加强子宫肌瘤护理:临床医生对诊断、差异和改善医疗保健策略的看法。

IF 1.6 Q3 OBSTETRICS & GYNECOLOGY Women's health reports (New Rochelle, N.Y.) Pub Date : 2024-03-27 eCollection Date: 2024-01-01 DOI:10.1089/whr.2023.0113
Alfu Laily, Isha Nair, Sophie E Shank, Cameron Wettschurack, Grace Khamis, Chandler Dykstra, Andrea L DeMaria, Monica L Kasting
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引用次数: 0

摘要

摘要探讨临床医生在诊断、治疗和管理子宫肌瘤方面的观点,找出医疗服务中存在的差距和挑战,并提出改善医疗服务的建议:采用定性设计对印第安纳州中部治疗子宫肌瘤患者的临床医生进行了 14 次半结构式访谈。对访谈进行了录音、逐字转录,并使用主题分析技术进行了分析。采用恒定比较分析法确定新出现的主题:结果:出现了四个主题。(1) 患者缺乏对子宫肌瘤的认识:患者对子宫肌瘤缺乏认识,导致在解释诊断和治疗时遇到困难。误解和情绪困扰凸显了加强教育的必要性。(2) 医疗和就医方面的不平等:医疗服务的不平等影响了黑人妇女和农村患者,交通、时间安排延误和经济限制阻碍了患者获得医疗服务。(3) 持续护理:临床医生优先考虑以患者为中心的护理和共同决策,根据严重程度、位置、大小、费用、生育目标和恢复时间等因素量身定制治疗方案。(4) 2019 年冠状病毒病(COVID-19)的影响:大流行带来了挑战和机遇,促使采用远程医疗并考虑非手术方案:临床医生从患者的角度指出了子宫肌瘤带来的挑战,呼吁加强教育、跨学科合作和无障碍护理,以解决子宫肌瘤管理的关键问题,改善妇女的福祉:临床医生发现,患者对子宫肌瘤缺乏认识,获得子宫肌瘤治疗的机会也不平等,这凸显了加强教育和解决不平等问题的必要性。研究结果还强调了考虑子宫肌瘤护理的多维方面以及适应 COVID-19 大流行所带来的挑战的重要性,建议开展更广泛的教育、可负担性、跨学科合作和研究,以改善子宫肌瘤保健。
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Enhancing Uterine Fibroid Care: Clinician Perspectives on Diagnosis, Disparities, and Strategies for Improving Health Care.

Objective: To explore clinicians' perspectives on diagnosing, treating, and managing uterine fibroids, identifying gaps and challenges in health care delivery, and offering recommendations for improving care.

Materials and methods: A qualitative design was used to conduct 14 semistructured interviews with clinicians who treat fibroid patients in central Indiana. Interviews were audio recorded, transcribed verbatim, and analyzed using thematic analysis techniques. Constant comparative analysis was used to identify emergent themes.

Results: Four themes emerged. (1) Lack of patient fibroid awareness: Patients lacked fibroid awareness, leading to challenges in explaining diagnoses and treatment. Misconceptions and emotional distress highlighted the need for better education. (2) Inequities in care and access: Health care disparities affected Black women and rural patients, with transportation, scheduling delays, and financial constraints hindering access. (3) Continuum of care: Clinicians prioritized patient-centered care and shared decision-making, tailoring treatment based on factors like severity, location, size, cost, fertility goals, and recovery time. (4) Coronavirus disease 2019 (COVID-19) impact: The pandemic posed challenges and opportunities, prompting telehealth adoption and consideration of nonsurgical options.

Conclusions: Clinician perspectives noted patient challenges with fibroids, prompting calls for enhanced education, interdisciplinary collaboration, and accessible care to address crucial aspects of fibroid management and improve women's well-being.

Practice implications: Clinicians identified a lack of patient awareness and unequal access to fibroid care, highlighting the need for improved education and addressing disparities. Findings also emphasized the importance of considering multidimensional aspects of fibroid care and adapting to challenges posed by the COVID-19 pandemic, recommending broader education, affordability, interdisciplinary collaboration, and research for better fibroid health care.

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来源期刊
CiteScore
1.30
自引率
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审稿时长
18 weeks
期刊最新文献
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