Rhynders Patricia A, Sayers Cynthia A, Presley Rodney J, Thierry JoAnn M
National Hemophilia Foundation (Rhynders), New York, New York.
The Division of Blood Disorders, National Center on Birth Defects and Developmental Disabilities, CDC, Atlanta, Georgia.
Am J Prev Med. 2014 Nov;47(5):674-80. doi: 10.1016/j.amepre.2014.07.040. Epub 2014 Sep 19.
Approximately 1% of U.S. women may have an undiagnosed bleeding disorder, which can diminish quality of life and lead to life-threatening complications during menstruation, childbirth, and surgery.
To understand young women's knowledge, attitudes, and perceptions about bleeding disorders and determine the preferred messaging strategy (e.g., gain- versus loss-framed messages) for presenting information.
In September 2010, a web-assisted personal interview of women aged 18-25 years was conducted. Preliminary analyses were conducted in 2011 with final analyses in 2013. In total, 1,243 women participated. Knowledge of blood disorders was tabulated for these respondents. Menstrual experiences of women at risk for a bleeding disorder were compared with those not at risk using chi-square analyses. Perceived influence of gain- versus loss-framed messages also was compared.
Participants knew that a bleeding disorder is a condition in which bleeding takes a long time to stop (77%) or blood does not clot (66%). Of the women, 57% incorrectly thought that a bleeding disorder is characterized by thin blood; many were unsure if bleeding disorders involve blood types, not getting a period, or mother and fetus having a different blood type. Women at risk for a bleeding disorder were significantly more likely to report that menstruation interfered with daily activities (36% vs 9%); physical or sports activities (46% vs 21%); social activities (29% vs 7%); and school or work activities (20% vs 9%) than women not at risk. Gain-framed messages were significantly more likely to influence women's decisions to seek medical care than parallel loss-framed messages. Findings suggest that the most influential messages focus on knowing effective treatment is available (86% gain-framed vs 77% loss-framed); preventing pregnancy complications (79% gain- vs 71% loss-framed); and maintaining typical daily activities during menstrual periods.
Lack of information about bleeding disorders is a serious public health concern. Health communications focused on gain-framed statements might encourage symptomatic young women to seek diagnosis and treatment. These findings and corresponding recommendations align with Healthy People 2020 and with CDC's goal of working to promote the health, safety, and quality of life of women at every life stage.
约1%的美国女性可能患有未被诊断出的出血性疾病,这会降低生活质量,并在月经、分娩和手术期间导致危及生命的并发症。
了解年轻女性对出血性疾病的知识、态度和看法,并确定呈现信息的首选信息传递策略(例如,获益框架信息与损失框架信息)。
2010年9月,对18至25岁的女性进行了网络辅助个人访谈。2011年进行了初步分析,2013年进行了最终分析。共有1243名女性参与。将这些受访者对血液疾病的了解制成表格。使用卡方分析比较了有出血性疾病风险的女性与无风险女性的月经经历。还比较了获益框架信息与损失框架信息的感知影响。
参与者知道出血性疾病是一种出血需要很长时间才能停止的状况(77%)或血液不凝固的状况(66%)。在这些女性中,57%错误地认为出血性疾病的特征是血液稀薄;许多人不确定出血性疾病是否涉及血型、不来月经或母亲与胎儿血型不同。有出血性疾病风险的女性比无风险女性更有可能报告月经干扰日常活动(36%对9%);体育活动(46%对21%);社交活动(29%对7%);以及学校或工作活动(20%对9%)。与平行的损失框架信息相比,获益框架信息显著更有可能影响女性寻求医疗护理的决定。研究结果表明,最具影响力的信息集中在知道有有效的治疗方法(获益框架信息为86%,损失框架信息为77%);预防妊娠并发症(获益框架信息为79%,损失框架信息为71%);以及在月经期间维持典型的日常活动。
关于出血性疾病的信息缺乏是一个严重的公共卫生问题。侧重于获益框架陈述的健康宣传可能会鼓励有症状的年轻女性寻求诊断和治疗。这些发现和相应建议与《健康人民2020》以及疾病控制与预防中心致力于促进每个生命阶段女性的健康、安全和生活质量的目标一致。