Lou Stina, Dahl Katja, Risør Mette Bech, Hvidman Lone E, Thomsen Sten Grove, Jørgensen Finn Stener, Olesen Frede, Kjaergaard Hanne, Kesmodel Ulrik
Aarhus Universitet, Institut for Folkesundhed, Afdeling for Epidemiologi.
Ugeskr Laeger. 2007 Mar 5;169(10):914-8.
In 2004, The Danish National Board of Health introduced new guidelines for prenatal screening and diagnosis. Subsequently, all pregnant women in Denmark have been offered a maternal serum screening and a nuchal translucency measurement (NTM). The results are combined to a single risk estimate of carrying a Down syndrome child. All pregnant women are also offered a late second trimester scan for fetal abnormalities. Pregnant woman should be fully informed to enable them to make an informed choice. We explored the role of information in the pregnant women's understanding and decision-making for the NTM.
26 consenting pregnant women were interviewed after their first visit to their GP and again after the late ultrasound scan. Our results are mainly based on the first interviews and the 24 participants who chose to have a NTM.
The pregnant women consider a fetal scan as an attractive routine procedure during pregnancy. Apart from the information about prenatal examinations given by the GP, the pregnant women do not subsequently seek further information. The most important motives for wanting to have the NTM are 1) assurance, 2) choice, 3) expectations of the scan being a happy event, and 4) the idea that the examinations are approved by the Danish health care system.
The decision to have a NTM is motivated by expectations that exceed the specific medical aim of the examination and the content of the information provided. The pregnant women believe in a link between knowledge and anxiety, and therefore do not wish to "know too much". Our results show that the pregnant woman's conception of the information provided and her motives for having a NTM are based on strategies and rationales that hinder an informed choice.
2004年,丹麦国家卫生局出台了新的产前筛查与诊断指南。随后,丹麦所有孕妇都接受了母血清筛查和颈部透明带测量(NTM)。这些结果被综合为一个怀有唐氏综合征患儿的单一风险评估。所有孕妇还接受了孕中期晚期的胎儿异常扫描。孕妇应充分了解相关信息,以便能够做出明智的选择。我们探讨了信息在孕妇对NTM的理解和决策中的作用。
26名同意参与的孕妇在首次就诊于全科医生后接受了访谈,并在晚期超声扫描后再次接受访谈。我们的结果主要基于首次访谈以及选择进行NTM的24名参与者。
孕妇认为胎儿扫描是孕期一项有吸引力的常规检查。除了全科医生提供的关于产前检查的信息外,孕妇随后并未寻求更多信息。想要进行NTM的最重要动机是:1)安心;2)选择;3)期望扫描是一件令人愉快的事;4)认为这些检查得到丹麦医疗保健系统的认可。
决定进行NTM的动机超出了检查的特定医学目的和所提供信息的内容。孕妇相信知识与焦虑之间存在联系,因此不希望“知道太多”。我们的结果表明,孕妇对所提供信息的理解以及她进行NTM的动机基于阻碍明智选择的策略和基本原理。