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孕期使用精神药物的决策:一项定性研究。

Decisions about the use of psychotropic medication during pregnancy: a qualitative study.

作者信息

Stevenson Fiona, Hamilton Sarah, Pinfold Vanessa, Walker Charlotte, Dare Ceri R J, Kaur Harminder, Lambley Ruth, Szymczynska Paulina, Nicolls Vicky, Petersen Irene

机构信息

Department of Primary Care and Population Health, UCL, London, UK.

McPin Foundation, London, UK.

出版信息

BMJ Open. 2016 Jan 27;6(1):e010130. doi: 10.1136/bmjopen-2015-010130.

Abstract

OBJECTIVE

To understand the perspectives of women with severe mental illness concerning the use of psychotropic medicines while pregnant.

DESIGN

Interviews conducted by female peer researchers with personal experience of making or considering decisions about using psychotropic medicines in pregnancy, supported by professional researchers.

PARTICIPANTS

12 women who had had a baby in the past 5 years and had taken antipsychotics or mood-stabilisers for severe mental illness within the 12-month period immediately prior to that pregnancy. Recruitment to the study was via peer networks and the women interviewed came from different regions of England.

SETTING

Interviews were arranged in places where women felt comfortable and that accommodated their childcare needs including their home, local library and the research office.

RESULTS

The views expressed demonstrated complex attempts to engage with decision-making about the use of psychotropic medicines in pregnancy. In nearly all cases, the women expressed the view that healthcare professionals had access to limited information leaving women to rely on experiential and common sense evidence when making decisions about medicine taking during pregnancy.

CONCLUSIONS

The findings complement existing work using electronic health records by providing explanations for the discontinuation of psychotropic medicines in pregnancy. Further work is necessary to understand health professionals' perspectives on the provision of services and care to women with severe mental illness during pregnancy.

摘要

目的

了解患有严重精神疾病的女性对于孕期使用精神药物的看法。

设计

由有在孕期使用或考虑使用精神药物经历的女性同伴研究者在专业研究者的支持下进行访谈。

参与者

12名在过去5年内生育过且在此次怀孕前12个月内曾因严重精神疾病服用过抗精神病药物或心境稳定剂的女性。通过同伴网络招募研究对象,受访女性来自英格兰不同地区。

地点

访谈安排在女性感到舒适且能满足其育儿需求的地方,包括她们的家中、当地图书馆和研究办公室。

结果

所表达的观点表明,在孕期使用精神药物的决策过程中存在复杂的尝试。几乎在所有情况下,女性都认为医疗保健专业人员掌握的信息有限,这使得女性在决定孕期用药时只能依靠经验和常识依据。

结论

这些发现通过解释孕期停用精神药物的原因,对现有利用电子健康记录开展的研究起到了补充作用。有必要进一步开展工作,以了解卫生专业人员对于为孕期患有严重精神疾病的女性提供服务和护理的看法。

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