Jaques Alice M, Sheffield Leslie J, Halliday Jane L
Public Health Genetics, Murdoch Childrens Research Institute, Parkville, Victoria, Australia.
Prenat Diagn. 2005 Aug;25(8):656-64. doi: 10.1002/pd.1218.
Informed choice for prenatal screening has long been considered an essential aspect of service provision, and has been researched extensively in the second trimester. This study aims at examining whether women having first-trimester screening in a private clinic had made an informed choice.
A cross-sectional survey recruited women having first-trimester screening at specialist ultrasound practices. Two questionnaires containing a validated Multidimensional Measure of Informed Choice (MMIC) were self-administered pre- and post-screening.
MMIC was completed by 81% (163/202) of women. Ninety-nine percent of women had a positive attitude towards screening, therefore informed choice was essentially measured on knowledge alone. Pre-screening, 68% made an informed choice, compared with 74% post-screening (chi2 = 1.6, p = 0.21 (McNemar)). Knowledge was associated with education level, information sources and perception of screening as routine or optional.
The Australasian Guidelines on prenatal screening state that all women having testing should be provided with written information, and it should be ensured that they have appropriate understanding of the test(s). These guidelines are not being met, even in private clinical care. Health professionals should ensure that all women are provided with suitable information about prenatal screening that is tailored to their level of education and individual needs, and should emphasise that screening is optional.
长期以来，产前筛查的知情选择一直被视为服务提供的一个重要方面，并且在孕中期已经进行了广泛的研究。本研究旨在调查在私人诊所进行孕早期筛查的女性是否做出了知情选择。
一项横断面调查招募了在专科超声检查机构进行孕早期筛查的女性。在筛查前和筛查后，自行填写两份包含有效知情选择多维量表（MMIC）的问卷。
81%（163/202）的女性完成了MMIC。99%的女性对筛查持积极态度，因此知情选择主要仅依据知识来衡量。筛查前，68%的女性做出了知情选择，筛查后这一比例为74%（卡方 = 1.6，p = 0.21（麦克尼马尔检验））。知识与教育水平、信息来源以及将筛查视为常规或可选择的认知相关。
澳大利亚产前筛查指南指出，所有接受检测的女性都应获得书面信息，并应确保她们对检测有适当的理解。即使在私人临床护理中，这些指南也未得到遵循。卫生专业人员应确保为所有女性提供适合其教育水平和个人需求的产前筛查相关信息，并应强调筛查是可选择的。
