Schneiderman Katarina S, Henderson Alexa P, Himes Katherine P
University of Pittsburgh School of Medicine, Pittsburgh, PA, USA.
University of Pittsburgh Medical Center Department of Obstetrics, Gynecology, and Reproductive Sciences, Pittsburgh, PA, USA.
Patient Educ Couns. 2025 Jun;135:108715. doi: 10.1016/j.pec.2025.108715. Epub 2025 Feb 27.
There is limited data regarding patients' experiences with periviable counseling. Exploring patient perspectives helps us improve provider communication and may aid in supporting high-quality decision-making. Our study explored patient-identified sources of support and conflict during discussions with their healthcare team when delivering during the periviable period with the goal of improving high-quality shared decision making (SDM).
We conducted semi-structured interviews of birthing people who delivered between 20 0/7 and 25 6/7 weeks gestational age from 2010 to 2014. Interviews focused on shared decision making at the time of periviable birth with an emphasis on the three-talk model of SDM. Interviews were coded to perform thematic analysis.
We interviewed 20 patients who delivered during the periviable period and 6 important others. Participants valued providers aiding in their emotional processing. Conversely, participants identified lack of clarity during counseling and an emphasis on hopelessness as barriers to SDM.
CONCLUSION(S): Participants highlighted the importance of using easy-to-understand language and focusing on hope. Finally, families emphasized the importance of explicitly eliciting values that might inform their choice and the positive impact of nursing staff.
Our findings underscore the importance of using a SDM model for periviability counseling and highlight areas for improvement.
关于可存活期咨询患者体验的数据有限。探索患者观点有助于我们改善医护人员沟通，并可能有助于支持高质量决策。我们的研究探讨了患者在可存活期分娩期间与医护团队讨论时确定的支持和冲突来源，目的是改善高质量的共同决策（SDM）。
我们对2010年至2014年孕龄在20 0/7至25 6/7周之间分娩的产妇进行了半结构化访谈。访谈重点是可存活期分娩时的共同决策，强调SDM的三谈模式。对访谈进行编码以进行主题分析。
我们采访了20名在可存活期分娩的患者和6名其他重要人员。参与者重视医护人员帮助他们进行情绪处理。相反，参与者认为咨询过程中缺乏清晰度以及强调绝望是SDM的障碍。
参与者强调了使用易懂语言和关注希望的重要性。最后，家庭强调了明确引出可能影响其选择的价值观的重要性以及护理人员的积极影响。
我们的研究结果强调了使用SDM模型进行可存活期咨询的重要性，并突出了改进领域。
