Kaiser Amy S, Ferris Lorraine E, Katz Randy, Pastuszak Anne, Llewellyn-Thomas Hilary, Johnson Jo-Ann, Shaw Brian F
Department of Psychiatry, Centre for Addiction and Mental Health, University of Toronto, 250 College Street, Toronto, Ont., Canada M5T 1R8.
Patient Educ Couns. 2004 Jul;54(1):45-53. doi: 10.1016/S0738-3991(03)00190-3.
This study examines women's psychological responses to prenatal group genetic counseling, and to subsequent individualized risk counseling. All women (N=123) aged 35 and older underwent nuchal translucency screening (NTS), a prenatal ultrasound screening test. After group counseling, decisional conflict decreased significantly among those reporting at baseline having made a decision about invasive testing (t(222)=2.0, P=0.014) and for those who were uncertain (t(222)=5.74, P <0.0005). After receiving NT-adjusted risks, decisional conflict decreased further for those uncertain about testing at baseline (t(222)=4.64, P <0.0005). There was no change in risk perception and anxiety after group counseling. After NT-adjusted risks were communicated, risk perception decreased significantly (t(230)=5.02, P <0.0005), as did anxiety (t(115)=7.91, P <0.005). Despite reassuring NTS results, the uptake rate for prenatal invasive testing was 78.4%. Risk perception, anxiety, and decisional conflict decreased after individual counseling for reassuring NTS results, but the uptake of invasive testing remained high.
本研究考察了女性对产前群体遗传咨询以及后续个体化风险咨询的心理反应。所有年龄在35岁及以上的女性（N = 123）均接受了颈部透明带筛查（NTS），这是一种产前超声筛查测试。在群体咨询后，对于那些在基线时报告已就侵入性检测做出决定的人（t(222)=2.0，P = 0.014）以及那些不确定的人（t(222)=5.74，P <0.0005），决策冲突显著降低。在收到经NT调整后的风险信息后，对于那些在基线时对检测不确定的人，决策冲突进一步降低（t(222)=4.64，P <0.0005）。群体咨询后，风险认知和焦虑没有变化。在传达经NT调整后的风险信息后，风险认知显著降低（t(230)=5.02，P <0.0005），焦虑也显著降低（t(115)=7.91，P <0.005）。尽管NTS结果令人安心，但产前侵入性检测的接受率仍为78.4%。在针对令人安心的NTS结果进行个体咨询后，风险认知、焦虑和决策冲突均有所降低，但侵入性检测的接受率仍然很高。
