Graduation Year
2022
Document Type
Thesis
Degree
M.S.P.H.
Degree Name
MS in Public Health (M.S.P.H.)
Degree Granting Department
Public Health
Major Professor
Deborah Cragun, M.S., Ph.D.
Committee Member
Reka Müller, M.S.P.H.
Committee Member
Nevena Krstic, M.S.
Committee Member
Sarah Obican, M.D.
Keywords
teratogen information service, teratogen counseling, teratogens polypharmacy
Abstract
In the United States, 88.8% of pregnant patients utilize at least one medication during pregnancy. The lack of guidance on medication use and teratogen exposures during pregnancy can induce stress and impact decision-making about continuing or adding medication in pregnancy. Although previous research has evaluated changes in patient knowledge after exposure counseling, we are unaware of studies that examined emotional outcomes or the extent to which patients feel informed and empowered to make decisions related to medication use. Our quasi-experimental study measured changes in patients’ feelings of guilt, anxiety, and decisional empowerment after receiving exposure counseling from trained teratogen information specialists. We administered pre- and post-counseling surveys to 25 patients referred to a perinatal exposure clinic in Tampa, Florida. Validated scales were used to measure anxiety and guilt related to medication use and other exposures, and the ‘SURE’ measure was used to assess decisional empowerment regarding their exposure. Paired samples t-tests were used to compare changes in anxiety and guilt and McNemar test assessed for changes in whether patients felt fully informed and empowered in decision making. Anxiety and guilt scores decreased significantly (t(24) = 6.07, p< 0.001; t(24) =5.37, p < 0.001 respectively). Although only 20% felt informed and empowered to make a decision before counseling, this increased to 81% after counseling (p< 0.001). Comprehensive counseling with a trained teratogen information specialist reduces feelings of guilt and anxiety about pregnancy exposures and substantially increases the number of patients who feel empowered to make decisions regarding medication use in pregnancy. This study highlights how benefits of patient-centered teratogen counseling goe beyond changes in patient knowledge.
Scholar Commons Citation
Lake, Madison J., "Impact of Perinatal Exposure Counseling on Patient Reported Emotional Outcomes and Decisional Empowerment" (2022). USF Tampa Graduate Theses and Dissertations.
https://digitalcommons.usf.edu/etd/10316
