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美国流产与医疗保健沟通述评。

A Review of Miscarriage and Healthcare Communication in the United States.

机构信息

Department of Public Health Sciences, University of North Carolina at Charlotte.

Department of Communications Studies, University of North Carolina at Charlotte.

出版信息

Health Commun. 2024 Aug;39(9):1847-1854. doi: 10.1080/10410236.2023.2245205. Epub 2023 Aug 9.

Abstract

Miscarriage is a pervasive and socioemotionally complex pregnancy complication. Evidence suggests that poor clinical management can worsen these experiences. Yet, assessments of healthcare communication during a miscarriage are limited and a systematic review of the literature is needed. This review identified and synthesized original research on miscarriage and healthcare communication in the United States from the past 20 years to identify existing knowledge gaps for future miscarriage research. The following databases were searched: PubMed, PsychINFO, and ERIC Database. Data were charted according to Arksey and O'Malley's Scoping Review Framework. Eleven articles were included in the review and three primary themes emerged: (a) patients overwhelmingly prefer patient-centered care; (b) miscarriage is often overmedicalized, which leads to poor communication; and (c) informed decision-making related to one's miscarriage can improve patient experiences. Several gaps were also identified, including studies seeking physician perspectives on miscarriage communication, evaluation of standard care guidelines, and studies evaluating diverse patients' perspectives. This review highlights the need for patient-centered care that utilizes compassionate and accessible language and promotes informed decision-making. Future research should use quantitative methodologies and longitudinal designs to build upon these findings and improve patient experiences of miscarriage.

摘要

流产是一种普遍存在且具有社会情绪复杂性的妊娠并发症。有证据表明,较差的临床管理可能会使这些经历恶化。然而,对流产期间医疗保健沟通的评估有限,因此需要进行系统的文献综述。本综述在美国过去 20 年中确定并综合了关于流产和医疗保健沟通的原始研究,以确定未来流产研究中的现有知识空白。检索了以下数据库:PubMed、PsychINFO 和 ERIC 数据库。根据 Arksey 和 O'Malley 的范围综述框架对数据进行图表绘制。有 11 篇文章被纳入综述,出现了三个主要主题:(a) 患者普遍更喜欢以患者为中心的护理;(b) 流产往往被过度医疗化,导致沟通不畅;(c) 与流产相关的知情决策可以改善患者体验。还确定了几个空白,包括研究寻求医生对流产沟通的看法、评估标准护理指南以及研究评估不同患者观点的研究。本综述强调了需要以患者为中心的护理,该护理采用富有同情心和可及的语言,并促进知情决策。未来的研究应使用定量方法和纵向设计来建立在这些发现的基础上,并改善患者对流产的体验。

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