Health anxiety and oppressive support: their impact on decisions for non-urgent use of the emergency department of obstetrics and gynecology

Abstract

The high number of non-urgent visits to the emergency departments of obstetrics and gynecology (EDOG) is receiving increasing attention from researchers and public health professionals. The decision to access the EDOG is the result of a decision-making process based on three phases, from the problem recognition to the intention to seek medical care, and the decision to visit the EDOG. Each stage may depend on different psychological and social factors, but their specific role is still unclear. The aim of this study was to investigate the psychological and social factors which are implied in the decision-making process leading to non-urgent visits to the emergency department. A questionnaire was administered to 280 women between the 10th and the 14th week of pregnancy. Results showed that health anxiety had a positive effect on all three stages of the decision-making process (problem recognition, seeking medical care, and visiting the emergency department). Satisfaction with the prenatal care service showed a positive effect on the first two stages, while oppressive support had a positive effect on visiting the emergency department. We suggest that educational interventions for patients and family members aimed at reducing health anxiety and oppressive support during pregnancy could reduce the number of inappropriate accesses to the emergency department, with a beneficial effect on its functioning, patient-and-caregiver relationship, and the healthcare system costs.

Pallier la fragmentation des soins en début de grossesse au Canada

“…L'anxiété associée aux problèmes de santé et l'inaccessibilité à des services de soins prénataux d'urgence jouent un rôle important dans la décision de se rendre aux services d'urgence 15 . Ces facteurs doivent être soigneusement pris en considération dans le cadre de la mise en place du dépistage multifactoriel en soins primaires ou de la prise en charge des cas de dépistage positif par les prestataires de soins primaires.…”

Addressing fragmented early pregnancy care in Canada

“…14 Health anxiety and the inability to access urgent prenatal care services play an important role in the decision process to visit the emergency department. 15 Thus, introducing multifactorial screening within primary care, or having expectations about how primary care providers manage a positive screen result, requires careful consideration of the aforementioned factors. Once screening is complete, people in early pregnancy will need to receive their results promptly to permit discussion with their informed care provider about initiating ASA.…”