Harris J M, Franck L, Green B, Michie S
Health Psychology Research Group, UCL, UK.
Department of Family Health Care Nursing, University of California, San Francisco, USA.
Midwifery. 2014 Dec;30(12):1187-95. doi: 10.1016/j.midw.2014.04.006. Epub 2014 Apr 30.
a new first-trimester universal antenatal screening test for pre-eclampsia was introduced into two UK hospitals. The aim of this study was to investigate the potential psychological benefits, harms and acceptability of providing pregnant women with formal risk information for pre-eclampsia.
cross-sectional interview study. Women were interviewed using a theoretically informed semi-structured schedule and transcripts were analysed thematically using Framework Analysis.
primigravid women receiving antenatal care at a central London National Health Service Foundation Trust found either high-risk or low-risk for pre-eclampsia.
15 primigravid women who received high risk (n=10) or low risk (n=5) results of a 12-week pre-eclampsia screening test were interviewed. Two types of coping typologies were evident from the data. The first were 'danger managers' who had an internal sense of control, were focused on the risk that pre-eclampsia presented to them and exhibited information seeking, positive behaviour changes, and cognitive reappraisal coping mechanisms. The second were 'fear managers' who had an external sense of control, were focused on the risk that pre-eclampsia presented to the fetus, and exhibited avoidance coping mechanisms. In addition to these typologies, three universal themes of 'medicalising the pregnancy', 'embracing technology' and 'acceptability' emerged from the data.
there are potential positive and negative unintended consequences following a first-trimester screening test for pre-eclampsia. A positive consequence could be self-instigated behaviour change, whereas a negative consequence could be reduced self-monitoring of fetal movements as the pregnancy develops.
this study indicates that women with an increased risk of pre-eclampsia would be willing to engage in efforts to reduce their risk of pre-eclampsia, and there is a potential to use this screening test as a basis for improving health more broadly.
一种用于子痫前期的新型孕早期通用产前筛查测试被引入英国的两家医院。本研究的目的是调查为孕妇提供子痫前期正式风险信息的潜在心理益处、危害及可接受性。
横断面访谈研究。采用理论指导的半结构化访谈提纲对女性进行访谈，并使用框架分析法对访谈记录进行主题分析。
在伦敦市中心的一家国民保健服务基金会信托机构接受产前护理的初产妇，其被判定为子痫前期高风险或低风险。
对15名接受了12周子痫前期筛查测试并得到高风险（n = 10）或低风险（n = 5）结果的初产妇进行了访谈。数据中出现了两种应对类型。第一种是“风险管理者”，她们有内在的控制感，关注子痫前期给自己带来的风险，并表现出信息寻求、积极的行为改变和认知重新评价应对机制。第二种是“恐惧管理者”，她们有外在的控制感，关注子痫前期给胎儿带来的风险，并表现出回避应对机制。除了这些类型，数据中还出现了“将妊娠医学化”“接受技术”和“可接受性”这三个普遍主题。
孕早期子痫前期筛查测试会产生潜在的积极和消极意外后果。积极后果可能是自我引发的行为改变，而消极后果可能是随着孕期进展对胎动的自我监测减少。
本研究表明，子痫前期风险增加的女性愿意努力降低子痫前期风险，并且有可能将这种筛查测试作为更广泛改善健康的基础。
