Anticipatory Counseling About Miscarriage Management in Catholic Hospitals: A Qualitative Exploration of Women's Preferences.

IF 3.4 2区 医学 Q1 DEMOGRAPHY
Erin E Wingo, Jocelyn M Wascher, Debra B Stulberg, Lori R Freedman
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引用次数: 2

Abstract

Context: Catholic hospitals represent a large and growing segment of U.S. health care. Because these facilities follow doctrines that restrict reproductive health services, including miscarriage management options when a fetal heartbeat is present, it is critical to understand whether and how women would want to learn about miscarriage treatment restrictions from providers.

Methods: From May 2018 to January 2019, semistructured interviews were conducted with 31 women aged 21-44 who had had exposure to religious-based health care; all were drawn from a nationally representative survey sample. Participants responded to a hypothetical scenario regarding the anticipatory disclosure of miscarriage management policy during routine prenatal care. Responses were inductively coded and thematically analyzed using modified grounded theory to understand women's attitudes and considerations related to receiving anticipatory miscarriage management information.

Results: Respondents supported the routine disclosure of miscarriage management policies during prenatal care. Some expressed concern that this might increase patient anxiety during pregnancy, but most felt that the information would serve to prepare and empower patients, and likened the topic to other anticipatory health information provided during prenatal care. Identified themes related to how providers can disclose this information (including the need for a precautionary framing to reduce patient stress), sharing the rationale for institutional policy, and the importance of provider neutrality to ensure patient autonomy.

Conclusions: To respect patient autonomy, health care providers working in Catholic hospitals should routinely discuss institutional miscarriage management policies with patients, and anticipatory counseling should give patients the balanced information they need to decide where to go for care should pregnancy complications arise.

天主教医院流产管理的预见性咨询:女性偏好的质性探讨。
背景:天主教医院代表了美国医疗保健的一个庞大且不断增长的部分。由于这些设施遵循限制生殖健康服务的原则,包括在有胎儿心跳时限制流产管理选择,因此了解妇女是否希望以及如何从提供者那里了解流产治疗限制至关重要。方法:2018年5月至2019年1月,对31名21-44岁曾接受过宗教医疗服务的女性进行半结构化访谈;所有这些都是从具有全国代表性的调查样本中抽取的。参与者回答了一个关于在常规产前护理中预先披露流产管理政策的假设情景。采用改进的扎根理论对回答进行归纳编码和主题分析,以了解妇女对接受预期流产管理信息的态度和考虑。结果:受访者支持在产前护理中常规披露流产管理政策。一些人表示关切,这可能会增加病人在怀孕期间的焦虑,但大多数人认为,这些信息将有助于病人做好准备,增强他们的能力,并将这一主题与产前护理期间提供的其他预期健康信息相提并论。确定的主题涉及提供者如何披露这些信息(包括需要预防性框架以减轻患者压力),分享机构政策的基本原理,以及提供者中立以确保患者自主的重要性。结论:为了尊重患者的自主权,天主教医院的医护人员应定期与患者讨论机构流产管理政策,预期咨询应向患者提供他们需要的平衡信息,以便在出现妊娠并发症时决定去哪里就诊。
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来源期刊
CiteScore
5.10
自引率
3.40%
发文量
24
期刊介绍: Perspectives on Sexual and Reproductive Health provides the latest peer-reviewed, policy-relevant research and analysis on sexual and reproductive health and rights in the United States and other developed countries. For more than four decades, Perspectives has offered unique insights into how reproductive health issues relate to one another; how they are affected by policies and programs; and their implications for individuals and societies. Published four times a year, Perspectives on Sexual and Reproductive Health includes original research, special reports and commentaries on the latest developments in the field of sexual and reproductive health, as well as staff-written summaries of recent findings in the field.
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