The Division of Nursing, Midwifery and Social Work, The University of Manchester, Oxford Road, Manchester M13 9PL, United Kingdom.
The University of Birmingham, Institute of Metabolism and Systems Research, Edgbaston, Birmingham B15 2TT, United Kingdom.
Sex Reprod Healthc. 2019 Oct;21:95-101. doi: 10.1016/j.srhc.2019.06.005. Epub 2019 Jun 27.
Minimising the risks of mortality, morbidities, and the costs associated with preterm birth is reliant on accurate prediction, appropriate decision-making and timely intervention. This study aimed to determine for the first time the decisional and informational requirements of women and clinicians during preterm labour diagnosis and intervention. A secondary objective was to explore their experiences.
A qualitative, interpretive approach was used in three tertiary referral units in England and Scotland. Women with experience of or risk factors for preterm birth and clinicians with experience of caring for women in preterm labour took part in semi-structured interviews individually face-face or via telephone, or in a small focus-group. Data was analysed using a framework approach.
Women and clinicians welcomed a more accurate tool for predicting preterm birth. Women wanted to be actively involved in their care, but desired different levels of control over decisions. Communication between women and clinicians influenced women's overall experiences and shaped clinicians' practice. Women found accessing care difficult, due to uncertainty about symptoms and gatekeepers to face-face care. The emotional impact of their experiences influenced family plans and subsequent pregnancies. Women's overall perception of their experience was influenced by their judgement of the care they received.
Decision-making is complex and a tool to more accurately predict preterm birth than is currently available was valued. Further research is warranted to evaluate a tool in clinical practice and to improve services for women with symptoms of preterm labour attempting to gain access to face-face care. Trial Registration ISRCTN: 41598423 and CPMS:31277.
降低与早产相关的死亡率、发病率和成本风险依赖于准确的预测、适当的决策和及时的干预。本研究首次旨在确定在早产诊断和干预期间女性和临床医生的决策和信息需求。次要目标是探索他们的经验。
在英格兰和苏格兰的三个三级转诊单位采用定性、解释性方法。有早产经历或风险因素的女性和有照顾早产妇女经验的临床医生分别进行了面对面或电话的半结构化访谈，或参加了小型焦点小组。使用框架方法分析数据。
女性和临床医生欢迎更准确的预测早产的工具。女性希望积极参与自己的护理，但对决策的控制程度有不同的要求。女性和临床医生之间的沟通影响了女性的整体体验，并塑造了临床医生的实践。由于对症状和面对面护理的把关者不确定，女性发现获得护理很困难。他们经历的情绪影响影响了家庭计划和随后的怀孕。女性对自己经历的整体看法受到她们对所接受护理的判断的影响。
决策是复杂的，比目前可用的更准确预测早产的工具受到重视。需要进一步研究，以评估临床实践中的工具，并改善有早产症状的女性获得面对面护理的服务。试验注册 ISRCTN：41598423 和 CPMS：31277。
