Statham Helen, Solomou Wendy, Green Josephine M
Centre for Family Research, University of Cambridge, Cambridge CB2 3RF, UK.
Public Health. 2003 Sep;117(5):348-57. doi: 10.1016/S0033-3506(03)00080-5.
To describe how prenatal screening and diagnostic test results are communicated to primary care health professionals.
Postal questionnaire.
Primary care practices across London, East Anglia, the Southeast and Southwest of England.
714 community-based health professionals (GPs, midwives and health visitors) identified by 247 women (participants in a study of experiences after a positive prenatal diagnosis) as members of their primary care team.
Description of how information about prenatal screening and diagnostic test results is communicated to health professionals working in the primary care team. Participants' views about the timeliness and sufficiency of the information they are given.
131 GPs, 143 midwives and 151 health visitors returned questionnaires, an overall response rate of 60.4%. Sixteen percent of primary care professionals reported that they were not usually informed of high-risk results after serum screening for Down's syndrome. Twenty eight percent were either not usually told about the possibility of abnormalities detected on ultrasound or only heard of such abnormalities from the woman herself. Even when informed, 28% of midwives and GPs did not know what action they were expected to take. Information about confirmed abnormalities is not always communicated to primary care. Only 29% were told soon enough about diagnosed abnormalities and only 17% of health professionals reported that the information they were given was always sufficient to allow them to discuss issues with their patients. The presence of specialist screening coordinators was perceived to be helpful by 76% of health professionals. Improvements in how they were told about abnormalities were suggested and these included the need for systems and protocols that ensured that quality information was communicated quickly.
The frequent absence of means of effective communication between primary and secondary care about diagnosed abnormalities, and health professionals' uncertainties about their role has implications for the quality of care given to women who receive positive results after prenatal screening or diagnosis. There is a need for standards to be established concerning the communication of information to the health professionals responsible for the community-based care of pregnant women after a positive test result.
描述产前筛查和诊断检测结果是如何传达给初级保健卫生专业人员的。
邮寄问卷调查。
伦敦、东安格利亚、英格兰东南部和西南部的初级保健机构。
247名女性（一项产前诊断呈阳性后的经历研究的参与者）确定为其初级保健团队成员的714名社区卫生专业人员（全科医生、助产士和健康访视员）。
描述产前筛查和诊断检测结果的信息是如何传达给在初级保健团队工作的卫生专业人员的。参与者对所获信息的及时性和充分性的看法。
131名全科医生、143名助产士和151名健康访视员返回了问卷，总体回复率为60.4%。16%的初级保健专业人员报告称，在唐氏综合征血清筛查后，他们通常不会被告知高危结果。28%的人要么通常未被告知超声检查发现异常的可能性，要么仅从女性本人那里听说过此类异常。即使被告知，28%的助产士和全科医生也不知道他们应该采取什么行动。确诊异常的信息并非总是传达给初级保健机构。只有29%的人足够快地被告知已诊断的异常情况，只有17%的卫生专业人员报告称，他们得到的信息总是足以让他们与患者讨论相关问题。76%的卫生专业人员认为有专科筛查协调员会有所帮助。他们提出了关于如何告知异常情况的改进建议，其中包括需要建立确保快速传达高质量信息的系统和规程。
初级保健和二级保健之间在确诊异常情况方面经常缺乏有效的沟通方式，以及卫生专业人员对自身角色的不确定性，这对产前筛查或诊断后结果呈阳性的女性所接受的护理质量产生影响。有必要制定标准，规定在检测结果呈阳性后，应如何向负责孕妇社区护理的卫生专业人员传达信息。
