Measuring Preferences for Childbirth After Cesarean

衡量剖腹产后分娩的偏好

• 批准号: 6831248
• 负责人: Karen Beekman Eden
• 金额: $ 10万
• 依托单位: OREGON HEALTH & SCIENCE UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2004
• 资助国家: 美国
• 起止时间: 2004-09-01 至 2007-08-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/6831248
• 关键词: behavioral /social science research tag; birth; cesarean section; choice; clinical research; clinical trials; computer assisted medical decision making; computer human interaction; computer system design /evaluation; disease /disorder proneness /risk; female; health behavior; health education; human pregnant subject; human subject; human therapy evaluation; medical complication; obstetrics; outcomes research; patient care management; patient oriented research; preference; pregnancy disorder; women' s health

DESCRIPTION (PROVIDED BY APPLICANT): As cesarean birth rates continue to climb, the number of women (currently about 420,000 annually) facing the decision of whether to have a repeat cesarean or to attempt a vaginal birth after cesarean (VBAC) will also increase. The objective of this proposed 18-month exploratory research study is to help pregnant women weigh risks and benefits in a childbirth decision using the Preferences-Assessment Computer Module developed by the principal investigator. The long-term objective of the proposed research is to understand and improve the decision-making process of these women by creating a computerized childbirth decision aid. Such decision aids provide value when the decision is complex, when the outcome is uncertain, and when people vary in how they prioritize preferences. Childbirth decisions for women with a prior cesarean meet all these criteria. No study to date quantifies how women weigh the complexities of various considerations--medical and otherwise--in the delivery decision. The proposed research is significant, therefore, in that it will provide a much-needed method to help women prioritize and weigh their preferences related to childbirth decisions. More broadly, it responds to the recent NIH and AHRQ initiatives to promote the development of computerized decision aids to improve the quality of medical decisions. A new investigator will lead a well-qualified, multidisciplined team that has expertise in decision analysis, obstetric medicine, and research methodology in pursuit of the following specific aims: 1. To validate a precise method for measuring childbirth preferences among pregnant women who are considering either a repeat cesarean or a vaginal birth after a cesarean (VBAC). During the initial phase of this study, we will verify the accuracy of the Preferences-Assessment Computer Module, measure internal consistency, and assess content validity in a cross-sectional study. 2. To test whether women who use the Preferences-Assessment Computer Module will have increased clarity about their preferences--and about the implication of those preferences--in comparison to women in a control group. We will conduct a randomized controlled trial of pregnant women with a prior cesarean. This Preferences-Assessment Computer Module is appropriate to address not only VBAC decisions, but also decisions related to elective cesareans and induction. In short, the proposed research will advance the field by improving the quality of the decision-making process for childbirth.

描述（由申请人提供）：随着剖腹产率持续攀升，面临是否再次剖腹产或剖腹产后尝试阴道分娩 (VBAC) 决定的女性人数（目前每年约 420,000 人）也会增加。 这项为期 18 个月的探索性研究的目的是帮助孕妇使用首席研究员开发的偏好评估计算机模块来权衡分娩决策的风险和收益。 拟议研究的长期目标是通过创建计算机化的分娩决策辅助工具来了解和改善这些妇女的决策过程。 当决策复杂、结果不确定以及人们优先考虑偏好的方式不同时，此类决策辅助工具就可以提供价值。 先前剖腹产的妇女的分娩决定符合所有这些标准。 迄今为止，还没有研究量化女性在做出分娩决定时如何权衡各种考虑因素（医疗和其他）的复杂性。 因此，拟议的研究意义重大，因为它将提供一种急需的方法来帮助妇女优先考虑和权衡与分娩决定相关的偏好。 更广泛地说，它响应了最近 NIH 和 AHRQ 的倡议，旨在促进计算机化决策辅助工具的开发，以提高医疗决策的质量。 一名新研究者将领导一支高素质、多学科的团队，该团队在决策分析、产科医学和研究方法方面拥有专业知识，以实现以下具体目标： 1. 验证一种精确的方法，用于测量正在考虑再次剖腹产或剖腹产后阴道分娩 (VBAC) 的孕妇的分娩偏好。 在本研究的初始阶段，我们将验证偏好评估计算机模块的准确性，测量内部一致性，并评估横断面研究中的内容有效性。 2. 测试与对照组的女性相比，使用偏好评估计算机模块的女性是否会更清楚地了解自己的偏好以及这些偏好的含义。 我们将对既往剖腹产的孕妇进行随机对照试验。 该偏好评估计算机模块不仅适用于 VBAC 决策，还适用于与选择性剖腹产和引产相关的决策。 简而言之，拟议的研究将通过提高分娩决策过程的质量来推动该领域的发展。