van den Berg Matthijs, Timmermans Danielle R M, Knol Dirk L, van Eijk Jacques Th M, de Smit Denhard J, van Vugt John M G, van der Wal Gerrit
EMGO Institute, Department of Public and Occupational Health, VU University Medical Center, The Netherlands.
Health Psychol. 2008 Jul;27(4):430-7. doi: 10.1037/0278-6133.27.4.430.
This study is aimed at enhancing understanding prenatal screening decision making through testing a hypothesized decision model based on decision theory and health behavior theory.
We obtained questionnaires from 1,666 pregnant women who were offered prenatal screening for Down's syndrome. Path analysis (using LISREL) resulted in a final model with reasonable model fit, which was verified by split-sample cross-validation.
These included perceived probability, perceived severity, attitude toward termination, response efficacy, attitude toward prenatal screening, subjective norm, child-related anxiety, and intention to undergo prenatal screening.
Attitude toward termination of pregnancy, perceived test efficacy, and subjective norm regarding the desirability of having prenatal screening determined a woman's attitude toward having a prenatal test. Anxiety was influenced by perceived risk and perceived severity of having a child with Down's syndrome, and by subjective norm, but this appeared to be a weak predictor of intention to test. Pregnant women with a positive attitude toward prenatal screening, and who perceived a subjective norm in favor of undergoing prenatal screening, showed a greater intention to have prenatal screening done.
These findings suggest that more attention should be paid toward the values and social context of pregnant women during the counseling process.
本研究旨在通过基于决策理论和健康行为理论测试一个假设的决策模型，增进对产前筛查决策过程的理解。
我们从1666名接受唐氏综合征产前筛查的孕妇那里获取了问卷。路径分析（使用LISREL）得出了一个拟合度合理的最终模型，并通过拆分样本交叉验证进行了验证。
这些指标包括感知概率、感知严重性、对终止妊娠的态度、反应效能、对产前筛查的态度、主观规范、与孩子相关的焦虑以及接受产前筛查的意愿。
对终止妊娠的态度、感知到的检测效能以及关于进行产前筛查可取性的主观规范决定了女性对进行产前检测的态度。焦虑受到生育唐氏综合征患儿的感知风险和感知严重性以及主观规范的影响，但这似乎是检测意愿的一个较弱预测因素。对产前筛查持积极态度且感知到支持进行产前筛查的主观规范的孕妇，进行产前筛查的意愿更强。
这些发现表明，在咨询过程中应更多关注孕妇的价值观和社会背景。
