探讨不明原因复发性妊娠丢失夫妇中性别差异与支持性护理偏好的关系。
Exploring gender differences among couples with unexplained recurrent pregnancy loss regarding preferences for supportive care.
机构信息
Department of Gynecology and Obstetrics, Leiden University Medical Center, Albinusdreef 2, Leiden, 2333 ZA, the Netherlands.
Department of Clinical Epidemiology, Leiden University Medical Center, Leiden, 2333 ZA, the Netherlands.
出版信息
BMC Pregnancy Childbirth. 2021 Nov 30;21(1):796. doi: 10.1186/s12884-021-04277-4.
BACKGROUND
International guidelines recommend to offer supportive care during a next pregnancy to couples affected by recurrent pregnancy loss (RPL). In previous research, several options for supportive care have been identified and women's preferences have been quantified. Although it is known that RPL impacts the mental health of both partners, male preferences for supportive care have hardly been explored.
METHODS
A cross-sectional study was conducted in couples who visited a specialized RPL clinic in the Netherlands between November 2018 and December 2019. Both members of the couples received a questionnaire that quantified their preferences for supportive care in a next pregnancy and they were asked to complete this independently from each other. Preferences for each supportive care option were analysed on a group level (by gender) and on a couple level, by comparing preferences of both partners.
RESULTS
Ninety-two questionnaires (completed by 46 couples) were analysed. The overall need for supportive care indicated on a scale from 1 to 10 was 6.8 for men and 7.9 for women (P = 0.002). Both genders preferred to regularly see the same doctor with knowledge of their obstetric history, to make a plan for the first trimester and to have frequent ultrasound examinations. A lower proportion of men preferred a doctor that shows understanding (80% of men vs. 100% of women, P = 0.004) and a doctor that informs on wellbeing (72% vs. 100%, P = ≤0.000). Fewer men preferred support from friends (48% vs. 74%, P = 0.017). Thirty-seven percent of men requested more involvement of the male partner at the outpatient clinic, compared to 70% of women (P = 0.007). In 28% of couples, partners had opposing preferences regarding peer support.
CONCLUSIONS
While both women and men affected by RPL are in need of supportive care, their preferences may differ. Current supportive care services may not entirely address the needs of men. Health care professionals should focus on both partners and development of novel supportive care programs with specific attention for men should be considered.
背景
国际指南建议为复发性妊娠丢失（RPL）夫妇提供下一胎的支持性护理。在之前的研究中，已经确定了几种支持性护理选择，并对女性的偏好进行了量化。尽管 RPL 会影响双方的心理健康，但男性对支持性护理的偏好几乎没有被探索过。
方法
2018 年 11 月至 2019 年 12 月，在荷兰一家专门的 RPL 诊所就诊的夫妇中进行了一项横断面研究。夫妇双方都收到了一份问卷，该问卷量化了他们在下一次妊娠中对支持性护理的偏好，并要求他们彼此独立完成。对支持性护理选项的偏好按群体（按性别）和夫妇两个层面进行分析，通过比较双方的偏好来进行。
结果
分析了 92 份问卷（由 46 对夫妇完成）。在 1 到 10 的量表上，男性的总体支持性护理需求为 6.8，女性为 7.9（P=0.002）。两性都更喜欢定期与了解他们产科病史的同一位医生就诊、制定孕早期计划和进行频繁的超声检查。较少的男性更喜欢理解他们的医生（80%的男性与 100%的女性相比，P=0.004）和告知他们健康状况的医生（72%与 100%相比，P≤0.000）。较少的男性喜欢朋友的支持（48%与 74%相比，P=0.017）。与女性相比，男性有 37%希望在门诊更多地参与男性伴侣，而女性有 70%（P=0.007）。在 28%的夫妇中，伴侣对同伴支持有相反的偏好。
结论
虽然受 RPL 影响的女性和男性都需要支持性护理，但他们的偏好可能不同。当前的支持性护理服务可能无法完全满足男性的需求。医疗保健专业人员应该关注双方，并考虑制定专门针对男性的新型支持性护理计划。
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