van Bruggen Metje J, Henneman Lidewij, Timmermans Daniëlle R M
Department of Clinical Genetics, Section of Community Genetics, VU University Medical Center, PO Box 7057, 1007 MB Amsterdam, the Netherlands; Amsterdam Public Health Research Institute, VU University Medical Center, PO Box 7057, 1007 MB, Amsterdam, the Netherlands.
Department of Clinical Genetics, Section of Community Genetics, VU University Medical Center, PO Box 7057, 1007 MB Amsterdam, the Netherlands; Amsterdam Public Health Research Institute, VU University Medical Center, PO Box 7057, 1007 MB, Amsterdam, the Netherlands; Amsterdam Reproduction and Development, VU University Medical Center, PO Box 7057, 1007 MB Amsterdam, the Netherlands.
Midwifery. 2018 Sep;64:93-100. doi: 10.1016/j.midw.2018.06.010. Epub 2018 Jun 20.
Situational factors of prenatal screening have changed in recent decades. To explore the effect of a changing context on women's decision making, differences and similarities in the decision-making process of pregnant women regarding prenatal screening for fetal aneuploidy between two periods in time were studied.
A qualitative comparison was made between a dataset of 22 semi-structured interviews with pregnant women from 2003 and a newly collected dataset with 19 semi-structured interviews from 2016.
Overall, women reported similar considerations in their decision-making process in 2003 and 2016, suggesting that decision making has not essentially changed. In 2016, women were still making a deliberate decision, however for some women costs and societal views as to what is acceptable did appear to impact the decision-making process. Moreover, new screening possibilities (e.g. improved test characteristics and including more conditions to be screened) seemed to impact the decision outcome.
Since most women based their decisions mainly on their personal values and personal experiences rather than on situational factors, the results suggest that the changing context with regard to prenatal screening had no major effect on women's decision making. It therefore seems unlikely that future changes in the field of prenatal screening will drastically change the decision-making process of pregnant women as long as informed and deliberate decision making is safeguarded.
近几十年来，产前筛查的情境因素发生了变化。为探讨不断变化的背景对女性决策的影响，研究了两个时期孕妇在胎儿非整倍体产前筛查决策过程中的差异与相似之处。
对2003年22名孕妇的半结构化访谈数据集与2016年新收集的19名孕妇的半结构化访谈数据集进行定性比较。
总体而言，女性在2003年和2016年的决策过程中报告了相似的考虑因素，这表明决策本质上没有改变。2016年，女性仍在做出慎重的决定，然而，对于一些女性来说，成本和社会可接受性观点似乎确实影响了决策过程。此外，新的筛查可能性（如改进的检测特征和包括更多要筛查的情况）似乎影响了决策结果。
由于大多数女性主要根据个人价值观和个人经历而非情境因素做出决定，结果表明产前筛查方面不断变化的背景对女性决策没有重大影响。因此，只要保障知情和慎重的决策，产前筛查领域未来的变化似乎不太可能彻底改变孕妇的决策过程。
