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丹麦超声医师对唐氏综合征产前筛查中引入“中度风险”的体验。

Danish Sonographers' Experiences of the Introduction of "Moderate Risk" in Prenatal Screening for Down Syndrome.

作者信息

Møller Anne, Vogel Ida, Petersen Olav Bjørn, Lou Stina

机构信息

Department of Public Health, Aarhus University, Aarhus, Denmark.

Center for Fetal Diagnostics, Aarhus University Hospital, Aarhus, Denmark.

出版信息

J Pregnancy. 2018 Oct 9;2018:1646035. doi: 10.1155/2018/1646035. eCollection 2018.

Abstract

OBJECTIVE

The aim of the study was to determine sonographers' experiences with the introduction of an offer of noninvasive prenatal testing (NIPT) to a new moderate-risk (MR) group at the combined first-trimester prenatal screening (cFTS).

STUDY DESIGN

A qualitative approach consisting of seven semistructured interviews with five sonographers (midwives and nurses). Data was analyzed using thematic analysis.

MAIN OUTCOME MEASURES

Sonographers' perception of offering NIPT to women in MR.

RESULTS

The sonographers understood NIPT as a positive development in prenatal screening due to a safe procedure and high detection rates for trisomies 13, 18, and 21. Prior to the introduction of MR, the sonographers were concerned about inducing worry in pregnant women in this new risk group. However, the pregnant women responded very positively, which the sonographers attributed to several factors such as the women's overall reason for participating in prenatal screening, the simplicity of the NIPT procedure, and the communicative strategies used by the sonographers. The strategies included all sonographers using the same words and explanations, emphasizing that statistics were in the women's favor, initiating the presentation of MR with a positive message, and downplaying the MR category.

CONCLUSION

Sonographers' communicative strategies succeeded in limiting worry in pregnant women in MR. As such, the findings are valuable for health professionals, who are responsible for communicating about prenatal screening results and diagnostic options.

摘要

目的

本研究旨在确定超声检查人员在孕早期联合产前筛查(cFTS)时向新的中度风险(MR)组提供无创产前检测(NIPT)的经验。

研究设计

采用定性研究方法,对五名超声检查人员(助产士和护士)进行了七次半结构化访谈。使用主题分析法对数据进行分析。

主要观察指标

超声检查人员对向MR组女性提供NIPT的看法。

结果

超声检查人员认为NIPT是产前筛查中的一项积极进展,因为其检测过程安全,对13、18和21三体的检测率高。在引入MR组之前,超声检查人员担心会给这个新的风险组中的孕妇带来担忧。然而,孕妇的反应非常积极,超声检查人员将此归因于几个因素,如女性参与产前筛查的总体原因、NIPT程序的简单性以及超声检查人员使用的沟通策略。这些策略包括所有超声检查人员使用相同的措辞和解释,强调统计数据对女性有利,以积极的信息开始介绍MR组,并淡化MR类别。

结论

超声检查人员的沟通策略成功地减少了MR组孕妇的担忧。因此,这些发现对负责传达产前筛查结果和诊断选择的卫生专业人员具有重要价值。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/908e/6198582/74288c79d7db/JP2018-1646035.001.jpg

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