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Abstract：
Globally, the incidence of hypertensive disorders of pregnancy, especially preeclampsia, remains high, particularly in low- and middle-income countries. The burden of adverse maternal and perinatal outcomes is particularly high for women who develop a hypertensive disorder remote from term (<34 weeks). In parallel, many women have a suboptimal experience of care. To improve the quality of care in terms of provision and experience, there is a need to support the communication of risks and making of treatment decision in ways that promote respectful maternity care. Our study objective is to co-create a tool(kit) to support clinical decision-making, communication of risks and shared decision-making in preeclampsia with relevant stakeholders, incorporating respectful maternity care, justice, and equity principles. This qualitative study detailing the exploratory phase of co-creation takes place over 17 months (Nov 2021-March 2024) in the Greater Accra and Eastern Regions of Ghana. Informed by ethnographic observations of care interactions, in-depth interviews and focus group and group discussions, the tool(kit) will be developed with survivors and women with hypertensive disorders of pregnancy and their families, health professionals, policy makers, and researchers. The tool(kit) will consist of three components: quantitative predicted risk (based on external validated risk models or absolute risk of adverse outcomes), risk communication, and shared decision-making support. We expect to co-create a user-friendly tool(kit) to improve the quality of care for women with preeclampsia remote from term which will contribute to better maternal and perinatal health outcomes as well as better maternity care experience for women in Ghana.
Adverse maternal and perinatal outcomes is high for women who develop preeclampsia remote from term (<34 weeks). To improve the quality of provision and experience of care, there is a need to support communication of risks and treatment decisions that promotes respectful maternity care.This article describes the methodology deployed to cocreate a user-friendly tool(kit) to support risk communication and shared decision-making in the context of severe preeclampsia in a low resource setting.
Adverse maternal and perinatal outcomes is high for women who develop preeclampsia remote from term (<34 weeks). To improve the quality of provision and experience of care, there is a need to support communication of risks and treatment decisions that promotes respectful maternity care.This article describes the methodology deployed to cocreate a user-friendly tool(kit) to support risk communication and shared decision-making in the context of severe preeclampsia in a low resource setting.
摘要：
全球范围内,妊娠期高血压疾病的发病率，尤其是先兆子痫,仍然很高，特别是在低收入和中等收入国家。不良的孕产妇和围产期结局的负担对于在足月远处（<34周）发展为高血压疾病的妇女尤其高。并行,许多妇女的护理体验欠佳。在提供和经验方面提高护理质量，有必要以促进尊重产妇护理的方式支持风险沟通和治疗决策。我们的研究目标是共同创建一个工具(套件)来支持临床决策，与相关利益相关者沟通先兆子痫的风险和共同决策，包括尊重产妇的护理，正义,和公平原则。这项定性研究详细介绍了共同创造的探索阶段，历时17个月（2021年11月至2024年3月），在加纳大阿克拉和东部地区进行。根据人种学对护理互动的观察，深入访谈和焦点小组和小组讨论，该工具（套件）将与患有妊娠高血压疾病的幸存者和妇女及其家人一起开发，卫生专业人员,政策制定者,和研究人员。该工具（套件）将包括三个组成部分：定量预测风险（基于外部验证的风险模型或不利结果的绝对风险），风险沟通,和共享决策支持。我们希望共同创建一个用户友好的工具（工具包），以提高远离足月的先兆子痫妇女的护理质量，这将有助于更好的孕产妇和围产期健康结果以及加纳妇女更好的产妇护理经验。
在足月远（<34周）发生先兆子痫的妇女中，不良的孕产妇和围产期结局很高。为了提高提供护理的质量和经验，有必要支持风险和治疗决定的沟通，以促进尊重产妇的护理。本文介绍了用于共同创建用户友好工具（工具包）的方法，以支持在资源匮乏的严重先兆子痫的情况下进行风险沟通和共享决策。
在足月远（<34周）发生先兆子痫的妇女中，不良的孕产妇和围产期结局很高。为了提高提供护理的质量和经验，有必要支持风险和治疗决定的沟通，以促进尊重产妇的护理。本文介绍了用于共同创建用户友好工具（工具包）的方法，以支持在资源匮乏的严重先兆子痫的情况下进行风险沟通和共享决策。
