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This study's purpose was to explore the current models and approaches of pregnancy options counseling across three types of agency settings in a Northeastern state. Additionally, this study aimed to determine if individuals who receive pregnancy options counseling obtained medically factual, non-directive, and non-biased information needed to make informed decisions related to their pregnancy decisions. Using qualitative research methodology, semi-structured interviews were conducted with 10 participants across three different agency settings in one state in the Northeastern United States. Results indicated agencies shared a definition of pregnancy options counseling. Outcomes also suggest agency type impacted how pregnancy options counseling was delivered, as variations were found in education provided to patients. Lastly, the interviews imply no standardized model or training for pregnancy options counselors is currently being used. [ABSTRACT FROM AUTHOR]

Pregnancy options counseling is an intervention that supports individuals who are struggling with making decisions related to an unintended pregnancy and typically occurs within medical and social service agencies across the United States. This intervention is important, as nearly 50% of pregnancies in the United States are unplanned or unintended. While little information is presently available on how pregnancy options counseling is practiced across settings, there are likely many opportunities where ethical dilemmas arise for the counselor. This paper will introduce pregnancy options counseling within medical and social service settings and identify ethical considerations for social workers and other helping professionals. The paper ends with a focus specifically on equipoise as a state of being. [ABSTRACT FROM AUTHOR]

Family planning services improve health and social outcomes through education, psychosocial interventions, and medical practice. Social workers are on the frontlines of providing such services to some of the most vulnerable clients; however, social work education may not be adequately preparing students to provide these interventions. This Teaching Note introduces family planning services and their significance to social work practice. Additionally, this article shares practical examples of including the subject of family planning in BSW classrooms. [ABSTRACT FROM AUTHOR]

Background: Psychosocial evaluations are required for long-term mechanical circulatory support (MCS) candidates, no matter whether MCS will be destination therapy (DT) or a bridge to heart transplantation. Although guidelines specify psychosocial contraindications to MCS, there is no comprehensive examination of which psychosocial evaluation domains are most prognostic for clinical outcomes. We evaluated whether overall psychosocial risk, determined across all psychosocial domains, predicted outcomes, and which specific domains appeared responsible for any effects., Methods: A single-site retrospective analysis was performed for adults receiving MCS between April 2004 and December 2017. Using an established rating system, we coded psychosocial evaluations to identify patients at low, moderate, or high overall risk. We similarly determined risk within each of 10 individual psychosocial domains. Multivariable analyses evaluated whether psychosocial risk predicted clinical decisions about MCS use (DT versus bridge), and postimplantation mortality, transplantation, rehospitalization, MCS pump exchange, and standardly defined adverse medical events (AEs)., Results: In 241 MCS recipients, greater overall psychosocial risk increased the likelihood of a DT decision (odds ratio, 1.76; P = 0.017); and postimplantation pump exchange and occurrence of AEs (hazard ratios [HRs] ≥ 1.25; P ≤ 0.042). The individual AEs most strongly predicted were cardiac arrhythmias and device malfunctions (HRs ≥ 1.39; P ≤ 0.032). The specific psychosocial domains predicting at least 1 study outcome were mental health problem severity, poorer medical adherence, and substance use (odds ratios and HRs ≥ 1.32; P ≤ 0.010)., Conclusions: The psychosocial evaluation predicts not only clinical decisions about MCS use (DT versus bridge) but important postimplantation outcomes. Strategies to address psychosocial risk factors before or soon after implantation may help to reduce postimplantation clinical risks., Competing Interests: A.K. is on the Medical Advisory Board, Medtronic, Inc. M.A.S. has received research support from Novartis and Aadi Bioscience. He has served as a consultant to Acceleron Pharma, Actelion Pharmaceuticals, Complexa, Inc., and United Therapeutics. M.E.K. is on the Medical Advisory Board, Medtronic, Inc., and is a consultant to Abbott Laboratories, Inc. R.L.K. is now employed by Abbott Laboratories, Inc. The work described herein was completed while he was at the University of Pittsburgh. The other authors declare no conflicts of interest., (Copyright © 2020 Wolters Kluwer Health, Inc. All rights reserved.)