Exploring the Preferences of Women Regarding Sexual and Reproductive Health Care in the Context of Rheumatology: A Qualitative Study

Abstract

Objective. To explore the sexual and reproductive health (SRH) care and counseling needs of young women with rheumatic diseases in the context of their rheumatology care.Methods. Semistructured qualitative telephone interviews were conducted with female patients with rheumatic diseases ages 18-45 years (n = 30). Women were recruited from outpatient rheumatology clinics in western Pennsylvania. Interviews were audiorecorded and transcribed verbatim. A codebook was inductively developed based on the interview transcripts, and the finalized coding was used to conduct a thematic analysis.Results. Four themes emerged from interviews: 1) women want rheumatologists to initiate conversations about SRH and to revisit the conversation over time; 2) women desire clear and complete information regarding fetal, pregnancy, and infertility risks associated with their diseases and disease-modifying antirheumatic drugs (DMARDs); 3) women want to be treated holistically, with SRH addressed in the context of their life circumstances and personal values in addition to their rheumatic diseases; 4) women generally feel that they are intermediaries between their rheumatologists and obstetrician-gynecologists (OB/GYNs), but preferred for providers to communicate directly with one another about their SRH.Conclusion. Patients strongly desired rheumatologists to play an active role in their SRH, by initiating family planning conversations, providing SRH education in the context of their diseases and DMARDs, and directly coordinating SRH care with OB/GYNs. To meet patients' SRH needs, further work is needed to clarify the specific role of rheumatologists in providing SRH care and to identify ways to better facilitate communication between rheumatologists and reproductive health care providers.

A Framework for Femtech: Guiding Principles for Developing Digital Reproductive Health Tools in the United States

“…Owing to the advent of new and highly effective medications targeting the underlying defect in CF, people with CF are anticipating longer, healthier lives, and many are considering and pursuing pregnancy [54]. Among women with RMDs and CF, family planning care is therefore essential for supporting informed decision-making about: (1) the benefits and risks of pregnancy, (2) medication safety in the context of pregnancy and lactation, (3) pregnancy intentions and preferred timing for pregnancy and/or parenthood, and (4) selection of safe and acceptable contraceptive methods [55,56].…”

The Intersection of Cultural Context and Research Encounter: Focus on Interviewing in Qualitative Research

“…The practice and approach to qualitative interviews necessitates more flexibility that paradigms appeared to limit (Koro-Ljungberg et al, 2009; Wolgemuth et al, 2020). Drawing on this call for flexibility in research design; and on the growing literature on the interplay of space, context, and place, I explore: the encounter of cultural context with the process of interviewing to highlight the situatedness of interview forms using the author’s research.…”

“…Ethnographic interviews align mainly with new paradigms (e.g., interpretative, constructivist, or feminist) philosophy as they purpose to understand the world, or participants' experiences through their own lenses and words, and not through the language or lenses of the researcher (Wolgemuth et al, 2020). Though paradigm-driven approach to qualitative interviews help researchers design research that allows them to use interviews informed by their assumptions about knowledge creation, interviews driven by research approach paradigms limit the ability to "capture the complexity represented in the field of qualitative [research interview practices]" (Roulston, 2010, p. 51).…”

Pregnancy Intention Screening in Patients With Systemic Rheumatic Diseases: Pilot Testing a Standardized Assessment Tool

“…Although provider screening behavior might have improved in a manner not captured by chart review, documentation of intention screening remained low. Patients and providers are increasingly interested in the incorporation of pregnancy intention screening and counseling into rheumatologic practice ( 10 , 19 ). Further investigations should explore both patient and provider satisfaction with pregnancy intention screening tools, and whether integration of a screening prompt into the EMR achieves higher uptake.…”