Gesser-Edelsburg Anat, Shahbari Nour Abed Elhadi
School of Public Health, University of Haifa, 199 Aba Khoushy Ave. Mount Carmel, Haifa, 3498838, Israel.
Reprod Health. 2017 Apr 4;14(1):49. doi: 10.1186/s12978-017-0312-7.
This study focused on decision-making on terminating pregnancy for Arab Muslim women in Israel who were pregnant with fetuses diagnosed with congenital anomalies. It examined the impact of the doctor-patient interaction on the women's decision, especially in light of social and religious pressures not to terminate under any circumstances. Our goal was to identify perceptions and attitudes of Muslim Arab women who choose to continue their pregnancy following the detection of congenital anomalies in prenatal tests. Specific objectives included (1) To examine the Muslim Arab women's perceptions on genetic testing, and ascertain the reasons for their decision to continue the pregnancy following the detection of a congenital anomaly in the fetus; and (2) To examine risk communication of gynecologists regarding genetic testing and abortions, and regarding the decision of continuing or terminating a pregnancy following detection of a congenital anomaly.
The research framework used the constructivist classical qualitative method to understand the experience of women at high risk for congenital anomalies and their experience of how doctors communicate the risk.
It showed that the emotional element is no less dominant than religious and social elements. The findings emphasized the disparities between doctors and women regarding emotional involvement (non-directive counselling). The women interviewees (N = 24) felt that this expressed insensitivity. As far as we know, the emotional component has not been raised in previous studies of Muslim women at high risk for congenital defects in their fetus, and therefore comprises a significant contribution of the present study.
To mitigate gaps, doctors should take affect into consideration in their communication with patients. It is important for doctors to understand the emotional element in risk communication, both in how they respect women's emotions and in creating an emotional interaction between themselves and the women.
本研究聚焦于以色列阿拉伯穆斯林女性怀有被诊断出先天性异常胎儿时的终止妊娠决策。它考察了医患互动对这些女性决策的影响,尤其是鉴于社会和宗教压力要求在任何情况下都不得终止妊娠。我们的目标是确定在产前检查发现先天性异常后选择继续妊娠的阿拉伯穆斯林女性的认知和态度。具体目标包括:(1)考察阿拉伯穆斯林女性对基因检测的认知,并确定她们在检测到胎儿先天性异常后决定继续妊娠的原因;(2)考察妇科医生在基因检测和堕胎方面以及在检测到先天性异常后继续或终止妊娠决策方面的风险沟通情况。
研究框架采用建构主义经典定性方法,以了解先天性异常高危女性的经历以及她们对医生如何沟通风险的体验。
结果表明,情感因素与宗教和社会因素同样重要。研究结果强调了医生与女性在情感投入(非指导性咨询)方面的差异。受访女性(N = 24)认为这表现出冷漠。据我们所知,在先前关于胎儿先天性缺陷高危穆斯林女性的研究中尚未提及情感因素,因此这是本研究的一项重要贡献。
为缩小差距,医生在与患者沟通时应考虑情感因素。医生了解风险沟通中的情感因素很重要,这既体现在他们如何尊重女性的情感,也体现在他们与女性之间建立情感互动方面。