Women's and Newborn Services Royal Brisbane and Women's Hospital, Metro North Hospital and Health Service, Brisbane, Queensland, Australia.
Faculty of Medicine, Centre for Clinical Research and Perinatal Research Centre, The University of Queensland, Brisbane, Queensland, Australia.
Aust N Z J Obstet Gynaecol. 2023 Apr;63(2):154-162. doi: 10.1111/ajo.13600. Epub 2022 Aug 12.
Consumer perspectives are a cornerstone of value-based healthcare. Screening and diagnosis of gestational diabetes mellitus (GDM) were among many of the rapid changes to health care recommended during the COVID-19 pandemic. The changes provided a unique opportunity to add information about women's perspectives on the debate on GDM screening.
The aim of this qualitative study was to explore women's perspectives and understanding of GDM screening and diagnosis comparing the modified COVID-19 recommendations to standard GDM screening and diagnostic practices.
Women who had experienced both the standard and modified GDM screening and diagnostic processes were recruited for telephone interviews. Data analysis used inductive reflexive thematic analysis. Online surveys were disseminated to any registrant not included in interviews to provide an opportunity for all interested participants to provide their perspective.
Twenty-nine telephone interviews were conducted and 19 survey responses were received. Seven themes were determined: (1) information provision from clinicians; (2) acceptability of GDM screening; (3) individualisation of GDM screening methods; (4) safety nets to avoid a missed diagnosis; (5) informed decision making; (6) women want information and evidence; and (7) preferred GDM screening methods for the future.
Overall, women preferred the modified GDM screening recommendations put in place due to the COVID-19 pandemic. However, their preference was influenced by their prior screening experience and perception of personal risk profile. Women expressed a strong need for clear communication from health professionals and the opportunity to be active participants in decision making.
消费者视角是基于价值的医疗保健的基石。在 COVID-19 大流行期间,建议对许多医疗保健进行快速改变,包括筛查和诊断妊娠糖尿病(GDM)。这些变化为增加有关女性对 GDM 筛查辩论的看法提供了独特的机会。
本定性研究的目的是探讨女性对 GDM 筛查和诊断的看法和理解,比较修改后的 COVID-19 建议与标准 GDM 筛查和诊断实践。
招募了经历过标准和改良 GDM 筛查和诊断过程的女性进行电话访谈。数据分析采用归纳式反思主题分析。在线调查分发给未参加访谈的任何注册者,为所有有兴趣的参与者提供提供他们观点的机会。
进行了 29 次电话访谈,并收到了 19 份调查回复。确定了七个主题:(1)临床医生提供的信息;(2)GDM 筛查的可接受性;(3)GDM 筛查方法的个体化;(4)避免漏诊的安全网;(5)知情决策;(6)女性希望获得信息和证据;(7)未来首选的 GDM 筛查方法。
总体而言,由于 COVID-19 大流行,女性更喜欢修改后的 GDM 筛查建议。然而,她们的偏好受到她们之前的筛查经验和个人风险状况的感知的影响。女性表示强烈需要来自卫生专业人员的明确沟通,并希望积极参与决策。