Bekker Hilary L, Hewison Jenny, Thornton Jim G
Academic Unit of Psychiatry and Behavioural Sciences, University of Leeds, Leeds, UK.
Prenat Diagn. 2004 Apr;24(4):265-75. doi: 10.1002/pd.851.
To evaluate decision analysis as a technique to facilitate women's decision-making about prenatal diagnosis for Down syndrome using measures of effective decision-making.
Randomised controlled trial in a UK hospital's prenatal diagnosis clinic.
Routine versus routine consultation structured by decision analysis.
117/132 women receiving a screen-positive maternal serum screening result participated (58 routine, 59 decision analysis).
Consultations were audio tape-recorded, transcribed and coded; questionnaires were completed after the consultation and one month later after receipt of a diagnostic test and/or the 19-week scan result.
Test decision, subjective expected utilities, knowledge, informed decision-making, risk perception, decisional conflict, anxiety, perceived usefulness and directiveness of consultation information.
48/59 in the decision-aided group and 47/58 in the routine group underwent prenatal diagnosis. Informed decision-making was higher, perceived risk more realistic and decisional conflict over time lower in the decision analysis group. Decision analysis had no impact on knowledge or SEU scores, and was no more or no less directive, useful or anxiety provoking than the routine care. Consultations were six minutes longer.
Decision analysis consultations enable women to make more informed prenatal diagnosis decisions. Professionals will need training to use this technique effectively.
运用有效决策衡量方法，评估决策分析作为一种促进女性对唐氏综合征产前诊断进行决策的技术。
在英国一家医院的产前诊断诊所进行随机对照试验。
常规咨询与基于决策分析构建的常规咨询。
132名收到筛查阳性母血清筛查结果的女性中有117名参与（58名接受常规咨询，59名接受决策分析咨询）。
咨询过程进行录音、转录和编码；咨询后以及收到诊断测试结果和/或19周扫描结果一个月后完成问卷调查。
检测决策、主观期望效用、知识、知情决策、风险认知、决策冲突、焦虑、咨询信息的感知有用性和指导性。
决策辅助组59名中有48名、常规组58名中有47名接受了产前诊断。决策分析组的知情决策程度更高，随着时间推移感知风险更现实，决策冲突更低。决策分析对知识或主观期望效用得分没有影响，在指导性、有用性或引发焦虑方面与常规护理没有差异。咨询时间长6分钟。
决策分析咨询能使女性做出更明智的产前诊断决策。专业人员需要接受培训以有效运用该技术。
