1
|
Park M, Choi E, Jeong M, Seo HJ, Kim J, Seo E. Interprofessional Educational Needs for Shared Governance of Integrated Care. Int J Integr Care 2024; 24:15. [PMID: 38736721 PMCID: PMC11086590 DOI: 10.5334/ijic.7674] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2023] [Accepted: 04/17/2024] [Indexed: 05/14/2024] Open
Abstract
Introduction This study investigated the educational needs of integrated care among professionals in the public sector of healthcare and social care services in South Korea. Methods A cross-sectional secondary data analysis was performed. Original data were obtained from 10 metropolitan communities with a convenience sample of 210 integrated care professionals. The Borich Needs Assessment Model and the Locus for Focus Model were used to examine the priority educational needs of each integrated care professional. Results This study analyzed the key details of educational needs in integrated care by focusing on the competencies of integrated care approaches for person-centered care, interprofessional collaboration, and community involvement. The core educational needs of community care administrators, care coordinators, healthcare and social care providers, and community health champions, which are common to all professionals, and the specific educational needs for each type of professional were demonstrated, which contained specific content to implement integrated care. Conclusion This study provides an opportunity to comprehensively understand the educational needs of integrated care professionals based on their competencies. They want better interprofessional cooperation through networking and collaborative strategies. The results of this study may be utilized as fundamental data by future instructors to provide evidence-based education programs.
Collapse
Affiliation(s)
- Myonghwa Park
- College of Nursing, Chungnam National University, Daejeon, Republic of Korea
| | - Eunjeong Choi
- Department of Public Health, Graduate School, Yonsei University, Seoul, Republic of Korea
| | - Miri Jeong
- Department of nursing, Joongbu University, Geumsan-gun, Chungnam-do, Republic of Korea
| | - Hyun-Ju Seo
- College of Nursing, Chungnam National University, Daejeon, Republic of Korea
| | - Jahyeon Kim
- College of Nursing, Chungnam National University, Daejeon, Republic of Korea
- Chung-ang University Gwangmyeong Hospital, Gwangmyeong-si, Gyeonggi-do, Republic of Korea
| | - Eunkyung Seo
- College of Nursing, Chungnam National University, Daejeon, Republic of Korea
| |
Collapse
|
2
|
Kazmerski TM, Stransky OM, Lavage DR, Hughan KS, Jain R, Ladores SL, Stalvey MS, Tangpricha V, Taylor-Cousar JL, West NE, Sawicki GS. Clinician perspectives and practices related to sexual and reproductive care provision for males with cystic fibrosis. J Cyst Fibros 2023:S1569-1993(23)01668-5. [PMID: 37953183 DOI: 10.1016/j.jcf.2023.10.023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2023] [Revised: 10/02/2023] [Accepted: 10/31/2023] [Indexed: 11/14/2023]
Abstract
BACKGROUND Males with cystic fibrosis (MwCF) have unique sexual and reproductive health (SRH) concerns. This study investigates multidisciplinary CF clinician perspectives related to SRH for MwCF in the current era of CF care. METHODS We surveyed multidisciplinary clinicians exploring attitudes, practices, and preferences toward male CF SRH care. We compared responses across groups by population served (pediatric vs. adult vs. both pediatric and adult MwCF) using chi square/Fisher's exact tests. RESULTS A total of 297 clinicians completed the survey (41 % pediatric, 36 % adult, 23 % both; 27 % physicians, 24 % social workers, 11 % nurses, 41 % other). Nearly all (98 %) believed the CF team had a role in SRH care with 75 % believing they should be primarily responsible. Pediatric clinicians were less likely to deem SRH topics important and less likely to report annual discussions compared to adult colleagues (all p<0.05). Pediatric clinicians reported less comfort in their SRH knowledge than adult colleagues (p<0.001) and in their ability to provide SRH care (p<0.05). Common barriers endorsed by respondents included lack of SRH knowledge (75 %) and presence of family/partners in exam room (64 %). A majority rated SRH screening tools (91 %), partnerships with SRH specialists (90 %), clinician training (83 %), and management algorithms (83 %) as potential facilitators. CONCLUSION Multidisciplinary CF clinicians perceive SRH for MwCF as important but report suboptimal SRH discussions. Pediatric clinicians report significantly less comfort and skill in discussing and managing male SRH. Identified barriers and facilitators should be used to improve SRH care for MwCF.
Collapse
Affiliation(s)
- Traci M Kazmerski
- Department of Pediatrics, University of Pittsburgh School of Medicine, 120 Lytton Avenue Suite M060 Pittsburgh, PA, 15213, United States; Center for Innovative Research on Gender Health Equity (CONVERGE), University of Pittsburgh, 120 Lytton Avenue Suite M060 Pittsburgh, PA, 15213, United States.
| | - Olivia M Stransky
- Center for Innovative Research on Gender Health Equity (CONVERGE), University of Pittsburgh, 120 Lytton Avenue Suite M060 Pittsburgh, PA, 15213, United States; UPMC Children's Hospital of Pittsburgh, 4401 Penn Ave. Pittsburgh, PA, 15224, United States.
| | - Danielle R Lavage
- Department of Pediatrics, University of Pittsburgh School of Medicine, 120 Lytton Avenue Suite M060 Pittsburgh, PA, 15213, United States; Department of Anesthesia and Perioperative Medicine, University of Pittsburgh School of Medicine, 3550 Terrace Street, Pittsburgh, PA 15261, United States.
| | - Kara S Hughan
- Department of Pediatrics, University of Pittsburgh School of Medicine, 120 Lytton Avenue Suite M060 Pittsburgh, PA, 15213, United States.
| | - Raksha Jain
- University of Texas Southwestern, 5323 Harry Hines Blvd., Dallas, TX 75390-8558, United States.
| | - Sigrid L Ladores
- School of Nursing, The University of Alabama at Birmingham, 1720 S. 2nd Ave., NB485-A, Birmingham, AL 35294, United States.
| | | | - Vin Tangpricha
- Department of Medicine, Emory University School of Medicine, 100 Woodruff Circle Atlanta, 30322, United States.
| | | | - Natalie E West
- The Johns Hopkins University, 1830 Building 5th Floor Pulmonary, Baltimore, MD 21287, United States.
| | - Gregory S Sawicki
- Boston Children's Hospital, 300 Longwood Ave, Boston, MA, 02115, United States.
| |
Collapse
|
3
|
Savant AP, McColley SA. Cystic fibrosis year in review 2019: Section 3 multisystem-based care and research. Pediatr Pulmonol 2023; 58:697-703. [PMID: 33210843 DOI: 10.1002/ppul.25158] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/19/2020] [Revised: 11/01/2020] [Accepted: 11/03/2020] [Indexed: 11/08/2022]
Abstract
During the year 2019, numerous research studies and other reports were published that are interesting and instructive to professionals who care for people with cystic fibrosis (CF) and their families. This report is the third of 3 CF year in review articles and focuses on the multisystem manifestations of CF care. Previous articles have addressed cystic fibrosis transmembrane regulator modulators and reports on CF pulmonary disease and airway infections. It is an exciting time to be involved in care and research that aims to improve care for people with CF and their families.
Collapse
Affiliation(s)
- Adrienne P Savant
- Division of Pulmonary Medicine, Children's Hospital of New Orleans, New Orleans, Louisiana, USA.,Department of Pediatrics, Tulane University School of Medicine, New Orleans, Louisiana, USA
| | - Susanna A McColley
- Department of Pediatrics, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA.,Department of Clinical Research, Stanley Manne Children's Research Institute, Chicago, Illinois, USA.,Division of Pulmonary Medicine, Ann & Robert H. Lurie Children's Hospital of Chicago, Chicago, Illinois, USA
| |
Collapse
|
4
|
Kazmerski TM, Stransky OM, Lavage DR, Taylor-Cousar JL, Sawicki GS, Ladores SL, Godfrey EM, Aitken ML, Fields A, Sufian S, Jain M, Barto TL, Billings J, Hadjiliadis D, Jain R. Sexual and reproductive health experiences and care of adult women with cystic fibrosis. J Cyst Fibros 2022; 22:223-233. [PMID: 36210323 DOI: 10.1016/j.jcf.2022.09.013] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2022] [Revised: 08/18/2022] [Accepted: 09/28/2022] [Indexed: 11/05/2022]
Abstract
BACKGROUND As survival and health improve in people with cystic fibrosis (CF), more women with CF (wwCF) are considering their sexual and reproductive health (SRH). This study compared SRH experiences, behaviors, and care utilization of wwCF to the general population and defined CF-impacted considerations and care preferences. METHODS We surveyed wwCF aged ≥25 years regarding SRH and compared results to the US National Survey of Family Growth (NSFG;n = 4357) and friend controls(n = 123). We used descriptive statistics and chi-squared/Fisher's exact testing and linear regression for comparisons. RESULTS A total of 460 wwCF (mean age 36.1 years) completed the survey. WwCF were less likely to report current contraceptive use (43%vs76% NSFG, p<0.001;60% friends, p = 0.005). Nearly 25% of wwCF reported worsened CF symptoms during their menstrual cycles, 50% experienced urinary incontinence, and 80% vulvovaginal candidiasis. WwCF were significantly less likely to be parents (46%vs62% friends, p = 0.015) and to have experienced pregnancy (37%vs78% NSFG, p<0.001;58% friends, p = 0.002). More wwCF required medical assistance to conceive (29%vs12% NSFG, p<0.001 and 5% friends, p<0.001). Eighty-four percent of wwCF view their CF doctor as their main physician and 41% report no primary care provider (vs19% friends; p<0.001). WwCF report suboptimal rates of contraceptive and preconception counseling/care and are less likely to have received HPV vaccination (42%vs55%friends, p = 0.02). Despite desiring SRH conversations with their CF team, <50% report discussing SRH topics. CONCLUSION WwCF have significantly different SRH experiences than non-CF peers. They report suboptimal SRH care compared to their preferences highlighting an urgent need to encourage SRH counseling/care in the CF model.
Collapse
|
5
|
Askew MA, Smaldone AM, Gold MA, Smith-Whitley K, Strouse JJ, Jin Z, Green NS. Pediatric hematology providers' contraceptive practices for female adolescents and young adults with sickle cell disease: A national survey. Pediatr Blood Cancer 2022; 69:e29877. [PMID: 35856776 PMCID: PMC9623811 DOI: 10.1002/pbc.29877] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/24/2022] [Revised: 05/25/2022] [Accepted: 06/15/2022] [Indexed: 11/08/2022]
Abstract
BACKGROUND Adolescent and young adult (AYA) women with sickle cell disease (SCD) have increased pregnancy-related health risks and are prescribed potentially teratogenic medications, yet limited data are available regarding pediatric SCD provider contraceptive practices. We aimed to assess pediatric hematology providers' beliefs, practices, motivators, and barriers for providing contraceptive care to female AYAs with SCD. METHODS Guided by the Health Belief Model (HBM), we developed a 25-question, web-based survey to assess practices. Survey links were distributed nationwide to pediatric SCD and/or general hematology providers through their publicly available emails and by request to directors of U.S.-accredited Pediatric Hematology-Oncology fellowship programs for distribution to their SCD providers. Data analysis included descriptive statistics, chi-square analysis, and logistic regression. RESULTS Of 177 respondents, 160 surveys meeting inclusion criteria were analyzed. Most providers reported counseling (77.5%) and referring female AYA patients for contraception (90.8%), but fewer reported prescribing contraception (41.8%). Proportionally fewer trainees provided counseling compared with established providers (54% vs. 85%, p < .001), with a similar trend for prescribing (p = .05). Prescription practices did not differ significantly by provider beliefs regarding potential teratogenicity of hydroxyurea. Key motivators included patient request and disclosure of sexual activity. Key barriers included inadequate provider training, limited visit time, and perceived patient/parent interest. CONCLUSION Provider contraceptive practices for female AYAs with SCD varied, especially by provider status. Health beliefs regarding teratogenic potential of hydroxyurea did not correlate with contraceptive practices. Clinical guidelines, provider training, and patient/parent decision-making tools may be tested to assess whether provider contraceptive practices could be improved.
Collapse
Affiliation(s)
- Megan A Askew
- Department of Pediatrics, Division of Pediatric Hematology, Oncology and Stem Cell Transplantation, Columbia University Irving Medical Center/New York-Presbyterian Hospital, New York, New York, USA
| | - Arlene M Smaldone
- Department of Scholarship and Research, School of Nursing and College of Dental Medicine, Columbia University Irving Medical Center, New York, New York, USA
| | - Melanie A Gold
- Department of Pediatrics, Division of Child and Adolescent Health, Columbia University Irving Medical Center/New York-Presbyterian Hospital, New York, New York, USA
| | - Kim Smith-Whitley
- Division of Hematology, Department of Pediatrics, The Children's Hospital of Philadelphia, Philadelphia, Pennsylvania, USA
| | - John J Strouse
- Division of Hematology, Department of Medicine, Duke University, Durham, North Carolina, USA
- Division of Pediatric Hematology/Oncology, Department of Pediatrics, Duke University School of Medicine, Durham, North Carolina, USA
| | - Zhezhen Jin
- Department of Biostatistics, Mailman School of Public Health, Columbia University, New York, New York, USA
| | - Nancy S Green
- Department of Pediatrics, Division of Pediatric Hematology, Oncology and Stem Cell Transplantation, Columbia University Irving Medical Center/New York-Presbyterian Hospital, New York, New York, USA
| |
Collapse
|
6
|
Clinician attitudes and practices on pregnancy planning and care in cystic fibrosis. J Cyst Fibros 2022; 22:201-206. [PMID: 35871973 DOI: 10.1016/j.jcf.2022.07.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2022] [Revised: 05/17/2022] [Accepted: 07/04/2022] [Indexed: 11/21/2022]
Abstract
BACKGROUND People with cystic fibrosis (CF) are living longer and healthier lives as a result of cystic fibrosis transmembrane conductance regulator (CFTR) modulator therapies, and are pursuing pregnancy. As the number of pregnancies in CF continue to increase, clinician attitudes and practices regarding care of pregnant people with CF remain largely unknown. OBJECTIVE To evaluate the current attitudes and practices of CF clinicians regarding pregnancy planning and care in CF. METHODS We conducted a national survey investigating practice patterns related to pregnancy care in CF. We used descriptive statistics to summarize responses and paired t-tests to compare population means. RESULTS A total of 93 clinicians completed the survey. Eighty-six percent of respondents believed family planning and pregnancy discussions should start before the age of 21 years, of which 67% believed these discussions should occur prior to age 18 years. Our results demonstrate variability in CF clinician comfort and management of various aspects of pregnancy care in CF including 1) potential complications of pregnancy 2) continuation of chronic CF therapies 3) continuation of CFTR modulators during pregnancy and lactation, and 4) approach to treatment of pulmonary exacerbation during pregnancy. CONCLUSIONS As more people with CF pursue pregnancy in the era of CFTR modulators, CF providers should be initiating discussions surrounding pregnancy early and often. Establishing best practices in the management of pregnancy in CF, expanding peri‑pregnancy expertise within the CF community, and future studies investigating the maternal-fetal effects of CF therapies are needed.
Collapse
|
7
|
West NE, Kazmerski TM, Taylor-Cousar JL, Tangpricha V, Pearson K, Aitken ML, Jain R. Optimizing sexual and reproductive health across the lifespan in people with cystic fibrosis. Pediatr Pulmonol 2022; 57 Suppl 1:S89-S100. [PMID: 34570960 PMCID: PMC9291766 DOI: 10.1002/ppul.25703] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/30/2021] [Revised: 09/14/2021] [Accepted: 09/23/2021] [Indexed: 11/19/2022]
Abstract
With improved therapies, people with cystic fibrosis are living longer and healthier lives and increasingly have questions surrounding their sexual and reproductive health. This article will summarize the important issues of which providers should be aware during the lifespan of people with cystic fibrosis, including puberty, adulthood, and menopause. A wide range of sexual and reproductive health topics are addressed such as puberty, transgender and gender nonbinary identities, contraception, sexually transmitted infections, hypogonadism, sexual functioning, cyclical hemoptysis, and urinary incontinence. We discuss gaps in knowledge and current evidence as well as management strategies to optimize care. Our goal is to support providers to enable them to give comprehensive care throughout the lifespan of people with cystic fibrosis.
Collapse
Affiliation(s)
- Natalie E West
- Department of Medicine, Johns Hopkins University, Baltimore, Maryland, USA
| | - Traci M Kazmerski
- Department of Pediatrics, University of Pittsburgh, Pittsburgh, Pennsylvania, USA.,Center for Women's Health Research and Innovation (CWHRI), University of Pittsburgh, Pittsburgh, Pennsylvania, USA
| | | | - Vin Tangpricha
- Department of Medicine, Division of Endocrinology, Metabolism & Lipids, Emory University, Atlanta, Georgia, USA
| | - Kelsie Pearson
- Cystic Fibrosis Foundation Therapeutics Development Network, Seattle Children's Hospital, Seattle, Washington, USA
| | - Moira L Aitken
- Department of Medicine, University of Washington, Seattle, Washington, USA
| | - Raksha Jain
- Department of Medicine, University of Texas Southwestern Medical Center, Dallas, Texas, USA
| |
Collapse
|
8
|
Roe AH, Merjaneh L, Oxman R, Hughan KS. Gynecologic health care for females with cystic fibrosis. J Clin Transl Endocrinol 2021; 26:100277. [PMID: 34849351 PMCID: PMC8607192 DOI: 10.1016/j.jcte.2021.100277] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2021] [Revised: 11/03/2021] [Accepted: 11/12/2021] [Indexed: 11/19/2022] Open
Abstract
Females with CF may have cyclic lung symptoms, yeast infections, and urinary incontinence. Contraception is safe, but comorbidities should be considered in method selection. Females with CF have reduced fertility, though the etiology is unknown. Females with CF underutilize basic preventive gynecologic services.
As females with cystic fibrosis (CF) increasingly reach their reproductive years, gynecologic issues have become an important area of clinical care and research. First, females with CF may have disease-specific gynecologic problems, including cyclic pulmonary symptoms, vaginal yeast infections, and urinary incontinence. Next, contraceptive methods are thought to be overall safe and effective, however further research is needed to confirm this and to understand the lower rates of uptake among females with CF compared to the general population. Further, females with CF have reduced fertility, although the etiology of this is unknown and under investigation. While assisted reproductive technologies may help achieve pregnancy, decision-making around parenthood remains complex. Finally, while patients and providers agree on the importance of sexual and reproductive health care, females with CF underutilize basic preventive services such as cervical cancer screening, and better approaches are needed to bridge the gap with gynecology. In this review, we discuss the current state of gynecologic care for females with CF, as well as clinical and research opportunities for improvement.
Collapse
Affiliation(s)
- Andrea H. Roe
- Division of Family Planning, Department of Obstetrics and Gynecology, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA 19104, United States
- Corresponding author.
| | - Lina Merjaneh
- Division of Endocrinology, Department of Pediatrics, University of Washington, Seattle, WA 98115, United States
| | - Rachael Oxman
- Division of Endocrinology, David Geffen School of Medicine at UCLA, Los Angeles, CA 90095, United States
| | - Kara S. Hughan
- Division of Pediatric Endocriology and Metabolism, Department of Pediatrics, University of Pittsburgh School of Medicine, Pittsburgh, PA 15224, United States
| |
Collapse
|
9
|
Dury S, Perotin JM, Ravoninjatovo B, Llerena C, Ancel J, Mulette P, Griffon M, Carré S, Perrin A, Lebargy F, Deslée G, Launois C. Identifying specific needs in adult cystic fibrosis patients: a pilot study using a custom questionnaire. BMC Pulm Med 2021; 21:270. [PMID: 34404378 PMCID: PMC8371823 DOI: 10.1186/s12890-021-01613-4] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2021] [Accepted: 07/13/2021] [Indexed: 11/10/2022] Open
Abstract
Background Adult patients with cystic fibrosis (CF) experience daily physical symptoms and disabilities that can be challenging to address for health care teams. Methods We sought to identify the most frequent topics that CF adults need to discuss with health care teams using a custom questionnaire including 62 items. Results Fifty patients were included, 70% men, mean age 27.6 years, with a mean body mass index of 21.8 kg/m2. Mean FEV1% was 64% of predicted value. Forty-two percent of patients selected at least one topic. The most frequently selected topics were fatigue (20%), professional or scholar worries (18%), procreation (16%), physical activities (16%) and evolution of CF disease (16%). Women were more frequently concerned about fatigue, procreation and profession/school. Conclusions Using a custom questionnaire, we identified that CF adults express various unmet needs that extend beyond usual respiratory and nutritional concerns or treatment adherence. The interest of this questionnaire by health care team for improving therapeutic management of CF patients remains to be validated. Trial registration: The study was registered on ClinicalTrials.gov (NCT02924818) on 5th October 2016.
Collapse
Affiliation(s)
- Sandra Dury
- Department of Respiratory Diseases, Reims University Hospital, Maison Blanche University Hospital, 45, rue de Cognacq-Jay, 51 092, Reims cedex, France. .,EA 4683 Medical and Pharmacological, University of Reims, Reims, France.
| | - Jeanne-Marie Perotin
- Department of Respiratory Diseases, Reims University Hospital, Maison Blanche University Hospital, 45, rue de Cognacq-Jay, 51 092, Reims cedex, France.,INSERM UMRS 1250, Reims University Hospital, Reims, France
| | - Bruno Ravoninjatovo
- Department of Respiratory Diseases, Reims University Hospital, Maison Blanche University Hospital, 45, rue de Cognacq-Jay, 51 092, Reims cedex, France
| | - Catherine Llerena
- Department of Pediatrics, Grenoble University Hospital, Grenoble, France
| | - Julien Ancel
- Department of Respiratory Diseases, Reims University Hospital, Maison Blanche University Hospital, 45, rue de Cognacq-Jay, 51 092, Reims cedex, France
| | - Pauline Mulette
- Department of Respiratory Diseases, Reims University Hospital, Maison Blanche University Hospital, 45, rue de Cognacq-Jay, 51 092, Reims cedex, France
| | - Muriel Griffon
- Department of Respiratory Diseases, Reims University Hospital, Maison Blanche University Hospital, 45, rue de Cognacq-Jay, 51 092, Reims cedex, France
| | - Sophie Carré
- Department of Respiratory Diseases, Reims University Hospital, Maison Blanche University Hospital, 45, rue de Cognacq-Jay, 51 092, Reims cedex, France
| | - Amélie Perrin
- Department of Pediatrics, Nantes University Hospital, Nantes, France
| | - François Lebargy
- Department of Respiratory Diseases, Reims University Hospital, Maison Blanche University Hospital, 45, rue de Cognacq-Jay, 51 092, Reims cedex, France.,EA 4683 Medical and Pharmacological, University of Reims, Reims, France
| | - Gaëtan Deslée
- Department of Respiratory Diseases, Reims University Hospital, Maison Blanche University Hospital, 45, rue de Cognacq-Jay, 51 092, Reims cedex, France.,INSERM UMRS 1250, Reims University Hospital, Reims, France
| | - Claire Launois
- Department of Respiratory Diseases, Reims University Hospital, Maison Blanche University Hospital, 45, rue de Cognacq-Jay, 51 092, Reims cedex, France
| |
Collapse
|
10
|
Men's health in the modern era of cystic fibrosis. J Cyst Fibros 2020; 20:e121-e123. [PMID: 33376059 DOI: 10.1016/j.jcf.2020.12.013] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2020] [Revised: 12/17/2020] [Accepted: 12/17/2020] [Indexed: 11/22/2022]
|
11
|
Leech MM, Stransky OM, Talabi MB, Borrero S, Roe AH, Kazmerski TM. Exploring the reproductive decision support needs and preferences of women with cystic fibrosis . Contraception 2020; 103:32-37. [PMID: 33068614 DOI: 10.1016/j.contraception.2020.10.004] [Citation(s) in RCA: 22] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2020] [Revised: 09/29/2020] [Accepted: 10/02/2020] [Indexed: 12/16/2022]
Abstract
OBJECTIVES As women with cystic fibrosis (CF) live longer, healthier lives, they increasingly face decisions related to their reproductive health. This qualitative study explores their unique decision support needs and preferences to aid in the development of a CF-specific reproductive goals decision aid. STUDY DESIGN Womenwith CF age 18-44 years participated in individual, semi-structured, telephone-based interviews, and women with CF age 18 years and older participated in semi-structured focus group discussions (FGDs). Both explored experiences and attitudes surrounding parenthood, pregnancy, contraception, and preferences for reproductive health care provision.FGDs also explored the use, content, and format of a reproductive goals decision aid for women with CF. We transcribed interviews and FGDs and conducted content and thematic analyses using an inductive approach. RESULTS Twenty women (age range 20-42 years) participated in interviews and 18 women (age range 26-63 years) participated in three FGDs. Major themes identified included: 1) CF complicates pregnancy and parenting decisions; 2) Women make contraceptive decisions within the context of their CF; 3) Women with CF prefer to receive reproductive health counseling from their CF team; 4) Women with CF desire defragmented, coordinated reproductive health care; and 5) A disease-specific reproductive goals decision aid would encourage relevant parenting, pregnancy, and contraceptive discussions. CONCLUSION Women with CF have unique reproductive health care needs and often face uncertainty and disjointed care when making reproductive health and contraceptive decisions. IMPLICATIONS This study underscores the central role of the CF team and illustrates opportunities to better support women with CF in their decisions surrounding sexual and reproductive health, including through a patient-centered, disease-specific, reproductive goals decision aid.
Collapse
Affiliation(s)
- Mary M Leech
- Geisel School of Medicine at Dartmouth, Hanover, NH, USA
| | - Olivia M Stransky
- Center for Women's Health Research and Innovation, Pittsburgh, PA, USA
| | - Mehret Birru Talabi
- Center for Women's Health Research and Innovation, Pittsburgh, PA, USA; UPMC, Pittsburgh, PA, USA
| | - Sonya Borrero
- Center for Women's Health Research and Innovation, Pittsburgh, PA, USA; UPMC, Pittsburgh, PA, USA; Center for Health Equity Research and Promotion, VA Pittsburgh Healthcare System, Pittsburgh, PA, USA
| | - Andrea H Roe
- Department of Obstetrics and Gynecology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - Traci M Kazmerski
- Center for Women's Health Research and Innovation, Pittsburgh, PA, USA; Department of Pediatrics, UPMC Children's Hospital of Pittsburgh, Pittsburgh, PA, USA.
| |
Collapse
|