生殖内分泌与不孕症照护团队对管理妊娠丢失患者的观点:一项质性研究
Reproductive endocrinology and infertility care team perspectives on managing fertility patients experiencing pregnancy loss: a qualitative study
摘要
本研究采用现象学质性案例设计,对美国中西部某学术医疗系统12名生殖内分泌与不孕症(REI)医生、护士及社会工作者进行半结构化访谈,并用Braun与Clarke六阶段框架分析。结果归纳出5个主题和2个亚主题,核心为“不孕背景下的妊娠丢失”及患者旅程;参与者强调高度期待妊娠合并妊娠丢失带来的体验差异,呼吁整合团队、改善沟通与支持策略,并建议讨论妊娠丢失时优先面对面沟通,以更好评估需求并定制资源。
原文摘要
RESEARCH QUESTION: What are the perceptions and recommendations of reproductive endocrinology and infertility (REI) patient care team members regarding best communication and support strategies for fertility patients experiencing pregnancy loss? DESIGN: This qualitative case study utilized a phenomenological approach to understand the lived work experiences and recommendations of REI professionals, with purposive sampling of physicians, nurses and social workers, at a US Midwest academic health system. Twelve semi-structured interviews were conducted, transcribed and analysed using Braun and Clarke's six-phase framework. RESULTS: The findings include five major themes and two subthemes, with the theme 'pregnancy loss in the context of infertility' or the 'patient journey' being most referenced by participants in representing the patient experience. Within this patient journey, the findings discuss how participants navigate highly desired pregnancies compounded by pregnancy loss, creating varying patient experiences and responses. Based on this variability, changes to operational management are indicated. The participants/providers primarily highlight the value of an integrated team and a call for improved communication and support strategies. CONCLUSIONS: The study findings suggest prioritizing face-to-face communication with fertility patients when discussing pregnancy loss. This may give REI professionals and patients greater opportunity to better assess and express needs, and tailor resources specific to pregnancy loss within the context of the infertility journey.
推荐理由:聚焦辅助生殖临床中常被忽视的妊娠丢失沟通与团队支持,对REI照护流程改进有直接参考价值;但为小样本单中心质性研究,证据层级有限,机制与量化影响不足。
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