Postnatal cardiovascular risk after hypertensive disorder of pregnancy: Identifying knowledge needs and education recommendations for women and healthcare providers

Roth, Heike

Postnatal cardiovascular risk after hypertensive disorder of pregnancy: Identifying knowledge needs and education recommendations for women and healthcare providers

Roth, Heike

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Publication Type:: Thesis
Issue Date:: 2021

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Field	Value	Language
dc.contributor.author	Roth, Heike
dc.date.accessioned	2022-02-21T23:44:40Z
dc.date.available	2022-02-21T23:44:40Z
dc.date.issued	2021
dc.identifier.uri	http://hdl.handle.net/10453/154739
dc.description	University of Technology Sydney. Faculty of Health.	en_US.UTF-8
dc.description.abstract	𝗕𝗮𝗰𝗸𝗴𝗿𝗼𝘂𝗻𝗱 Women with a history of hypertensive disorder of pregnancy (HDP) are at significantly increased risk of future cardiovascular disease compared to women with no HDP pregnancies. Recent findings suggest this information is not transferred sufficiently to women, and how best to do this, including how to equip healthcare providers (HCP) for the knowledge transfer process, is not known. The aim of this study was to (i) identify knowledge and knowledge gaps of Australian women and HCPs regarding health risks after HDP and (ii) to explore their education preferences. 𝗠𝗲𝘁𝗵𝗼𝗱 A sequential explanatory mixed method design was undertaken. After a scoping review of relevant literature, data were collected from two cohorts: women and HCPs. Quantitative data on knowledge related to health after HDP were collected using online surveys. Qualitative data were collected through interviews and analysed using framework analysis. 𝗙𝗶𝗻𝗱𝗶𝗻𝗴𝘀 The scoping review identified that published literature reflected a lack of, or insufficient knowledge amongst HCP and women regarding CVD risks after HDP. The surveys (266 women and 492 HCPs) found that women’s and HCP level of knowledge about health post-HDP was similar. Knowledge was highest in both groups regarding risk of recurrent hypertensive disorders in future pregnancies and future chronic hypertension, and lowest/greatest knowledge gaps regarding risks after gestational hypertension versus preeclampsia, and increased risk of Type 2 diabetes. Only one-third of participants in each cohort were aware that risks start within 10 years after the HDP affected pregnancy. In the qualitative component (13 women and 20 HCPs), women’s preference included early post-HDP birth risk counselling about long-term and modifiable risk factors from their HCPs accompanied with evidence-based, print or web-based information. HCPs wanted access to similar material to assist in their risk discussions with women. HCPs expressed a preference for multi-disciplinary education, preferably endorsed or facilitated by professional colleges and health organisations. Both groups were in favour of structured long-term follow-up, including reminder systems, to facilitate the transition from hospital to community health and align with international and local societies’ hypertension guidelines. 𝗖𝗼𝗻𝗰𝗹𝘂𝘀𝗶𝗼𝗻 Important knowledge gaps in women and healthcare providers were found regarding health after HDP in the Australian context. Women and healthcare providers want more information about long-term and modifiable risk factors post-HDP. Recommendations are made to enable a more structured transition from hospital to community health post-HDP, including automated alerts to remind women about key points of follow-up.	en_US.UTF-8
dc.format	Thesis (PhD)
dc.language.iso	en_US	en_US.UTF-8
dc.relation	https://opus.lib.uts.edu.au/bitstream/10453/154739/2/02whole.pdf
dc.rights	The author owns the copyright in this thesis including all reproduction and reuse rights for the work. The work may not be altered without the permission of the copyright owner. Attribution is essential when quoting or paraphrasing from this thesis.
dc.rights	au.edu.uts.lib/ppc
dc.rights	info:eu-repo/semantics/openAccess
dc.title	Postnatal cardiovascular risk after hypertensive disorder of pregnancy: Identifying knowledge needs and education recommendations for women and healthcare providers	en_US.UTF-8
dc.type	Thesis
utslib.copyright.status	open_access	*

Abstract:

𝗕𝗮𝗰𝗸𝗴𝗿𝗼𝘂𝗻𝗱 Women with a history of hypertensive disorder of pregnancy (HDP) are at significantly increased risk of future cardiovascular disease compared to women with no HDP pregnancies. Recent findings suggest this information is not transferred sufficiently to women, and how best to do this, including how to equip healthcare providers (HCP) for the knowledge transfer process, is not known. The aim of this study was to (i) identify knowledge and knowledge gaps of Australian women and HCPs regarding health risks after HDP and (ii) to explore their education preferences. 𝗠𝗲𝘁𝗵𝗼𝗱 A sequential explanatory mixed method design was undertaken. After a scoping review of relevant literature, data were collected from two cohorts: women and HCPs. Quantitative data on knowledge related to health after HDP were collected using online surveys. Qualitative data were collected through interviews and analysed using framework analysis. 𝗙𝗶𝗻𝗱𝗶𝗻𝗴𝘀 The scoping review identified that published literature reflected a lack of, or insufficient knowledge amongst HCP and women regarding CVD risks after HDP. The surveys (266 women and 492 HCPs) found that women’s and HCP level of knowledge about health post-HDP was similar. Knowledge was highest in both groups regarding risk of recurrent hypertensive disorders in future pregnancies and future chronic hypertension, and lowest/greatest knowledge gaps regarding risks after gestational hypertension versus preeclampsia, and increased risk of Type 2 diabetes. Only one-third of participants in each cohort were aware that risks start within 10 years after the HDP affected pregnancy. In the qualitative component (13 women and 20 HCPs), women’s preference included early post-HDP birth risk counselling about long-term and modifiable risk factors from their HCPs accompanied with evidence-based, print or web-based information. HCPs wanted access to similar material to assist in their risk discussions with women. HCPs expressed a preference for multi-disciplinary education, preferably endorsed or facilitated by professional colleges and health organisations. Both groups were in favour of structured long-term follow-up, including reminder systems, to facilitate the transition from hospital to community health and align with international and local societies’ hypertension guidelines. 𝗖𝗼𝗻𝗰𝗹𝘂𝘀𝗶𝗼𝗻 Important knowledge gaps in women and healthcare providers were found regarding health after HDP in the Australian context. Women and healthcare providers want more information about long-term and modifiable risk factors post-HDP. Recommendations are made to enable a more structured transition from hospital to community health post-HDP, including automated alerts to remind women about key points of follow-up.

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