University of Illinois at Chicago, College of Nursing and College of Medicine, Chicago, IL 60612, USA.
Patient Educ Couns. 2010 Oct;81(1):53-62. doi: 10.1016/j.pec.2009.11.017. Epub 2010 Jan 8.
To illuminate and synthesize what is known about the underlying decision making processes surrounding couples' preimplantation genetic diagnosis (PGD) use or disuse and to formulate an initial conceptual framework that can guide future research and practice.
This systematic review targeted empirical studies published in English from 1990 to 2008 that examined the decision making process of couples or individual partners that had used, were eligible for, or had contemplated PGD. Sixteen studies met the eligibility requirements. To provide a more comprehensive review, empirical studies that examined healthcare professionals' perceptions of couples' decision making surrounding PGD use and key publications from a variety of disciplines supplemented the analysis.
The conceptual framework formulated from the review demonstrates that couples' PGD decision making is composed of three iterative and dynamic dimensions: cognitive appraisals, emotional responses, and moral judgments.
Couples think critically about uncertain and probabilistic information, grapple with conflicting emotions, and incorporate moral perspectives into their decision making about whether or not to use PGD.
The quality of care and decisional support for couples who are contemplating PGD use can be improved by incorporating focused questions and discussion from each of the dimensions into counseling sessions.
阐明并综合有关夫妇在使用或不使用植入前遗传学诊断（PGD）时的潜在决策过程的知识，并制定一个可以指导未来研究和实践的初步概念框架。
本系统评价针对的是 1990 年至 2008 年间以英语发表的、考察了使用过、有资格使用或考虑使用 PGD 的夫妇或个别伴侣的决策过程的实证研究。有 16 项研究符合入选标准。为了提供更全面的综述，从多个学科补充了考察医疗保健专业人员对夫妇使用 PGD 决策的看法的实证研究和主要出版物。
从综述中制定的概念框架表明，夫妇的 PGD 决策由三个迭代和动态的维度组成：认知评估、情绪反应和道德判断。
夫妇会批判性地思考不确定和概率信息，努力应对冲突的情绪，并将道德观点纳入他们是否使用 PGD 的决策中。
通过在咨询中纳入每个维度的重点问题和讨论，可以提高对考虑使用 PGD 的夫妇的护理质量和决策支持。
