妊娠期炎症性肠病的管理：医疗保健专业人员的参与、知识和决策

Managing Inflammatory Bowel Disease in Pregnancy: Health Care Professionals' Involvement, Knowledge, and Decision Making.

作者信息

Liu Eleanor, Laube Robyn, Leong Rupert W, Fraser Aileen, Selinger Christian, Limdi Jimmy K

机构信息

Section of IBD, Division of Gastroenterology, Northern Care Alliance NHS Foundation Trust, Manchester, United Kingdom.

Faculty of Medicine and Health Sciences, Macquarie University, Sydney, NSW, Australia.

出版信息

Inflamm Bowel Dis. 2023 Apr 3;29(4):522-530. doi: 10.1093/ibd/izac101.

DOI:10.1093/ibd/izac101

PMID:35713620

Abstract

BACKGROUND

The management of pregnant women with inflammatory bowel disease (IBD) is complex. We aimed to assess health care professionals' (HCPs) theoretical and applied knowledge of pregnancy-related IBD issues.

METHODS

A cross-sectional international survey was distributed to HCPs providing IBD care between October 2020 and March 2021. Knowledge was assessed using the validated Crohn's and Colitis Pregnancy Knowledge Score (CCPKnow; range, 0-17). Decision-making was assessed by free text responses to 3 clinical scenarios scored against predetermined scoring criteria (maximum score 70).

RESULTS

Among 81 participants, median CCPKnow score was 16 (range, 8-17), and median total scenario score was 29 (range, 9-51). Health care professionals who treat >10 IBD patients per week (CCPKnow P = .03; scenarios P = .003) and are more regularly involved in pregnancy care (CCPKnow P = .005; scenarios P = .005) had significantly better scores. Although CCPKnow scoring was consistently high (median score ≥15) across all groups, consultants scored better than trainees and IBD nurses (P = .008 and P = .031). Median scenario scores were higher for consultants (32) and IBD nurses (33) compared with trainees (24; P = .018 and P = .022). There was a significant positive correlation between caring for greater numbers of pregnant IBD patients and higher CCPKnow (P = .001, r = .358) and scenario scores (P = .001, r = .377). There was a modest correlation between CCPKnow and scenario scores (r = .356; P < 0.001).

CONCLUSIONS

Despite "good" theoretical pregnancy-related IBD knowledge as assessed by CCPKnow, applied knowledge in the scenarios was less consistent. There is need for further HCP education and clinical experience to achieve optimal standardized care for IBD in pregnancy.

摘要

背景

炎症性肠病（IBD）孕妇的管理较为复杂。我们旨在评估医疗保健专业人员（HCPs）对妊娠相关IBD问题的理论和应用知识。

方法

在2020年10月至2021年3月期间，向提供IBD护理的HCPs开展了一项横断面国际调查。使用经过验证的克罗恩病和结肠炎妊娠知识评分（CCPKnow；范围为0 - 17）评估知识水平。通过对3个临床情景的自由文本回复来评估决策能力，根据预先确定的评分标准进行评分（最高分为70分）。

结果

在81名参与者中，CCPKnow评分中位数为16（范围为8 - 17），情景总分中位数为29（范围为9 - 51）。每周治疗超过10例IBD患者的医疗保健专业人员（CCPKnow P = 0.03；情景 P = 0.003）以及更经常参与妊娠护理的人员（CCPKnow P = 0.005；情景 P = 0.005）得分明显更高。尽管所有组的CCPKnow评分一直较高（中位数评分≥15），但顾问的得分高于实习医生和IBD护士（P = 0.008和P = 0.031）。与实习医生（24分）相比，顾问（32分）和IBD护士（33分）的情景得分中位数更高（P = 0.018和P = 0.022）。照顾更多IBD孕妇与更高的CCPKnow（P = 0.001，r = 0.358）和情景得分（P = 0.001，r = 0.377）之间存在显著正相关。CCPKnow与情景得分之间存在适度相关性（r = 0.356；P < 0.001）。