剖宫产后静脉血栓栓塞风险沟通与药物预防的医患视角质性研究
结果显示常规教育已开展，但存在知识缺口、沟通障碍和最优管理不确定性，双方均认可需研究支持个体化VTE风险估算与预防利弊。
要点
- 剖宫产后患者普遍接受VTE风险及药物预防教育，并愿意用药降低VTE风险。
- 患者报告注射部位瘀伤、疼痛等不适，仍希望获得更好的教育材料。
- 临床医生认可VTE风险沟通必要，但面临障碍且对最优管理存在不确定性。
核心结论
- 剖宫产后VTE风险与药物预防的常规教育已提供，但沟通仍有改进空间。
- 医患双方均认为需要研究以提供精确的个体化VTE风险估计及预防措施的疗效与风险信息。
研究设计与样本
- 定性研究，单一学术医疗中心，半结构化虚拟访谈。
- 采用标准化归纳编码框架，双人独立编码后识别主题。
主要发现
- 患者接受剖宫产后VTE风险及药物预防理由的教育。
- 尽管药物注射带来瘀伤、疼痛等不适，患者仍愿意使用以降低VTE风险。
- 患者存在知识缺口，希望改善教育材料，并愿意参与研究。
- 临床医生认可提供VTE风险沟通与药物预防咨询，但存在障碍和对最优管理的不确定性。
临床怎么用
- 继续向剖宫产后患者常规提供VTE风险与药物预防教育。
- 改进教育材料以弥补患者识别出的知识缺口。
- 临床医生应关注沟通障碍，并参与以循证指南改进为目标的研究。
局限性
- 小样本单中心定性设计，主题可能不具广泛代表性。
- 访谈为产后12周内回顾，可能存在回忆偏倚。
以上解读依据论文摘要（全文未开放获取或许可不允许翻译转载）。
原文
ABSTRACT Objective Pregnancy-associated venous thromboembolism (VTE) risk is highest after delivery, and many hospitals recommend pharmacologic thromboprophylaxis during this period. There is a paucity of data on patient counselling received and clinician counselling provided on VTE risk and thromboprophylaxis. We aimed to determine information needs, perspectives and priorities regarding postpartum VTE risk communication and thromboprophylaxis education among people undergoing caesarean delivery and their obstetric clinicians. Design Qualitative study. Setting Single academic medical centre. Population Postpartum individuals after caesarean delivery and obstetric clinicians. Methods Semi-structured interviews were completed virtually by trained personnel with individuals within 12 weeks postpartum and obstetric clinicians to explore: (1) patient information needs on VTE risk communication; (2) perspectives on pharmacologic thromboprophylaxis; and (3) outcome priorities for decision-making around VTE and future research. Transcribed interviews were imported into a qualitative analytics software program. A standardized inductive coding framework was used in duplicate to identify themes. Main Outcome Measures Qualitative data. Results Fifteen patients and 10 obstetric clinicians were interviewed. Patients were educated on the risk for VTE after caesarean delivery and rationale for thromboprophylaxis. Although patients reported discomfort (e.g., bruising, injection site pain) from prophylaxis administration, they reflected a willingness to use this therapy to reduce their risk of VTE and protect themselves. Patients identified some gaps in knowledge, opportunities for enhanced materials for education and willingness to participate in research. Clinicians endorsed providing counselling on VTE risk and thromboprophylaxis but identified barriers and recognized uncertainties on optimal management. Clinicians valued research that will improve evidence-based guidelines. Conclusions While routine education on VTE risk and thromboprophylaxis is being provided, there are opportunities to improve communication. Patients and clinicians alike identified the necessity of research to inform precise individualized VTE risk estimates and the efficacy and risks of thromboprophylaxis.
引用
- BJOG：Patient and Clinician Perspectives on Postpartum Thromboembolism Risk and Pharmacologic Thromboprophylaxis Use: A Qualitative Study
供执业医师工作参考，不替代临床判断；数值与分级以指南原文为准。