Are pregnant Australian women well informed about prenatal genetic screening? A systematic investigation using the Multidimensional Measure of Informed Choice
Are pregnant Australian women well informed about prenatal genetic screening? A systematic investigation using the Multidimensional Measure of Informed Choice
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DOI：
10.1111/j.1479-828x.2006.00630.x
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发表时间：
2006-10-01
影响因子：
1.7
通讯作者：
Quinlivan, Julie A.
中科院分区：
文献类型：
--
作者：
Rowe, Heather J.;Fisher, Jane R. W.;Quinlivan, Julie A.
背景：道德实践要求参与医疗保健的决定是在充分知情的情况下做出的。对唐氏综合症产前基因筛查的调查评估了妇女的知识，但尚未检验充分了解筛查的潜在后果（例如随后的诊断测试、诊断和终止妊娠）是否与妇女的心理困扰有关。目的：使用经过验证的措施评估孕妇参与中期妊娠母体血清筛查（2MSS）的知情选择，并比较知情与不知情的妇女的焦虑水平。方法：一项前瞻性队列研究，其中孕妇完成了知情选择的多维测量以及在提供 2MSS 之前的医院焦虑和抑郁量表。评估心理症状的后续调查问卷在妊娠 20 周和 30 周时完成。结果：只有 37% 的决定被告知；参与筛选的人比未参加筛选的人更有可能做出明智的决定（P = 0.01）； 31% 的人不知道流产是风险筛查结果增加后诊断测试的可能结果，只有 62% 的人正确地确定如果诊断出唐氏综合症，将提供终止妊娠。知情者的短期焦虑水平与知情者的短期焦虑水平没有显着差异（P = 0.14）。结论：需要易于应用于临床环境并满足孕妇不同学习需求和态度的健康促进策略。产前筛查对妊娠心理其他方面的影响仍有待研究。
Background: Ethical practice requires that decisions to participate in medical care be well informed. Investigations into prenatal genetic screening for Down syndrome have assessed women's knowledge but have not examined whether being well informed about the potential consequences of screening, such as subsequent diagnostic testing, diagnosis and termination, is associated with psychological distress for women.Aims: To assess informed choice to participate in second trimester maternal serum screening (2MSS) in pregnant women using a validated measure and to compare anxiety levels in women who were well informed versus poorly informed.Methods: A prospective cohort study where pregnant women completed the Multidimensional Measure of Informed Choice and the Hospital Anxiety and Depression Scale immediately prior to the offer of 2MSS. Follow-up questionnaires assessing psychological symptomatology were completed at 20 and 30 weeks gestation.Results: Only 37% of decisions were informed; those who participated in screening were more likely to have made an informed decision than those who did not (P = 0.01); 31% did not know that miscarriage was a possible consequence of diagnostic testing subsequent to an increased risk screening result and only 62% correctly identified that termination of pregnancy would be offered if Down syndrome were to be diagnosed. Short-term anxiety levels in those who were well informed were not significantly different from those who were poorly informed (P = 0.14).Conclusions: Health promotion strategies, which are readily applicable in clinical settings and address diverse learning needs and attitudes of pregnant women, are needed. The impact of antenatal screening on other dimensions of pregnancy psychology remains to be investigated.