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Abstract
Discussion Forum (0)
Introduction: Pregnancy of unknown location (PUL) occurs with a positive pregnancy test and no confirmed intrauterine pregnancy. While most are inevitably diagnosed with miscarriage or early pregnancy, these women are subjected to rigid follow up plans to definitively rule out ectopic. To develop a patient centered approach to management of PUL, more information is required on experiences when confronted with this diagnosis. No current literature exists in this vane.
Methods: This is a qualitative study using semi-structured interviews with women diagnosed with PUL in the emergency room at a high volume center. Interview domains included comprehension and recall of counseling content, decisional conflict, and patient satisfaction with care received. Interviews were conducted after initial presentation and final diagnosis. Data was coded and analyzed for recurrent themes using grounded theory methodology. This study was approved by Montefiore IRB.
Results: We conducted 20 initial and 11 follow up interviews. Most were satisfied with overall care, however were concerned and appalled by the emergency room environment including the long wait times, overcrowded rooms, and overwhelmed, disinterested providers. Though many recalled follow up instructions, few comprehended significance of follow up and most desired insight into future pregnancy prognosis.
Conclusion/Implications: Our findings suggest the emergency room is not an appropriate environment for patient counseling after diagnosis of PUL. Given chaos accompanying the emergency room, counseling with an informed provider that ensures comprehension of diagnosis, follow up implications and management options may not be possible. In addition, thorough counseling should include importance of strict follow-up and expectations for future pregnancies
Methods: This is a qualitative study using semi-structured interviews with women diagnosed with PUL in the emergency room at a high volume center. Interview domains included comprehension and recall of counseling content, decisional conflict, and patient satisfaction with care received. Interviews were conducted after initial presentation and final diagnosis. Data was coded and analyzed for recurrent themes using grounded theory methodology. This study was approved by Montefiore IRB.
Results: We conducted 20 initial and 11 follow up interviews. Most were satisfied with overall care, however were concerned and appalled by the emergency room environment including the long wait times, overcrowded rooms, and overwhelmed, disinterested providers. Though many recalled follow up instructions, few comprehended significance of follow up and most desired insight into future pregnancy prognosis.
Conclusion/Implications: Our findings suggest the emergency room is not an appropriate environment for patient counseling after diagnosis of PUL. Given chaos accompanying the emergency room, counseling with an informed provider that ensures comprehension of diagnosis, follow up implications and management options may not be possible. In addition, thorough counseling should include importance of strict follow-up and expectations for future pregnancies
Introduction: Pregnancy of unknown location (PUL) occurs with a positive pregnancy test and no confirmed intrauterine pregnancy. While most are inevitably diagnosed with miscarriage or early pregnancy, these women are subjected to rigid follow up plans to definitively rule out ectopic. To develop a patient centered approach to management of PUL, more information is required on experiences when confronted with this diagnosis. No current literature exists in this vane.
Methods: This is a qualitative study using semi-structured interviews with women diagnosed with PUL in the emergency room at a high volume center. Interview domains included comprehension and recall of counseling content, decisional conflict, and patient satisfaction with care received. Interviews were conducted after initial presentation and final diagnosis. Data was coded and analyzed for recurrent themes using grounded theory methodology. This study was approved by Montefiore IRB.
Results: We conducted 20 initial and 11 follow up interviews. Most were satisfied with overall care, however were concerned and appalled by the emergency room environment including the long wait times, overcrowded rooms, and overwhelmed, disinterested providers. Though many recalled follow up instructions, few comprehended significance of follow up and most desired insight into future pregnancy prognosis.
Conclusion/Implications: Our findings suggest the emergency room is not an appropriate environment for patient counseling after diagnosis of PUL. Given chaos accompanying the emergency room, counseling with an informed provider that ensures comprehension of diagnosis, follow up implications and management options may not be possible. In addition, thorough counseling should include importance of strict follow-up and expectations for future pregnancies
Methods: This is a qualitative study using semi-structured interviews with women diagnosed with PUL in the emergency room at a high volume center. Interview domains included comprehension and recall of counseling content, decisional conflict, and patient satisfaction with care received. Interviews were conducted after initial presentation and final diagnosis. Data was coded and analyzed for recurrent themes using grounded theory methodology. This study was approved by Montefiore IRB.
Results: We conducted 20 initial and 11 follow up interviews. Most were satisfied with overall care, however were concerned and appalled by the emergency room environment including the long wait times, overcrowded rooms, and overwhelmed, disinterested providers. Though many recalled follow up instructions, few comprehended significance of follow up and most desired insight into future pregnancy prognosis.
Conclusion/Implications: Our findings suggest the emergency room is not an appropriate environment for patient counseling after diagnosis of PUL. Given chaos accompanying the emergency room, counseling with an informed provider that ensures comprehension of diagnosis, follow up implications and management options may not be possible. In addition, thorough counseling should include importance of strict follow-up and expectations for future pregnancies
The grey zone: patient experiences after a diagnosis of pregnancy of unknown location
Alexa Cohen
Abstract
Discussion Forum (0)
Introduction: Pregnancy of unknown location (PUL) occurs with a positive pregnancy test and no confirmed intrauterine pregnancy. While most are inevitably diagnosed with miscarriage or early pregnancy, these women are subjected to rigid follow up plans to definitively rule out ectopic. To develop a patient centered approach to management of PUL, more information is required on experiences when confronted with this diagnosis. No current literature exists in this vane.
Methods: This is a qualitative study using semi-structured interviews with women diagnosed with PUL in the emergency room at a high volume center. Interview domains included comprehension and recall of counseling content, decisional conflict, and patient satisfaction with care received. Interviews were conducted after initial presentation and final diagnosis. Data was coded and analyzed for recurrent themes using grounded theory methodology. This study was approved by Montefiore IRB.
Results: We conducted 20 initial and 11 follow up interviews. Most were satisfied with overall care, however were concerned and appalled by the emergency room environment including the long wait times, overcrowded rooms, and overwhelmed, disinterested providers. Though many recalled follow up instructions, few comprehended significance of follow up and most desired insight into future pregnancy prognosis.
Conclusion/Implications: Our findings suggest the emergency room is not an appropriate environment for patient counseling after diagnosis of PUL. Given chaos accompanying the emergency room, counseling with an informed provider that ensures comprehension of diagnosis, follow up implications and management options may not be possible. In addition, thorough counseling should include importance of strict follow-up and expectations for future pregnancies
Methods: This is a qualitative study using semi-structured interviews with women diagnosed with PUL in the emergency room at a high volume center. Interview domains included comprehension and recall of counseling content, decisional conflict, and patient satisfaction with care received. Interviews were conducted after initial presentation and final diagnosis. Data was coded and analyzed for recurrent themes using grounded theory methodology. This study was approved by Montefiore IRB.
Results: We conducted 20 initial and 11 follow up interviews. Most were satisfied with overall care, however were concerned and appalled by the emergency room environment including the long wait times, overcrowded rooms, and overwhelmed, disinterested providers. Though many recalled follow up instructions, few comprehended significance of follow up and most desired insight into future pregnancy prognosis.
Conclusion/Implications: Our findings suggest the emergency room is not an appropriate environment for patient counseling after diagnosis of PUL. Given chaos accompanying the emergency room, counseling with an informed provider that ensures comprehension of diagnosis, follow up implications and management options may not be possible. In addition, thorough counseling should include importance of strict follow-up and expectations for future pregnancies
Introduction: Pregnancy of unknown location (PUL) occurs with a positive pregnancy test and no confirmed intrauterine pregnancy. While most are inevitably diagnosed with miscarriage or early pregnancy, these women are subjected to rigid follow up plans to definitively rule out ectopic. To develop a patient centered approach to management of PUL, more information is required on experiences when confronted with this diagnosis. No current literature exists in this vane.
Methods: This is a qualitative study using semi-structured interviews with women diagnosed with PUL in the emergency room at a high volume center. Interview domains included comprehension and recall of counseling content, decisional conflict, and patient satisfaction with care received. Interviews were conducted after initial presentation and final diagnosis. Data was coded and analyzed for recurrent themes using grounded theory methodology. This study was approved by Montefiore IRB.
Results: We conducted 20 initial and 11 follow up interviews. Most were satisfied with overall care, however were concerned and appalled by the emergency room environment including the long wait times, overcrowded rooms, and overwhelmed, disinterested providers. Though many recalled follow up instructions, few comprehended significance of follow up and most desired insight into future pregnancy prognosis.
Conclusion/Implications: Our findings suggest the emergency room is not an appropriate environment for patient counseling after diagnosis of PUL. Given chaos accompanying the emergency room, counseling with an informed provider that ensures comprehension of diagnosis, follow up implications and management options may not be possible. In addition, thorough counseling should include importance of strict follow-up and expectations for future pregnancies
Methods: This is a qualitative study using semi-structured interviews with women diagnosed with PUL in the emergency room at a high volume center. Interview domains included comprehension and recall of counseling content, decisional conflict, and patient satisfaction with care received. Interviews were conducted after initial presentation and final diagnosis. Data was coded and analyzed for recurrent themes using grounded theory methodology. This study was approved by Montefiore IRB.
Results: We conducted 20 initial and 11 follow up interviews. Most were satisfied with overall care, however were concerned and appalled by the emergency room environment including the long wait times, overcrowded rooms, and overwhelmed, disinterested providers. Though many recalled follow up instructions, few comprehended significance of follow up and most desired insight into future pregnancy prognosis.
Conclusion/Implications: Our findings suggest the emergency room is not an appropriate environment for patient counseling after diagnosis of PUL. Given chaos accompanying the emergency room, counseling with an informed provider that ensures comprehension of diagnosis, follow up implications and management options may not be possible. In addition, thorough counseling should include importance of strict follow-up and expectations for future pregnancies
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