Centre for Reproductive Medicine, Department of Obstetrics and Gynaecology, Academic Medical Centre, University of Amsterdam, PO Box 22700, Amsterdam 1100 DE, The Netherlands.
Hum Reprod. 2013 Feb;28(2):398-405. doi: 10.1093/humrep/des374. Epub 2012 Dec 4.
Supportive care is regularly offered to women with recurrent miscarriages (RMs). Their preferences for supportive care in their next pregnancy have been identified by qualitative research. The aim of this study was to quantify these supportive care preferences and identify women's characteristics that are associated with a higher or lower need for supportive care in women with RM.
A questionnaire study was conducted in women with RMs (≥ 2 miscarriages) in three hospitals in the Netherlands. All women who received diagnostic work-up for RMs from January 2010 to December 2010 were sent a questionnaire. The questionnaire quantified supportive care options identified by a previous qualitative study. We next analysed associations between women's characteristics (age, ethnicity, education level, parity, pregnancy during questionnaire and time passed since last miscarriage) and their feelings about supportive care options to elucidate any differences between groups.
Two hundred and sixty-six women were asked to participate in the study. In total, 174 women responded (response rate 65%) and 171 questionnaires were analysed. Women with RM preferred the following supportive care options for their next pregnancy: a plan with one doctor who shows understanding, takes them seriously, has knowledge of their obstetric history, listens to them, gives information about RM, shows empathy, informs on progress and enquires about emotional needs. Also, an ultrasound examination during symptoms, directly after a positive pregnancy test and every 2 weeks. Finally, if a miscarriage occurred, most women would prefer to talk to a medical or psychological professional afterwards. The majority of women expressed a low preference for admission to a hospital ward at the same gestational age as previous miscarriages and for bereavement therapy. The median preference, on a scale from 1 to 10, for supportive care was 8.0. Ethnicity, parity and pregnancy at the time of the survey were associated with different preferences, but female age, education level and time passed since the last miscarriage were not.
Women with RM preferred a plan for the first trimester that involved one doctor, ultrasounds and the exercise of soft skills, like showing understanding, listening skills, awareness of obstetrical history and respect towards the patient and their miscarriage, by the health care professionals. In the event of a miscarriage, women prefer aftercare. Women from ethnic minorities and women who were not pregnant during the questionnaire investigation were the two patient groups who preferred the most supportive care options. Tailor-made supportive care can now be offered to women with RM.
经常为复发性流产（RM）的女性提供支持性护理。通过定性研究确定了她们对下一次妊娠中支持性护理的偏好。本研究的目的是量化这些支持性护理偏好，并确定与 RM 女性对支持性护理的更高或更低需求相关的女性特征。
在荷兰的三家医院对 RM（≥2 次流产）的女性进行了一项问卷调查研究。2010 年 1 月至 2010 年 12 月期间接受 RM 诊断检查的所有女性均被发送了一份问卷。该问卷量化了先前定性研究确定的支持性护理方案。我们接下来分析了女性特征（年龄、种族、教育水平、生育次数、问卷期间怀孕以及上次流产后时间）与她们对支持性护理方案的感受之间的关联，以阐明组间的任何差异。
邀请了 266 名女性参与研究。共有 174 名女性（应答率为 65%）做出回应，并对 171 份问卷进行了分析。RM 女性对下次妊娠的以下支持性护理方案表示偏好：一位能够理解、认真对待、了解她们的产科病史、倾听、提供 RM 信息、表现出同理心、告知进展情况并询问情感需求的医生。此外，还需要在出现症状时、阳性妊娠试验后直接以及每 2 周进行一次超声检查。如果发生流产，大多数女性更愿意在之后与医疗或心理专业人员交谈。大多数女性对在与上次流产相同的妊娠周数时住院治疗以及丧亲治疗的偏好较低。在 1 到 10 的量表上，支持性护理的中位数偏好为 8.0。种族、生育次数和调查时的怀孕情况与不同的偏好相关，但女性年龄、教育水平和上次流产后时间则没有。
RM 女性更喜欢由一位医生、超声检查和软技能（如理解、倾听技巧、对产科病史的认识以及对患者及其流产的尊重）组成的妊娠早期计划。如果发生流产，女性更希望得到后续护理。少数民族妇女和调查期间未怀孕的妇女是最需要支持性护理方案的两个患者群体。现在可以为 RM 女性提供定制的支持性护理。
