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支持性护理对不明原因复发性流产的女性:患者的观点。

Supportive care for women with unexplained recurrent miscarriage: patients' perspectives.

机构信息

Centre for Reproductive Medicine, Department of Obstetrics and Gynaecology (H4-240), Academic Medical Centre, University of Amsterdam, PO Box 22700, 1100 DE Amsterdam, The Netherlands.

出版信息

Hum Reprod. 2011 Apr;26(4):873-7. doi: 10.1093/humrep/der021. Epub 2011 Feb 11.

Abstract

BACKGROUND Supportive care is currently the only 'therapy' that can be offered to women with unexplained recurrent miscarriage (RM). What these women themselves prefer as supportive care in their next pregnancy has never been substantiated. Therefore the aim of this study was to explore what women with unexplained RM prefer as supportive care during their next pregnancy. METHODS We performed explorative, semi-structured, in-depth interviews. The interviews were performed with 15 women with unexplained RM who were actively seeking conception. All interviews were conducted by telephone. The interviews were fully transcribed and two researchers independently identified text segments from the transcribed interviews and categorized them in the appropriate domain. RESULTS Women identified 20 different supportive care options; 16 of these options were preferred for their next pregnancy. Examples of the preferred supportive care were early and frequently repeated ultrasounds, βHCG monitoring, practical advice concerning life style and diet, emotional support in the form of counselling, a clear policy for the upcoming 12 weeks and medication. The four supportive care options that were not preferred by the women were admittance to a hospital ward at the same gestational age as previous miscarriages, Complementary Alternative Medicine, ultrasound every other day and receiving supportive care from their general practitioner. CONCLUSIONS Our study identified several relevant preferences for supportive care in women with unexplained RM. Many of these can be offered by the gynaecologist and will help in guaranteeing high-quality patient-centred care.

摘要

背景

目前,对于不明原因复发性流产(RM)的女性,支持性护理是唯一可提供的“治疗方法”。这些女性在下次妊娠中作为支持性护理所偏好的内容从未得到证实。因此,本研究旨在探讨不明原因 RM 女性在下次妊娠中偏好何种支持性护理。

方法

我们进行了探索性、半结构化、深入的访谈。对 15 名正在积极寻求妊娠的不明原因 RM 女性进行了访谈。所有访谈均通过电话进行。访谈内容完整转录,两名研究人员独立识别转录访谈中的文本片段,并将其归类到适当的领域。

结果

女性确定了 20 种不同的支持性护理选择;其中 16 种选择是为她们的下一次妊娠所偏好的。偏好的支持性护理示例包括早期和频繁重复的超声检查、βHCG 监测、有关生活方式和饮食的实用建议、咨询形式的情感支持、未来 12 周的明确政策以及药物治疗。女性不偏好的四种支持性护理选择是在与之前流产相同的妊娠周数时入住医院病房、补充替代医学、每隔一天进行超声检查以及接受全科医生的支持性护理。

结论

本研究确定了不明原因 RM 女性支持性护理的一些相关偏好。其中许多可由妇科医生提供,有助于保证高质量的以患者为中心的护理。

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