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医学手机应用程序(QUiPP)预测早产对有早产风险孕妇焦虑和决策冲突的影响。

Impact of a medical mobile phone app (QUiPP) for predicting preterm birth on the anxiety and decisional conflicts faced by women in threatened preterm labour.

机构信息

Department of Women and Children's Health, School of Life Course Sciences, King's College London, 10th Floor North Wing, St Thomas' Hospital, Westminster Bridge Road, SE1 7EH.

Department of Women and Children's Health, School of Life Course Sciences, King's College London, 10th Floor North Wing, St Thomas' Hospital, Westminster Bridge Road, SE1 7EH.

出版信息

Midwifery. 2021 Jan;92:102864. doi: 10.1016/j.midw.2020.102864. Epub 2020 Oct 20.

Abstract

BACKGROUND

The QUiPP app is a free, validated mobile phone application (app) that supports clinical decision-making for women in threatened preterm labour by providing an individualised risk of delivery within clinically important time points. Alongside generating a percentage risk score, the QUiPP app also provides the risk score in an infographic donut chart, allowing the clinician to communicate with the woman in an easy to understand format. Informing women of their risk status using the QUIPP app may help to reduce anxiety in women and decrease decisional conflict.

METHOD

A subset of participants from the EQUIPTT study [REC Ref. 17/LO/1802] were asked to complete a questionnaire booklet which was used to evaluate decisional conflict and anxiety. Seven sites were randomised to the QUiPP app intervention (to use as a decision and communication tool) and six sites were randomised to the control (continued their normal practice). The first section of the questionnaire booklet was completed by the woman before her assessment, and the second section after. The pre and postassessment anxiety scores utilised the Visual Analogue Scale for Anxiety (Hornblow and Kidson, 1976). The Decisional Conflict Scale (O'Connor, 1995) measured decisional conflict post assessment. The data were then analysed to determine the impact of the QUiPP App on the anxiety and decisional conflicts faced by women in threatened preterm labour.

RESULTS

Questionnaires were completed by 221 women from 12 of the potential 13 sites. After exclusions 202 questionnaires were included in the analysis. There was a significant reduction in difference between anxiety scores before and after clinical assessment. While there were reductions in anxiety and decisional conflict for women who were aware of the QUiPP app use, this failed to reach statistical significance.

CONCLUSIONS

The QUiPP app has potential to reduce anxiety and decisional conflict in women who are aware that it is being used in their care. Additional work is required to ensure clinicians are aware of the QUiPP app and optimise using it as a communication tool when counselling women.

摘要

背景

QUiPP 应用程序是一款免费的、经过验证的手机应用程序,通过提供在临床重要时间点内分娩的个体化风险,为有早产风险的女性提供临床决策支持。除了生成百分比风险评分外,QUiPP 应用程序还以环形图的形式提供风险评分,以便临床医生以易于理解的格式与女性进行沟通。使用 QUIPP 应用程序告知女性其风险状况可能有助于减轻女性的焦虑并减少决策冲突。

方法

从 EQUIPTT 研究[REC 参考 17/LO/1802]的一部分参与者中,要求他们填写一份问卷手册,用于评估决策冲突和焦虑。七个地点被随机分配到 QUiPP 应用程序干预组(用作决策和沟通工具),六个地点被随机分配到对照组(继续进行正常实践)。问卷手册的第一部分在女性评估前完成,第二部分在评估后完成。焦虑评分采用视觉模拟焦虑量表(Hornblow 和 Kidson,1976)。决策冲突量表(O'Connor,1995)在评估后测量决策冲突。然后分析数据以确定 QUiPP 应用程序对有早产风险的女性面临的焦虑和决策冲突的影响。

结果

来自 13 个潜在地点中的 12 个地点的 221 名女性完成了问卷。排除后,共有 202 份问卷纳入分析。临床评估前后焦虑评分的差异有显著降低。虽然那些知道 QUiPP 应用程序使用的女性的焦虑和决策冲突有所减少,但这并未达到统计学意义。

结论

QUiPP 应用程序有可能减轻女性的焦虑和决策冲突,前提是她们知道该应用程序正在用于她们的护理。需要进一步努力确保临床医生了解 QUiPP 应用程序,并优化将其用作与女性咨询时的沟通工具。

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