The routine and the traumatic in prenatal genetic diagnosis:: does clinical information inform patient decision-making?
The routine and the traumatic in prenatal genetic diagnosis:: does clinical information inform patient decision-making?
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DOI：
10.1016/j.pec.2004.03.004
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发表时间：
2005-03-01
影响因子：
3.5
通讯作者：
Castañeda, H
中科院分区：
文献类型：
--
作者：
Hunt, LM;de Voogd, KB;Castañeda, H
随着医学技术的日益成熟，临床医生确保患者知情同意的任务越来越难以捉摸。以产前基因检测为例，我们检查了向患者传达遗传知识和风险计算复杂性的努力。在这个定性的描述性研究中，我们采访了50名临床医生和40名患者，并观察了101次遗传咨询。我们发现临床医生和患者在检测方面有不同的目标、目的和价值观，这影响了他们的临床互动。临床医生向患者提供的信息反映了他们对识别和控制病理生理的临床兴趣，而患者则相反，最关心的是保护和培养他们的妊娠。我们认为知情的患者决策产前检测的选择需要的信息是响应患者的利益。我们建议制定一种共同的决策方法，以促进临床医生和患者在决策过程中的充分参与。2004爱思唯尔爱尔兰有限公司版权所有。
With the increasing technical sophistication of medicine, clinicians' task of assuring patient informed consent is increasingly elusive. Taking the example of prenatal genetic testing, we examine efforts to communicate the complexities of genetic knowledge and risk calculation to patients. In this qualitative, descriptive study, we interviewed 50 clinicians and 40 patients, and observed 101 genetic counseling sessions. We found the clinicians and patients have different goals, purposes, and values regarding testing, which affect their clinical interactions. The information the clinicians provide patients reflects their clinical interest in identifying and controlling pathophysiology, while patients, in contrast, are most concerned with protecting and nurturing their pregnancy. We argue informed patient decision-making about prenatal testing options requires information that is responsive to patient interests. We recommend developing a shared decision-making approach, to facilitate the full participation of both clinicians and patients in the decision-making process. (c) 2004 Elsevier Ireland Ltd. All rights reserved.