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先天性心脏病产前诊断后终止妊娠决策过程中的警惕性-“冲突决策模型”的应用。

Vigilance in the Decision-Making Process Regarding Termination of Pregnancy Following Prenatal Diagnosis of Congenital Heart Disease-Application of the 'Conflict Decision-Making Model'.

机构信息

Department of Nursing, School of Health Sciences, Ariel University, Ariel 40700, Israel.

Department of Nursing, School of Health Professions, Tel-Aviv University, Tel-Aviv 69978, Israel.

出版信息

Int J Environ Res Public Health. 2022 Jul 26;19(15):9137. doi: 10.3390/ijerph19159137.

Abstract

The decision-making process regarding termination of pregnancy following prenatal diagnosis of congenital heart disease is a stressful experience for future parents. Janis and Mann’s conflict decision-making model describes seven ideal stages that comprise vigilant information-gathering as an expression of the qualitative decision-making process. In our study, we attempted to determine whether parents who face the decision regarding termination of pregnancy undertake a qualitative decision-making process. Data were collected over 2-year period using structural questionnaires. The sample consisted of two hundred forty participants; sixty-nine (28.75%) declared that their decision was to terminate the pregnancy. A significant difference in the quality of the decision-making score was noted between parents who decided to continue with the pregnancy vs. parents who opted for termination (mean score of 10.15 (5.6) vs. 18.51 (3.9), respectively, p < 0.001). Sixty-two (90%) participants within the termination of pregnancy group went through all seven stages of vigilant decision-making process and utilized additional sources for information and consultation. Parents who decided to continue with the pregnancy made swift decisions, often without considering the negative and positive outcomes; this decision-making pattern is considered non-vigilant and ineffective. Identification of future parents at risk of going through an ineffective decision-making process may help health professionals to determine the best way to provide them with information and support.

摘要

产前诊断先天性心脏病后终止妊娠的决策过程对未来父母来说是一种压力体验。Janis 和 Mann 的冲突决策模型描述了包含警惕信息收集的七个理想阶段,作为定性决策过程的表现。在我们的研究中,我们试图确定面临终止妊娠决策的父母是否进行了定性决策过程。使用结构问卷在 2 年期间收集数据。样本由 240 名参与者组成;69 名(28.75%)表示他们的决定是终止妊娠。选择继续妊娠的父母与选择终止妊娠的父母在决策质量评分上存在显著差异(平均评分分别为 10.15(5.6)和 18.51(3.9),p<0.001)。终止妊娠组中的 62 名(90%)参与者经历了警惕决策过程的所有七个阶段,并利用额外的信息和咨询来源。决定继续妊娠的父母做出了迅速的决定,往往不考虑负面和正面的结果;这种决策模式被认为是非警惕和无效的。识别可能经历无效决策过程的未来父母,可能有助于医疗保健专业人员确定为他们提供信息和支持的最佳方式。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/c80d/9331975/982032043ef7/ijerph-19-09137-g001.jpg

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