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替代产前遗传咨询方法在低社会经济人群孕妇队列中的有效性。

Effectiveness of alternative prenatal genetic counselling methods in a cohort of pregnant women from a low socio-economic population.

作者信息

Battese Ellis Katie

机构信息

Genea, Deakin, Australian Capital Territory, Australia.

出版信息

Aust N Z J Obstet Gynaecol. 2022 Oct;62(5):674-680. doi: 10.1111/ajo.13522. Epub 2022 May 9.

Abstract

BACKGROUND

There are concerns about the capacity of healthcare providers to adequately counsel women on the implications of noninvasive prenatal screening (NIPS). Studies suggest that more resource-efficient counselling methods are needed for broad adoption.

AIMS

We prospectively examined the effectiveness of alternative methods of prenatal counselling on a patient's knowledge and understanding of prenatal testing choices, with a focus on NIPS. We also evaluated prenatal test choice and emotional well-being after making this decision.

METHODS

Women from a low socio-economic population were offered NIPS at no additional cost along with typical prenatal screening and diagnosis. Study participants underwent prenatal counselling via a web-based video consultation or a telephone consultation with a genetic counsellor. Participants were asked to complete pre-counselling and post-counselling questionnaires.

RESULTS

Of 1000 women enrolled, 600 completed both surveys in full and were included in the analysis. Of these, 354 (59%) underwent counselling via a telephone consultation and 246 (41%) via the web-based video consultation. Both counselling methods led to a significant increase in patient knowledge (P < 0.01). NIPS uptake was equivalent between groups. Patients expressed a high level (90%) of satisfaction with their prenatal screen choice, with no significant difference (P > 0.10) between telephone and web participants.

CONCLUSIONS

Alternative methods of counselling such as a web-based education portal can be highly effective and should be considered to enable informed decision-making prior to undergoing prenatal screening such as NIPS. Further, web-based education tools could be beneficial for those in rural areas with limited access to healthcare providers and non-native speakers.

摘要

背景

医疗保健提供者能否就无创产前筛查(NIPS)的影响向女性提供充分咨询受到关注。研究表明,需要更具资源效率的咨询方法以便广泛采用。

目的

我们前瞻性地研究了产前咨询替代方法对患者关于产前检测选择的知识和理解的有效性,重点是NIPS。我们还评估了做出该决定后的产前检测选择和情绪健康状况。

方法

向社会经济地位较低人群的女性免费提供NIPS以及典型的产前筛查和诊断。研究参与者通过与遗传咨询师进行基于网络的视频咨询或电话咨询接受产前咨询。要求参与者完成咨询前和咨询后的问卷。

结果

在登记的1000名女性中,600名完整完成了两项调查并纳入分析。其中,354名(59%)通过电话咨询接受咨询,246名(41%)通过基于网络的视频咨询接受咨询。两种咨询方法均使患者知识显著增加(P<0.01)。两组间NIPS的接受率相当。患者对其产前筛查选择的满意度较高(90%),电话咨询组和网络咨询组之间无显著差异(P>0.10)。

结论

诸如基于网络的教育门户等咨询替代方法可能非常有效,在进行诸如NIPS等产前筛查之前应考虑采用这些方法以促进知情决策。此外,基于网络的教育工具可能对那些难以接触到医疗保健提供者的农村地区人群和非母语人士有益。

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