Oxenford Kerry, Daley Rebecca, Lewis Celine, Hill Melissa, Chitty Lyn S
Fetal Medicine Unit, University College London Hospitals NHS Foundation Trust, London, UK.
NE Thames Regional Genetics Service, Great Ormond Street Hospital for Children NHS Foundation Trust, London, UK.
BMC Pregnancy Childbirth. 2017 Apr 27;17(1):132. doi: 10.1186/s12884-017-1315-7.
The availability of non-invasive prenatal testing (NIPT) for aneuploidies is expanding rapidly throughout the world. Training health professionals to offer NIPT in a way that supports informed choice is essential for implementation. The aim of this study was to develop and evaluate a training package for health professionals to support the introduction of NIPT into clinical practice.
Training on NIPT was offered to health professionals, primarily midwives, involved in Down syndrome screening and testing in eight hospitals located in England and Scotland as part of a research study evaluating the implementation of NIPT in the UK National Health Service. Training was evaluated using a mixed methods approach that included quantitative questionnaires at three time points and post-training qualitative interviews. The questionnaires measured confidence, self-perceived knowledge and actual knowledge about NIPT for Down syndrome. Interviews explored opinions about the training and experiences of offering NIPT.
The training provided to the health professionals was found to positively impact on their confidence in discussing NIPT with women in their clinic, and both their perceived and actual knowledge and understanding of NIPT was improved. Knowledge remained weak in four areas; cell-free fetal DNA levels increase with gestation; turnaround time for NIPT results; cell-free fetal DNA is placental in origin; and NIPT false positive rate.
Training materials, including a lesson plan, PowerPoint presentation and written factsheet on NIPT, have been developed and evaluated for use in educating midwives and supporting the introduction of NIPT. Implementation of training should include a greater focus on the areas where knowledge remained low. Some groups of midwives will need additional training or support to optimise their confidence in discussing NIPT with women.
非侵入性产前检测（NIPT）用于检测染色体非整倍体的技术在全球范围内迅速推广。培训卫生专业人员以支持知情选择的方式提供NIPT对于该技术的实施至关重要。本研究的目的是开发并评估一套针对卫生专业人员的培训材料，以支持将NIPT引入临床实践。
作为一项评估NIPT在英国国家医疗服务体系中实施情况的研究的一部分，对英格兰和苏格兰八家医院中参与唐氏综合征筛查和检测的卫生专业人员（主要是助产士）进行了NIPT培训。采用混合方法对培训进行评估，包括在三个时间点进行定量问卷调查以及培训后的定性访谈。问卷测量了对唐氏综合征NIPT的信心、自我认知的知识和实际知识。访谈探讨了对培训的看法以及提供NIPT的经验。
发现提供给卫生专业人员的培训对他们在诊所与女性讨论NIPT的信心产生了积极影响，并且他们对NIPT的认知和实际知识及理解都有所提高。在四个方面知识仍然薄弱；游离胎儿DNA水平随孕周增加；NIPT结果的周转时间；游离胎儿DNA起源于胎盘；以及NIPT假阳性率。
已经开发并评估了培训材料，包括一份教案、PowerPoint演示文稿和关于NIPT的书面情况说明书，用于教育助产士并支持NIPT的引入。培训的实施应更加关注知识仍然薄弱的领域。一些助产士群体需要额外的培训或支持，以增强他们与女性讨论NIPT的信心。
