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Ten women's decision-making experiences in threatened preterm labour: Qualitative findings from the EQUIPTT trial

Research output: Contribution to journalArticlepeer-review

Original languageEnglish
Article number100611
Pages (from-to)100611
Number of pages7
JournalSexual & reproductive healthcare : official journal of the Swedish Association of Midwives
Volume29
Early online date29 Mar 2021
DOIs
E-pub ahead of print29 Mar 2021
PublishedSep 2021

Bibliographical note

Funding Information: The development of the QUiPP app and the EQUIPTT study are funded by the Guy’s and St Thomas’ Charity (Registered Charity No. 1160316) and Tommy’s (1060508). As it is a portfolio study, recruitment is supported through local Clinical Research Networks. King’s College London and Guy’s and St Thomas’ NHS Foundation Trust are co-sponsors of the study but neither sponsor provided funding for the trial. Funding Information: We would like to thank the women involved in this study who were willing to give their time and share their experiences. The development of the QUiPP app and the EQUIPTT study are funded by the Guy’s and St Thomas’ Charity (Registered Charity No. 1160316) and Tommy’s (1060508). This work is supported by Biomedical Research Centre at Guy’s and St Thomas’ NHS Foundation Trust and King’s College London. HW is funded by a Guy’s and St Thomas’ NHS Trust Biomedical Research Centre Clinical Training Fellowship. PTS is partly funded by King’s Health Partners Institute of Women and Children’s Health, Tommy’s (Registered charity no. 1060508) and by ARC South London (NIHR). JC was funded by the National Institute for Health Research’s NIHR/HEE CAT Clinical Doctoral Research Fellowship Programme (Ref. CDRF-2013-04-026). AHS and RMT receive funding from the NIHR Biomedical Research Centre based at Guy's and St Thomas' NHS Foundation Trust and King's College London. JS is an NIHR Senior Investigator and supported ARC by the National Institute for Health Research (NIHR) Applied Research Collaboration South London (NIHR ARC South London) at King’s College Hospital NHS Foundation Trust. The views expressed are those of the authors and not necessarily those of the NHS, the NIHR or the Department of Health and Social Care. Funding Information: We would like to thank the women involved in this study who were willing to give their time and share their experiences. The development of the QUiPP app and the EQUIPTT study are funded by the Guy's and St Thomas? Charity (Registered Charity No. 1160316) and Tommy's (1060508). This work is supported by Biomedical Research Centre at Guy's and St Thomas? NHS Foundation Trust and King's College London. HW is funded by a Guy's and St Thomas? NHS Trust Biomedical Research Centre Clinical Training Fellowship. PTS is partly funded by King's Health Partners Institute of Women and Children's Health, Tommy's (Registered charity no. 1060508) and by ARC South London (NIHR). JC was funded by the National Institute for Health Research's NIHR/HEE CAT Clinical Doctoral Research Fellowship Programme (Ref. CDRF-2013-04-026). AHS and RMT receive funding from the NIHR Biomedical Research Centre based at Guy's and St Thomas' NHS Foundation Trust and King's College London. JS is an NIHR Senior Investigator and supported ARC by the National Institute for Health Research (NIHR) Applied Research Collaboration South London (NIHR ARC South London) at King's College Hospital NHS Foundation Trust. The views expressed are those of the authors and not necessarily those of the NHS, the NIHR or the Department of Health and Social Care. Publisher Copyright: © 2021 The Author(s) Copyright: Copyright 2021 Elsevier B.V., All rights reserved.

King's Authors

Abstract

BACKGROUND: Clinical triage of women in threatened preterm labour (TPTL) could be improved through utilising the QUiPP App, as symptoms alone are poor predictors of early delivery. As most women in TPTL ultimately deliver at term, they must weigh this likelihood with their own personal considerations, and responsibilities. The importance of personal considerations was highlighted by the 2015 Montgomery ruling, and the significance of shared decision-making.

AIMS: Through qualitative interviews, the primary aim was to explore women's decision-making experiences in TPTL through onset of symptoms, triage, clinical assessment, and discharge.

METHODS: Qualitative interviews were undertaken as part of the EQUIPTT study (REC: 17/LO/1802) using a semi-structured interview schedule. Descriptive labels of the coding scheme were applied to the raw transcript data. This coding scheme was then increasingly refined into key themes and allowed parallels to be made within and between cases.

RESULTS: Ten ethnically diverse women who presented at six different London hospitals sites in TPTL were interviewed. Three final themes emerged from the data incorporating 10 sub-themes, 'Seeking help', 'Being "assessed" vs making clinical decisions together', and 'End result.'

CONCLUSION: Women described their busy lives and the need to juggle their commitments. Participants drew comparisons between their TPTL symptoms and 'period pain,' contrasting to typical medical terminology. Shared decision-making and the clinician-patient relationship could be improved through clinicians utilizing terminology women understand and relate to. Women used language that highlighted the clinician-patient power balance. While not fully involved in shared decision-making, women were overall satisfied with their care.

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