Joshi Avina, Beyuo Titus K, Oppong Samuel A, Moyer Cheryl A, Lawrence Emma R
University of Massachusetts Medical School, Worcester, Massachusetts, United States of America.
University of Ghana School of Medicine and Dentistry, Accra, Ghana.
PLOS Glob Public Health. 2022 Jul 13;2(7):e0000121. doi: 10.1371/journal.pgph.0000121. eCollection 2022.
Preeclampsia and eclampsia are common and serious complications of pregnancies, often presenting as obstetric emergencies. In low- and middle-income countries, limited numbers of healthcare providers and a high volume of critically ill patients can negatively impact provider communication and counseling. Lack of knowledge or awareness of preeclampsia and eclampsia among pregnant women can lead to delays in health seeking behavior. Our study uses grounded theory to explore patients' experience of preeclampsia and eclampsia in a low-resource setting. Participants were postpartum women diagnosed with preeclampsia or eclampsia at Korle Bu Teaching Hospital in Ghana. Interviews consisted of semi-structured, open-ended questions regarding participant understanding of their diagnosis of preeclampsia and eclampsia; counseling from their healthcare providers; and experiences with their delivery, monitoring, and treatment. Qualitative thematic analysis was performed according to the Attride-Sterling analytical framework, using NVivo 12. A total of 45 women were interviewed, 88.9% with preeclampsia and 11.1% with eclampsia. Major themes identified include participants' low general knowledge of their diagnosis, inadequate counseling from healthcare providers, and resulting emotional distress. Women desire more information regarding their diagnosis and associate their health-seeking behaviors with counseling they receive from healthcare providers. Women also acknowledge the systemic barriers that make patient care and counseling challenging for providers, especially in low- and middle-income countries. These findings highlight the need for improved models of counseling and health education for women with pregnancies complicated by preeclampsia and eclampsia.
子痫前期和子痫是常见且严重的妊娠并发症，常表现为产科急症。在低收入和中等收入国家，医疗服务提供者数量有限，危重症患者数量众多，这可能会对医疗服务提供者之间的沟通和咨询产生负面影响。孕妇对子痫前期和子痫缺乏了解或认识，可能导致就医行为延迟。我们的研究采用扎根理论，在资源匮乏的环境中探索患者子痫前期和子痫的经历。研究对象是在加纳科勒布教学医院被诊断为子痫前期或子痫的产后妇女。访谈包括关于参与者对子痫前期和子痫诊断的理解、医疗服务提供者提供的咨询，以及她们分娩、监测和治疗经历的半结构化、开放式问题。根据阿特里德 - 斯特林分析框架，使用NVivo 12进行定性主题分析。共访谈了45名妇女，其中88.9%患有子痫前期，11.1%患有子痫。确定的主要主题包括参与者对自身诊断的一般知识水平较低、医疗服务提供者提供的咨询不足以及由此产生的情绪困扰。女性希望获得更多关于自身诊断的信息，并将她们的就医行为与从医疗服务提供者那里获得的咨询联系起来。女性也认识到系统性障碍，这些障碍使得医疗服务提供者在提供患者护理和咨询时面临挑战，尤其是在低收入和中等收入国家。这些发现凸显了需要改进针对患有子痫前期和子痫并发症孕妇的咨询和健康教育模式。
