Reproductive Health & Childbirth Research, Royal Free London NHS Foundation Trust, Royal Free Hospital, Pond Street, London, NW3 2QG, UK.
Royal Free London NHS Foundation Trust, Royal Free Hospital, Pond Street, London, NW3 2QG, UK.
BMC Health Serv Res. 2024 Nov 1;24(1):1328. doi: 10.1186/s12913-024-11750-1.
Early pregnancy loss (EPL) can have profound implications for physical and psychological health. In the UK, significant variation in service provision exists for women affected by EPL. There is very little guidance on what hospital-based follow-up support services should entail, and how these can be implemented and integrated into current care provision to meet the needs of women who experience EPL. This service evaluation (SE) reports on an Early Pregnancy Loss Support Clinic (EPLSC) in an inner-city Hospital Trust.
This SE gathered both quantitative and qualitative feedback from women to assess the value of a locally implemented Early Pregnancy Loss Support Clinic (EPLSC). Quantitative feedback was collected using the Short Assessment of Patient Satisfaction (SAPS) questionnaire and the Visual Anxiety Scale (VAS-A), both administered to women attending the EPLSC. Qualitative feedback was collected through semi-structured interviews and focused on four pre-determined themes based on EPL literature - physical health, mental health, role of the bereavement midwife and overall service user experience. Quantitative feedback was summarised using descriptive statistics, while qualitative feedback was analysed using framework analysis.
A total of 127 women were invited to the EPLSC, with 110 (87%) attending, and 17 (13%) not attending their appointment. SAPS scores ranged from 21 to 28, indicating that women were either satisfied or very satisfied with the care they received at the EPLSC. Results from VAS-A scores showed that 76 (69%) women reported a decrease in anxiety immediately after attending the EPLSC, compared to 8 (7%) who reported no change or a small increase in anxiety. Qualitative findings highlighted women's concerns around future fertility, the importance of emotional support and the value of connecting with the bereavement midwife.
An EPLSC that focuses on providing emotional support and reassurance, particularly regarding future fertility, is important to women. Further rigorous evaluation of national disparities in EPL follow-up is urgently needed to assess the gaps in clinical care delivery.
早期妊娠丢失（EPL）会对身心健康产生深远影响。在英国，受 EPL 影响的女性的服务提供存在显著差异。几乎没有关于医院随访支持服务应包含哪些内容的指导，以及如何将这些服务纳入当前的护理服务中，以满足经历 EPL 的女性的需求。本服务评估（SE）报告了一家市区内医院信托基金的早期妊娠丢失支持诊所（EPLSC）。
本 SE 从女性那里收集了定量和定性反馈，以评估在当地实施的早期妊娠丢失支持诊所（EPLSC）的价值。使用简短患者满意度评估（SAPS）问卷和视觉焦虑量表（VAS-A）收集定量反馈，这两种量表均在接受 EPLSC 治疗的女性中使用。定性反馈是通过半结构化访谈收集的，重点关注基于 EPL 文献的四个预先确定的主题——身体健康、心理健康、丧亲助产士的角色和整体服务用户体验。定量反馈使用描述性统计进行总结，而定性反馈使用框架分析进行分析。
共有 127 名女性被邀请参加 EPLSC，其中 110 名（87%）参加了，17 名（13%）未参加预约。SAPS 评分范围从 21 到 28，表明女性对她们在 EPLSC 接受的护理感到满意或非常满意。VAS-A 评分结果显示，与 8 名（7%）报告焦虑无变化或略有增加的女性相比，76 名（69%）女性在参加 EPLSC 后立即报告焦虑减轻。定性研究结果突出了女性对未来生育能力的担忧、情感支持的重要性以及与丧亲助产士联系的价值。
专注于提供情感支持和保证的 EPLSC 对女性非常重要。迫切需要对全国 EPL 随访中的差异进行进一步严格评估，以评估临床护理服务提供方面的差距。
