McNeill Jennifer, Alderdice Fiona
Nursing & Midwifery Research Unit, School of Nursing & Midwifery, Queen's University, Belfast, UK.
J Clin Nurs. 2009 Oct;18(20):2888-96. doi: 10.1111/j.1365-2702.2008.02761.x. Epub 2009 Jul 8.
To explore the perspective of midwives offering serum screening for Down's syndrome.
Previous literature has indicated that the offer and discussion of prenatal serum screening tests with women is complex, and health professionals may influence women's decisions to accept or decline screening. Midwives are usually the key professional to offer serum screening for Down's syndrome in the UK but their perspective is relatively neglected in the literature.
An explorative qualitative interview study with 15 midwives employed in a maternity unit in Northern Ireland involved in offering prenatal screening to pregnant women. Data were collected from 1 July 2005-31 October 2005.
A focused ethnographic approach was used to explore the perspective of midwives.
Midwives reported difficulty in explaining the test to women and felt unable to provide the necessary information to adequately inform women within their appointment time. The test offered (the triple test) and potential pathway of subsequent care, were identified as sources of professional and personal conflict by midwives. The expectation that midwives would provide a universal offer of Down's syndrome serum screening but be unable to support women regarding termination of pregnancy also created dissonance.
The feasibility of proceeding with a universal serum screening programme for Down's syndrome is questionable in countries which legally or culturally oppose termination of pregnancy. Professionals practising within environments such as this experience conflict in their role, which affects communication with women when discussing screening tests.
As midwives are often, the primary health professional providing information to women, it is important that midwives are key participants in ongoing planning and discussions about screening policy to ensure programmes are implemented successfully.
探讨助产士提供唐氏综合征血清筛查的观点。
以往文献表明，向女性提供和讨论产前血清筛查测试很复杂，且卫生专业人员可能会影响女性接受或拒绝筛查的决定。在英国，助产士通常是提供唐氏综合征血清筛查的关键专业人员，但她们的观点在文献中相对被忽视。
对北爱尔兰一家产科单位的15名从事为孕妇提供产前筛查工作的助产士进行探索性定性访谈研究。数据收集时间为2005年7月1日至2005年10月31日。
采用聚焦人种志方法来探究助产士的观点。
助产士报告称难以向女性解释该测试，并且觉得无法在预约时间内为女性提供足够的必要信息。所提供的测试（三联测试）及后续护理的潜在途径被助产士视为专业和个人冲突的根源。期望助产士普遍提供唐氏综合征血清筛查，但在终止妊娠方面无法为女性提供支持，这也造成了矛盾。
在法律上或文化上反对终止妊娠的国家，推行唐氏综合征通用血清筛查项目的可行性值得怀疑。在这样的环境中执业的专业人员会经历角色冲突，这在讨论筛查测试时会影响与女性的沟通。
由于助产士通常是向女性提供信息的主要卫生专业人员，助产士成为正在进行的筛查政策规划和讨论的关键参与者很重要，以确保项目成功实施。
