Kerns Jennifer L, Mengesha Biftu, McNamara Blair C, Cassidy Arianna, Pearlson Geffan, Kuppermann Miriam
Department of Obstetrics, Gynecology, and Reproductive Sciences, University of California San Francisco, San Francisco, CA.
Department of Obstetrics, Gynecology, and Reproductive Sciences, University of California San Francisco, San Francisco, CA.
Contraception. 2018 Jun;97(6):520-523. doi: 10.1016/j.contraception.2018.02.007. Epub 2018 Mar 26.
We sought to explore the relationship between counseling quality, measured by shared decision making and decision satisfaction, and psychological outcomes (anxiety, grief, and posttraumatic stress) after second-trimester abortion for pregnancy complications.
We conducted a cross-sectional study of women who underwent second-trimester abortion for complications. We recruited participants from Facebook and online support groups and surveyed them about counseling experiences and psychosocial issues. We used multivariate linear regression to evaluate relationships between counseling quality and psychological outcomes.
We analyzed data from 145 respondents. Shared decision making and decision satisfaction scores were positively and strongly correlated in bivariate analysis (r=0.7, p<.0001), as were posttraumatic stress and grief scores (r=0.7, p<.0001). In the adjusted analysis, higher decision satisfaction was associated with lower grief and posttraumatic stress scores (p=.02 and p=.01, respectively) and higher shared decision making was associated with lower posttraumatic stress scores (p=.01).
Decision satisfaction and shared decision making have a positive effect on psychological outcomes after second-trimester abortion for pregnancy complications. Counseling quality may be especially important in this setting given the sensitive nature of decisions regarding pregnancy termination for complications.
These results highlight the importance of patient-centered counseling for women seeking pregnancy termination.
我们试图探讨以共同决策和决策满意度衡量的咨询质量与孕中期因妊娠并发症进行流产后的心理结果（焦虑、悲伤和创伤后应激）之间的关系。
我们对因并发症接受孕中期流产的女性进行了一项横断面研究。我们从脸书和在线支持小组招募参与者，并就咨询经历和心理社会问题对她们进行调查。我们使用多元线性回归来评估咨询质量与心理结果之间的关系。
我们分析了145名受访者的数据。在双变量分析中，共同决策和决策满意度得分呈正且强相关（r = 0.7，p <.0001），创伤后应激和悲伤得分也是如此（r = 0.7，p <.0001）。在调整分析中，更高的决策满意度与更低的悲伤和创伤后应激得分相关（分别为p =.02和p =.01），更高的共同决策与更低的创伤后应激得分相关（p =.01）。
对于因妊娠并发症进行孕中期流产后的心理结果，决策满意度和共同决策具有积极影响。鉴于因并发症终止妊娠决策的敏感性，在这种情况下咨询质量可能尤为重要。
这些结果凸显了以患者为中心的咨询对寻求终止妊娠的女性的重要性。
