Exploring pregnant individuals' counseling needs regarding urgent imaging to rule out pulmonary embolism.

computed tomography angiography patient education pregnancy pulmonary embolism radiation ventilation-perfusion scan

Journal

Research and practice in thrombosis and haemostasis
ISSN: 2475-0379
Titre abrégé: Res Pract Thromb Haemost
Pays: United States
ID NLM: 101703775

Informations de publication

Date de publication:
Feb 2024
Historique:
received: 31 07 2023
revised: 12 12 2023
accepted: 18 12 2023
medline: 18 3 2024
pubmed: 18 3 2024
entrez: 18 3 2024
Statut: epublish

Résumé

Computed tomography pulmonary angiogram and lung scintigraphy with ventilation/perfusion scan are needed to diagnose pulmonary embolism (PE) in pregnancy. Their associated ionizing radiation doses are considered safe in pregnancy. A standardized patient information tool may improve patient counseling and reduce testing hesitancy. In this context, we sought to address 1) what patients want to know before undergoing these tests and 2) how they want the information to be provided to them. We used a qualitative descriptive methodology. We recruited pregnant participants at the McGill University Health Center in Montreal, Canada. Structured interviews explored information needs about PE and diagnostic imaging for PE. The interview transcripts' themes were analyzed with a hybrid deductive and inductive approach. Of 21 individuals approached, 20 consented to participate. Four had been previously investigated for PE. Participants requested information about the risks associated with PE and radiation and their effects on maternal and fetal health. They preferred for radiation doses to be presented in comparison with known radiation thresholds for fetal harm. They suggested that a written tool should be developed using an accessible language. Participants also indicated that the tool would be integrated into their decision-making process, emphasizing a lower risk tolerance for their fetus than for themselves. This single-center group of pregnant patients wished to be informed about the risks of PE and radiation associated with imaging. A written tool could help put information into context and facilitate decision making. These new insights may be used to inform counseling.

Sections du résumé

Background UNASSIGNED
Computed tomography pulmonary angiogram and lung scintigraphy with ventilation/perfusion scan are needed to diagnose pulmonary embolism (PE) in pregnancy. Their associated ionizing radiation doses are considered safe in pregnancy. A standardized patient information tool may improve patient counseling and reduce testing hesitancy.
Objectives UNASSIGNED
In this context, we sought to address 1) what patients want to know before undergoing these tests and 2) how they want the information to be provided to them.
Methods UNASSIGNED
We used a qualitative descriptive methodology. We recruited pregnant participants at the McGill University Health Center in Montreal, Canada. Structured interviews explored information needs about PE and diagnostic imaging for PE. The interview transcripts' themes were analyzed with a hybrid deductive and inductive approach.
Results UNASSIGNED
Of 21 individuals approached, 20 consented to participate. Four had been previously investigated for PE. Participants requested information about the risks associated with PE and radiation and their effects on maternal and fetal health. They preferred for radiation doses to be presented in comparison with known radiation thresholds for fetal harm. They suggested that a written tool should be developed using an accessible language. Participants also indicated that the tool would be integrated into their decision-making process, emphasizing a lower risk tolerance for their fetus than for themselves.
Conclusion UNASSIGNED
This single-center group of pregnant patients wished to be informed about the risks of PE and radiation associated with imaging. A written tool could help put information into context and facilitate decision making. These new insights may be used to inform counseling.

Identifiants

pubmed: 38496711
doi: 10.1016/j.rpth.2024.102317
pii: S2475-0379(24)00003-7
pmc: PMC10943056
doi:

Types de publication

Journal Article

Langues

eng

Pagination

102317

Informations de copyright

© 2024 The Authors.

Auteurs

Suzie Ouellet (S)

Department of Medicine, McGill University Health Centre, Montréal, Québec, Canada.

Sandrine Hamel (S)

Department of Medicine, McGill University Health Centre, Montréal, Québec, Canada.

Camille Simard (C)

Department of Medicine, Jewish General Hospital, Montréal, Québec, Canada.
Centre for Clinical Epidemiology, Lady Davis Institute of the Jewish General Hospital, Montréal, Québec, Canada.

Maral Koolian (M)

Department of Medicine, Jewish General Hospital, Montréal, Québec, Canada.

Antony Robert (A)

Department of Emergency Medicine, McGill University Health Centre, Montréal, Québec, Canada.

Karen Wou (K)

Department of Obstetrics and Gynecology, McGill University Health Centre, Montréal, Québec, Canada.

Stéphanie Lam (S)

Department of Diagnostic Radiology, McGill University Health Center, Montréal, Québec, Canada.

Amal Bessissow (A)

Department of Medicine, McGill University Health Centre, Montréal, Québec, Canada.
Centre for Outcomes Research and Evaluation, Research Institute of the McGill University Health Centre, Montréal, Québec, Canada.

Sarah St-Georges (S)

Department of Obstetrics and Gynecology, McGill University Health Centre, Montréal, Québec, Canada.

Vicky Tagalakis (V)

Department of Medicine, Jewish General Hospital, Montréal, Québec, Canada.
Centre for Clinical Epidemiology, Lady Davis Institute of the Jewish General Hospital, Montréal, Québec, Canada.

Alexandra de Pokomandy (A)

Department of Medicine, McGill University Health Centre, Montréal, Québec, Canada.
Centre for Outcomes Research and Evaluation, Research Institute of the McGill University Health Centre, Montréal, Québec, Canada.
Department of Family Medicine, McGill University, Montréal, Québec, Canada.

Linda Snell (L)

Department of Medicine, McGill University Health Centre, Montréal, Québec, Canada.
Institute for Health Sciences Education, McGill University, Montréal, Québec, Canada.

Ning-Zi Sun (NZ)

Department of Medicine, McGill University Health Centre, Montréal, Québec, Canada.
Institute for Health Sciences Education, McGill University, Montréal, Québec, Canada.

Isabelle Malhamé (I)

Department of Medicine, McGill University Health Centre, Montréal, Québec, Canada.
Centre for Outcomes Research and Evaluation, Research Institute of the McGill University Health Centre, Montréal, Québec, Canada.

Classifications MeSH