each section has a dedicated editor who is a leader in his/her field and who has full editorial authority in his/her area.