Electronic Theses and Dissertations

Feifei Gu

Date

2023

Document Type

Dissertation

Degree Name

Doctor of Philosophy

Department

Nursing

Committee Chair

Marie Gill

Committee Member

Lin Zhan

Committee Member

Xichen Mou

Committee Member

Xu Li

Abstract

Women of childbearing age are a high-risk group for hyperthyroidism. Although several hyperthyroidism treatment options are available, none are optimal. Women with hyperthyroidism planning to become pregnant may face the challenge of making a “trade-off” treatment decision for a future safe pregnancy. Shared treatment decision making (STDM) is an ideal model for physicians and patients to adopt in reaching an agreement and determining treatment decisions while considering the patient’s preferences, values, treatment costs and side effects. However, limited studies exist on STDM in women with hyperthyroidism before pregnancy. Therefore, this study aims to examine STDM on hyperthyroidism in Chinese women planning for pregnancy. A cross-sectional survey was designed using a modified STDM questionnaire. A non-probability sample of 144 Chinese women with hyperthyroidism planning for pregnancy from two hospitals in eastern China participated in the study. This study was IRB-cleared and participants’ privacies and confidentialities were protected. The women in this study had a high level of preference, a high extent of involvement, and a low level of decisional conflict regarding STDM. Involvement had a strongly negative relationship with decisional conflict. Preference had a moderately negative relationship with decisional conflict, while preference had a moderately positive relationship with involvement. Multiple linear regressions showed that current treatment option was a significant preference predictive factor; preference was a significant predictive factor for involvement; and marriage status, childbearing history, and involvement were significant predictors of decisional conflict. Chinese women with hyperthyroidism planning for pregnancy exhibit good STDM qualities. They have higher preferences when using anti-thyroid drugs (ATDs) compared to non-ATDs as a treatment modality. Involvement rises as preference increases. Women with hyperthyroidism who are unmarried or have children have little conflict in decision-making. Future studies should expand to hospitals outside eastern China and also include physicians, nurses, and family members as subjects. Qualitative research is recommended to explore the feelings and experiences of individuals with poor STDM involvement and invalid decisions. In addition, interventional studies are required to determine the effect of decision aids used by STDM nurses to improve STDM quality and health outcomes in the study population.

Comments

Data is provided by the student.

Library Comment

Dissertation or thesis originally submitted to ProQuest

Notes

Embargoed until 2024-01-18

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