Guerrero Kerly M, Wolfe Diana S, Hameed Afshan B, Thiel De Bocanegra Heike
Obstetrics, Gynecology and Women's Health, Division of Maternal Fetal Medicine, Montefiore Medical Center, Albert Einstein College of Medicine, Bronx, NY, USA.
Obstetrics and Gynecology, Maternal Fetal Medicine, University of California, Irvine, CA, USA.
J Patient Exp. 2025 Apr 13;12:23743735251325130. doi: 10.1177/23743735251325130. eCollection 2025.
Cardiovascular disease (CVD) is the leading cause of maternal mortality in the United States. Two major hospital networks implemented a novel CVD risk assessment of pregnant and postpartum patients to standardize identification of patients with previously unknown CVD or at risk to develop CVD. This qualitative study explored the experience of being identified as at CVD risk in a purposive sample of 10 obstetric patients. Participants varied by age, race/ethnicity, language (English/Spanish), and comorbidities. Interviews focused on patients' awareness, emotional responses, clinician-patient communication, and behavioral intentions. Thematic analysis using Atlas.ti 8 revealed a limited understanding of the association between CVD and pregnancy complications and lifetime CVD risk. Positive risk assessments triggered surprise and concern. Overall, patients evaluated the clinician-patient communication positively but found information too cursory and varied in strategies to find out more details. Several patients initiated immediate lifestyle changes, while others waited for guidance from clinicians. The study underscores the need to engage patients in the implementation of screening tests and to improve health literacy to facilitate follow up care and behavior change.
心血管疾病（CVD）是美国孕产妇死亡的主要原因。两个主要医院网络对孕妇和产后患者实施了一种新型的心血管疾病风险评估，以规范对先前未知患有心血管疾病或有患心血管疾病风险患者的识别。这项定性研究在10名产科患者的目标样本中探讨了被确定为有心血管疾病风险的经历。参与者在年龄、种族/民族、语言（英语/西班牙语）和合并症方面存在差异。访谈集中在患者的认知、情绪反应、医患沟通和行为意图上。使用Atlas.ti 8进行的主题分析显示，患者对心血管疾病与妊娠并发症之间的关联以及终身心血管疾病风险的理解有限。积极的风险评估引发了惊讶和担忧。总体而言，患者对医患沟通给予了积极评价，但认为信息过于简略，并且在获取更多细节的策略上存在差异。一些患者立即开始改变生活方式，而另一些患者则等待临床医生的指导。该研究强调需要让患者参与筛查测试的实施，并提高健康素养，以促进后续护理和行为改变。
