University of California, San Francisco, Department of Obstetrics, Gynecology and Reproductive Sciences, San Francisco, CA, USA.
Washington Hospital Center, Department of Obstetrics and Gynecology, MedStar Washington Hospital Center, Washington, DC, USA.
Patient Educ Couns. 2018 Oct;101(10):1859-1864. doi: 10.1016/j.pec.2018.06.012. Epub 2018 Jun 22.
The decision to undergo a surgical or medical method of second-trimester termination for pregnancy complications should be preference-sensitive. Decision satisfaction has not been described in this population; understanding how women describe decision satisfaction in this setting could inform decision support efforts.
We conducted qualitative interviews with women one to three weeks after termination who chose either a surgical or medical termination for fetal anomalies, pregnancy complications or fetal demise. We analyzed transcripts using modified grounded theory in an iterative manner with a generative thematic approach.
We interviewed 36 women (24 surgical and 12 medical). Subjects connected decision satisfaction with counseling experiences and their personal values, including (1) importance of adequate information, (2) autonomous decision making, and (3) choosing the method that facilitates coping.
Offering women a choice between surgical and medical termination procedures in the setting of pregnancy complications is integral to decision satisfaction. Women in our study reported wanting this decision to be driven by their personal values.
Women should be able to choose between surgical and medical termination based on preference and not availability of services. Decision support from women's health providers should be based on values clarification and providing accurate information.
对于妊娠并发症，选择手术或药物方式终止妊娠应考虑偏好因素。该人群的决策满意度尚未得到描述；了解女性在这种情况下如何描述决策满意度，可以为决策支持工作提供信息。
我们对选择手术或药物终止妊娠的胎儿畸形、妊娠并发症或胎儿死亡的女性在终止妊娠后一至三周进行了定性访谈。我们使用修改后的扎根理论进行分析，并采用生成主题的方法进行迭代。
我们采访了 36 名女性（24 名手术，12 名药物）。研究对象将决策满意度与咨询经验和个人价值观联系起来，包括（1）充分信息的重要性，（2）自主决策，和（3）选择有利于应对的方法。
在妊娠并发症的情况下，为女性提供手术和药物终止妊娠的选择是决策满意度的关键。本研究中的女性希望这一决定能够基于个人价值观。
女性应能够根据个人偏好而不是服务的可及性选择手术或药物终止妊娠。妇女健康提供者的决策支持应基于价值观澄清和提供准确信息。
