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唐氏综合征的产前筛查:调查女性和家庭医生在共同决策方面的参与意愿。

Prenatal screening for Down syndrome: a survey of willingness in women and family physicians to engage in shared decision-making.

机构信息

Department of Family Medicine and Emergency Medicine, Faculty of Medicine, Université Laval, Québec City, Canada.

出版信息

Prenat Diagn. 2011 Apr;31(4):319-26. doi: 10.1002/pd.2624. Epub 2011 Jan 26.

Abstract

OBJECTIVE

To assess the willingness of women and their family physicians (FPs) to engage in shared decision-making (SDM) as regards prenatal Down-syndrome screening and the factors that might influence their willingness to do so.

METHODS

We conducted a survey of participants in Québec City, Canada, using the theory of planned behavior. We used a general linear model and multilevel approach that took the fact that some women consulted the same FP into account.

RESULTS

This study comprised 109 pregnant women and 41 FPs. On a scale of - 3 to + 3, the pregnant women's and FPs' response scores were, respectively, 2.11 ± 1.38 and 2.66 ± 0.40. In women, attitude, significant others, self-efficacy, perceived moral correctness, and their FP's attitude influenced their willingness to engage in SDM. However, women without a post-secondary education were less likely to engage in SDM than women with a post-secondary education, mostly because the former lacked a sense of self-efficacy. In FPs, only attitude and significant others influenced their willingness to engage in SDM.

CONCLUSION

Overall, the women and their FPs wished to engage in SDM as regards prenatal Down-syndrome screening. Only a few factors influenced this desire which therefore may be modifiable.

摘要

目的

评估女性及其家庭医生(FP)在参与产前唐氏综合征筛查的决策方面的意愿,以及可能影响其参与意愿的因素。

方法

我们在加拿大魁北克市对参与者进行了一项基于计划行为理论的调查。我们使用一般线性模型和多层次方法,考虑到一些女性咨询了同一位 FP 的情况。

结果

这项研究包括 109 名孕妇和 41 名 FP。孕妇和 FP 的反应得分分别为 2.11 ± 1.38 和 2.66 ± 0.40。在女性中,态度、重要他人、自我效能感、感知道德正确性以及他们的 FP 的态度影响了她们参与 SDM 的意愿。然而,没有接受过高等教育的女性比接受过高等教育的女性更不愿意参与 SDM,主要是因为前者缺乏自我效能感。在 FP 中,只有态度和重要他人影响了他们参与 SDM 的意愿。

结论

总体而言,女性及其 FP 希望在产前唐氏综合征筛查方面进行 SDM。只有少数因素影响了这种意愿,因此这些因素可能是可以改变的。

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