Reproductive autonomy of women living with multiple myeloma participating in a pregnancy prevention program
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Notice bibliographique
Résumé
BACKGROUND: Multiple myeloma is an incurable hematologic cancer that primarily affects older adults. Females of childbearing potential represent a small but uniquely affected proportion of the multiple myeloma population. The immunomodulatory agents (thalidomide, lenalidomide and pomalidomide) are highly effective treatments in improving prolonged periods of deep remission and long-term survival in Multiple Myeloma, is dispensed through controlled distribution programs that require pregnancy monitoring for females of childbearing potential to reduce the risk of fetal exposure. There is limited understanding of the impact of pregnancy prevention and monitoring measures on the reproductive health, autonomy, and rights of women living with multiple myeloma. METHODS: This critical qualitative study is informed by a descriptive methodological approach, and a feminist reproductive justice theoretical framework informed the data analysis and interpretation. We employed purposive sampling to identify and conduct interviews with females of childbearing potential, living with multiple myeloma, that have experience participating in a controlled distribution program. RESULTS: This study reflects the experiences of 15 females of childbearing potential living with MM, all of whom identified as women and ranged in age from 33–50 at diagnosis. Participants were situated in provinces across Canada, with most identifying as White, married, and of higher socioeconomic status. Findings illuminate a multitude of ways in which controlled distribution programs imposed threats to the reproductive health and autonomy of these women. Although many participants acknowledged the importance of preventing fetal exposure to teratogenic medications, the prescriptive and controlling nature of hyper-vigilant pregnancy monitoring programs and practices imposed significant burden and constraints on females of childbearing potential. Key analytic themes highlight the perceived paternalistic nature of controlled distribution programs, the systemic distrust of females of childbearing potential, and women’s actions and advocacy efforts to (re)claim their reproductive agency. CONCLUSION: Participant-informed adaptations to the design and delivery of pregnancy monitoring and prevention requirements in existing controlled distribution programs to promote the reproductive autonomy and agency of females of childbearing potential are both necessary and feasible. Key recommendations include increased provision of timely, comprehensive information and education, psychosocial support, as well as modifications to programs and regulatory bodies to recognize women as trustworthy and capable of autonomous, reproductive health decision-making.
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Prédiction distillée sur la base complète
Imitation des enseignantsNi prévalence calibrée, ni vérité terrain. Validation humaine à venir. Apprise à partir de 10 348 étiquettes directes de Codex et de 10 348 étiquettes directes de Gemma. Le mode candidate est l'union des têtes enseignantes seuillées; le consensus est leur intersection. Ces sorties portent le statut machine_predicted_unvalidated et ne sont ni des étiquettes humaines ni des étiquettes directes de modèles de pointe.
Scores Codex et Gemma par catégorie
| Catégorie | Codex | Gemma |
|---|---|---|
| Métarecherche | 0,001 | 0,002 |
| Méta-épidémiologie (sens strict) | 0,000 | 0,000 |
| Méta-épidémiologie (sens large) | 0,001 | 0,000 |
| Bibliométrie | 0,000 | 0,001 |
| Études des sciences et des technologies | 0,000 | 0,000 |
| Communication savante | 0,000 | 0,000 |
| Science ouverte | 0,000 | 0,000 |
| Intégrité de la recherche | 0,000 | 0,000 |
| Charge utile insuffisante (le modèle a refusé de juger) | 0,000 | 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 découle