The Experiences and Challenges of Pregnant Women Coping with Thrombophilia.
Notice bibliographique
Résumé
Abstract Background and Objectives: Pregnancy may be adversely affected by thrombophilia via venous thromboembolism-induced morbidity and mortality or via gestational vascular complications such as fetal loss or preeclampsia. Women with thrombophilia are often prescribed heparin for daily self-injection during pregnancy. The purpose of this study was to explore the unique experiences, challenges, and coping strategies of pregnant women with thrombophilia who are on daily heparin injections. Study Methods: A qualitative, descriptive approach with semi-structured, individual interviews was used. Women with thrombophilia followed at the Thrombosis Clinic of a large university affiliated hospital in Quebec, Canada who were prescribed heparin during pregnancy and who were pregnant at the time of the study or within the last 12 months were eligible. Interviews lasting 45 minutes performed by a trained graduate nursing student were conducted with each participant. Thematic analysis was used throughout the processes of interviewing, transcribing verbatim, and categorizing the data. Results: Nine women (age range 30–36) participated in the study. Four participants had antiphospholipid antibody syndrome, three had the lupus anticoagulant, one had Factor V Leiden and one had Protein S deficiency. For all participants, the diagnosis of thrombophilia was made via blood testing after referral to Clinic for evaluation of multiple early pregnancy losses, late pregnancy losses, or other serious pregnancy complications. None had previous venous thromboembolic events. Four main themes were identified based on analysis of the interview transcripts: the emotional impact of diagnosis and treatment of thrombophilia, which was influenced by past pregnancy experiences as well as the experiences of others; the need for professional support, particularly concerning medical decision-making regarding whether to choose treatment in certain cases, but also with regards to information, injection technique, and emotional needs; uncertainty vis-à-vis treatment outcomes; and successful coping strategies such as taking control and maintaining perspective. Conclusions: This qualitative research shows that, during pregnancy, coping with thrombophilia and daily heparin injections can be a stressful experience. However, the ensuing challenges are perceived as manageable discomforts in light of the outcome of a healthy baby. Implications for health professionals include providing written information to complement explanations given during appointments, standardization of self-injection teaching, establishing peer networks among women who have had similar experiences, and follow-up with a nurse, who can provide ongoing support around coping with uncertainty and the stress of self-injection, revisit the information given, and provide emotional support and referral, if needed. Greater standardization of physician decision making regarding the need for thrombophilia screening and anticoagulation may also be beneficial, since differences in physicians’ approaches across institutions was reported by participants as a source of stress. Nurses, in collaboration with physicians, are in a key position to enhance the quality of care to this population. Further research should evaluate a standardized program based on interventions suggested by this study.
Récupéré en direct depuis OpenAlex et désinversé. Les résumés ne sont pas conservés dans cette base de données : les index inversés représentent 8,6 Go des 9,3 Go de texte de la base, et le serveur dispose de 13 Go libres.
Comment cette classification a été obtenuedéplier
Prédiction machine sur la base complète
Imitation des enseignantsNi prévalence calibrée, ni vérité terrain. Validation humaine à venir. Le volet Gemma est une étiquette directe du modèle pour chaque travail de la base, lue sur la notice réduite au titre. Le volet Codex est un classifieur appris des 10 348 étiquettes directes de Codex et calibré sur les taux pondérés de l'échantillon; les champs sans appui suffisant ne portent aucun appel Codex. Le mode candidate est l'union des deux volets; le consensus est leur intersection. Ces sorties portent le statut machine_predicted_unvalidated et ne sont pas des étiquettes humaines.
Scores du classifieur distillé par catégorie (deux têtes)
| Catégorie | Codex | Gemma |
|---|---|---|
| Métarecherche | 0,003 | 0,008 |
| Méta-épidémiologie (sens strict) | 0,000 | 0,001 |
| Méta-épidémiologie (sens large) | 0,000 | 0,000 |
| Bibliométrie | 0,000 | 0,000 |
| Études des sciences et des technologies | 0,004 | 0,004 |
| Communication savante | 0,003 | 0,001 |
| Science ouverte | 0,001 | 0,004 |
| Intégrité de la recherche | 0,001 | 0,002 |
| Charge utile insuffisante (le modèle a refusé de juger) | 0,001 | 0,000 |
Scores machine (provisoires)
Les deux têtes enseignantes du modèle étudiant, lues sur ce travail. Un score ordonne la base pour la relecture; il n'affirme jamais une catégorie, et le statut de validation accompagne chaque rangée tel quel.
Scores de référence d'un modèle non mature (critères de maturité non atteints, 7 itérations). Un score ordonne; il n'affirme jamais une catégorie.
score_only:v0-immature-baseline · tel quel depuis la passe de notation : score_only signifie que le nombre peut ordonner les travaux, et qu'aucune étiquette de catégorie n'en découleClassification
machine, non validéePrédiction automatique; un appel candidat d’une seule source (Gemma direct ou Codex distillé), pas un consensus.
Le détail, modèle par modèle et score par score, se trouve en fin de page sous « Comment cette classification a été obtenue ».