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通过电话接收唐氏综合征产前诊断:对孕妇夫妇经历的定性研究。

Receiving a prenatal diagnosis of Down syndrome by phone: a qualitative study of the experiences of pregnant couples.

机构信息

Central Denmark Region, DEFACTUM - Public Health and Quality Improvement, Aarhus N, Denmark.

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

出版信息

BMJ Open. 2019 Mar 13;9(3):e026825. doi: 10.1136/bmjopen-2018-026825.

Abstract

OBJECTIVES

To examine how pregnant couples experience receiving a prenatal diagnosis of Down syndrome (DS) by phone-a practice that has been routine care in the Central Denmark Region for years.

DESIGN

Qualitative interview study.

SETTING

Participants were recruited from hospitals in Central Denmark Region, Denmark.

PARTICIPANTS

Couples who had received a prenatal diagnosis of DS by phone and decided to terminate the pregnancy. They were recruited from the obstetric department where the termination was undertaken. During the study period (February 2016 to July 2017), 21 semistructured, audio-recorded interviews were conducted by an experienced anthropologist. Interviews were conducted 4-22 weeks after the diagnosis and analysed using thematic analysis.

RESULTS

A prearranged phone call was considered an acceptable practice. However, the first theme shows how the call often came earlier than expected. Consequently, most women were not with their partner and were thus initially alone with their grief and furthermore responsible for informing their partner, which some considered difficult. The second theme shows how during the phone calls, physicians were quick to enquire about the couples' agendas. As the majority had already decided to seek termination of pregnancy, the dialogue focused on related questions and arrangements. Only half of the couples received additional counselling.

CONCLUSION

A prearranged phone call was considered an acceptable and appropriate practice. However, some aspects of this practice (particularly related to the context of the call) showed to be less than optimal for the couples. To make sure that a diagnostic result is delivered in accordance with the couples' needs and requests, the context of the call could be addressed and agreed on in advance by physicians and couples.

摘要

目的

研究丹麦中部地区多年来一直采用的电话产前诊断唐氏综合征(DS)的方式如何影响夫妇的感受。

设计

定性访谈研究。

地点

参与者在丹麦中部地区的医院招募。

参与者

通过电话接受 DS 产前诊断并决定终止妊娠的夫妇。他们是从实施终止妊娠的产科病房招募的。在研究期间(2016 年 2 月至 2017 年 7 月),一位经验丰富的人类学家进行了 21 次半结构化、录音访谈。访谈在诊断后 4-22 周进行,并使用主题分析进行分析。

结果

预先安排的电话被认为是一种可以接受的做法。然而,第一个主题表明,电话往往比预期的更早打来。因此,大多数女性都没有和伴侣在一起,最初是独自面对悲痛,而且还需要负责通知伴侣,这让一些人感到困难。第二个主题表明,在电话交谈中,医生很快就会询问夫妇的议程。由于大多数夫妇已经决定寻求终止妊娠,对话的重点是相关问题和安排。只有一半的夫妇接受了额外的咨询。

结论

预先安排的电话被认为是一种可以接受和适当的做法。然而,这种做法的某些方面(特别是与电话交谈的背景有关)对夫妇来说并不理想。为了确保诊断结果符合夫妇的需求和要求,可以由医生和夫妇事先讨论并商定电话交谈的背景。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f34e/6429881/53764c4b7707/bmjopen-2018-026825f01.jpg

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