Health-related needs of survivors of hypertensive disorders of pregnancy: implications for health communication interventions

ABSTRACT

Background:

Hypertensive disorders of pregnancy (HDP) are key contributors to maternal morbidity, mortality, and future risk of cardiovascular disease. This exploratory study aimed to unearth the health-related needs of women with a reported history of HDP by inquiring about preferences for care.

Method:

Deductive, qualitative analysis was conducted of HDP survivors’ retrospective ‘wishes’ about the care received.

Results:

In analyzing 244 open-ended, online survey responses, we identified a taxonomy of health-related needs arising across the trajectory of HDP: clinical information, needs requiring clinical knowledge, such as information about the etiology or prognosis of HDP; medical, needs associated with HDP intervention and management; logistical, needs regarding practical information, such as how to contact a provider or obtain the correct medical device; emotional, needs involving a desire for support or validation; and communication, needs for improved explanations and recognition of HDP.

Conclusions:

A taxonomy of diverse health-related needs may assist clinicians in approaching HDP patients more holistically. Additionally, opportunities exist for health communication research to inform standard approaches to HDP-related communication flowing from provider to patient.

KEYWORDS:

• Health communication
• preeclampsia
• consumer health information
• pregnancy-induced hypertension
• women’s health
• maternal health intervention
• healthy pregnancy
• healthcare needs

Acknowledgements

Author contribution: Drs Emily Cramer and Jae Eun Chung contributed to the design and implementation of the research; Dr Cramer and Chung along with Professors Bukky Babalola and Lillian Agosto-Maldonado contributed to the analysis of the results and to the writing of the manuscript.

Disclosure statement

No potential conflict of interest was reported by the authors.

Ethical approval

Study protocol was approved by the Howard University Institutional Review Board (IRB-20-COM-01) on May 4, 2020.

Data availability statement

The data that support the findings of this study are available on request from the corresponding author, EMC.

Notes

1 Hypertensive disorders of pregnancy (HDP) include gestational hypertension, preeclampsia, eclampsia, chronic hypertension with superimposed preeclampsia, and unspecified maternal hypertension [5].

2 Curiously, the Postpartum Preeclampsia Checklist in the ACOG Severe Hypertension in Pregnancy Bundle does not mention ‘debriefing the patient, family and OB team.’

3 The California Maternal Quality Care Collaborative’s Improving Health Care Response to Hypertensive Disorders of Pregnancy: California Quality Improvement Toolkit [37] is widely regarded as a standard bearer in improving care of HDP in hospital settings.

Additional information

Funding

The study was funded in part by a grant from the Howard University Summer Fellowship.

Notes on contributors

Emily M. Cramer

Emily M. Cramer, associate professor and assistant chair, Department of Strategic, Legal and Management Communication, Howard University, examines strategic affordances of new media in healthcare with a focus on reducing health disparities, addressing information needs, and closing communication gaps.

Bukky Babalola

Bukky Babalola, doctoral student in Communication, Culture, and Media Studies at Howard University, specializes in health communication research and strategies that address health disparities within Black Maternal Health in order to promote birth equity and reproductive justice.

Lillian E. Agosto Maldonado

Lillian E. Agosto Maldonado is a Communication, Culture, and Media Studies doctoral student at Howard University and explores Puerto Ricans and ‘DiaspoRicans’ identity representation in media and cultural spaces.

Jae Eun Chung

Jae Eun Chung, professor in the School of Communications at Howard University, focuses on the intersection of health communication, digital technologies, and inclusivity in her research.