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Couples' experiences of an extended information visit about prenatal screening: decision making and satisfaction
Örebro University, School of Health and Medical Sciences, Örebro University, Sweden.ORCID iD: 0000-0002-5316-0492
2014 (English)Doctoral thesis, comprehensive summary (Other academic)
Abstract [en]

The overall aim of this thesis was to describe pregnant women's and partners' views and experiences on early prenatal screening with the combined test, with special focus on the two-step information model.

Interviews were performed with 15 couples who had taken part in the extended information visit about prenatal screening, describing their perceptions of the information model (I) and ten couples or women of those, for a follow-up interview exploring their decision-making process (II). Seven couples, who had not taken part in the extended information visit, were interviewed describing their views and experiences about prenatal screening (III). A questionnaire was answered by 295 women and by 223 partners about their satisfaction about the decision whether or not to participate in the combined test, and their assessment of whether or not this choice had been difficult (IV).

The results showed that different opinions were expressed about the offer of the extended information visit. The separate visit was welcomed by most couples (I). The decision-making process regarding whether to take part in the test or not was described by most couples as a fairly straightforward decision, while for others it was a more complex process that required a great deal of consideration (II). An apprehension of the test, by some of those who had refrained the extended information visit, was that it was an expression of society's involvement in decisions that belong to the expectant parents (III). Ninety-three percent of both women and partners considered the decision about participating in the combined tests as uncomplicated, and well over 90%, of both women and partners were satisfied with their decision (IV).

The conclusions in this thesis, are that the decision whether or not to participate in the combined test is multidimensional and influenced by different views. The two-step information model helped the pregnant woman and the partner to make a decision in a fairly straightforward process or a more complex process with mixed feelings.

Place, publisher, year, edition, pages
Örebro: Örebro university , 2014. , 69 p.
Series
Örebro Studies in Care Sciences, ISSN 1652-1153 ; 59
Keyword [en]
decision-making, patient education, patient satisfaction, prenatal screening
National Category
Nursing
Research subject
Caring sciences
Identifiers
URN: urn:nbn:se:oru:diva-36105ISBN: 978-91-7529-045-4 (print)OAI: oai:DiVA.org:oru-36105DiVA: diva2:740481
Public defence
2014-11-21, Prismahuset, Hörsal 2, Örebro universitet, Fakultetsgatan 1, Örebro, 09:00 (Swedish)
Opponent
Supervisors
Available from: 2014-08-25 Created: 2014-08-25 Last updated: 2017-10-17Bibliographically approved
List of papers
1. Pregnant women's and their partners' perception of an information model on prenatal screening
Open this publication in new window or tab >>Pregnant women's and their partners' perception of an information model on prenatal screening
2012 (English)In: Prenatal Diagnosis, ISSN 0197-3851, E-ISSN 1097-0223, Vol. 32, no 5, 461-466 p.Article in journal (Refereed) Published
Abstract [en]

Objective: Extended verbal information on prenatal screening was given when combined ultrasound and biochemistry screening test was offered at Örebro County Council, Sweden, in 2008. The aim of this study was to describe pregnant women's and her partners' perceptions of this information model.

Method: The interviews were semi-structured, and altogether, 26 interviews were performed with pregnant women and partners. Qualitative content analysis was used to analyze the data.

Results: The result consists of two main categories, ‘form and content’ and ‘managing the information’, to describe the couples' perceptions of the information given. Nine categories describe the information model in: voluntariness, a separate visit, a special midwife, the content, missing information, ethical considerations, a visit on equal terms, communication within the couple, communication with other people, and emotional management.

Conclusion: The information model helps expecting parents to focus on prenatal screening. Only information about prenatal screening and diagnosis was not enough for everybody; some couples want this to be an opportunity to discuss with a professional the pros and cons of prenatal screening as well as ethical considerations. The information visit gives the partner a chance to be involved and an opportunity for the couple to discuss the subject.

Place, publisher, year, edition, pages
Malden, USA: Wiley-Blackwell, 2012
Keyword
Prenatal screening, CUB, Information model, Qualitative study
National Category
Medical and Health Sciences Nursing
Research subject
Caring sciences
Identifiers
urn:nbn:se:oru:diva-22685 (URN)10.1002/pd.2940 (DOI)000303797700010 ()22505351 (PubMedID)2-s2.0-84860770397 (Scopus ID)
Note

Funding Agencies:

Örebro County Council, Sweden 

Signhild Engkvist Foundation, Sweden

Available from: 2012-04-27 Created: 2012-04-27 Last updated: 2017-12-07Bibliographically approved
2. Decision-making process of prenatal screening described by pregnant women and their partners
Open this publication in new window or tab >>Decision-making process of prenatal screening described by pregnant women and their partners
2015 (English)In: Health Expectations, ISSN 1369-6513, E-ISSN 1369-7625, Vol. 18, no 5, 1582-1592 p.Article in journal (Refereed) Published
Abstract [en]

Background: Pregnant women are often faced with having to decide about prenatal screening for Down’s syndrome. However,the decision to participate in or refrain from prenatal screening can be seen as an important decision not only for the pregnant woman but also for both the partners.

Objective: The aim of this study was to explore the couples’ processes of decision making about prenatal screening.

Methods: A total of 37 semi-structured interviews conducted at two time points were analysed using the interpretive description.

Setting: The study was carried out in Maternal health-care centres,Örebro County Council, Sweden.

Participants: Fifteen couples of different ages and with different experiences of pregnancy and childbirth were interviewed.

Results: Three different patterns of decision making were identified. For the couples in The open and communicative decision-making process’, the process was straightforward and rational, and the couples discussed the decision with each other. ‘The closed and personal decision-making process’ showed an immediate and non-communicative decision making where the couples decided each for themselves. The couples showing ‘The searching and communicative decision-making process’ followed an arduous road in deciding whether to participate or not in prenatal screening and how to cope with the result.

Conclusions: The decision-making process was for some couples a fairly straightforward decision, while for others it was a more complex process that required a great deal of consideration.

Place, publisher, year, edition, pages
Wiley-Blackwell, 2015
Keyword
decision making, prenatal, screening, qualitative analysis
National Category
Nursing
Research subject
Caring sciences
Identifiers
urn:nbn:se:oru:diva-31088 (URN)10.1111/hex.12147 (DOI)000365046700079 ()24118867 (PubMedID)2-s2.0-84942293987 (Scopus ID)
Available from: 2013-10-04 Created: 2013-10-04 Last updated: 2017-12-06Bibliographically approved
3. Views on prenatal screening among pregnant women and partners declining an extended information
Open this publication in new window or tab >>Views on prenatal screening among pregnant women and partners declining an extended information
(English)Article in journal (Refereed) Submitted
Abstract [en]

Objective: A County Council in Sweden has implemented a two-step information model about prenatal screening. In addition to the regular brief information delivered by the midwife at the first routine visit at the maternal health care centre, the two-step model includes an offer of extended information at a separate visit. However, a substantial number of the couples decline and there is a lack of knowledge about their reasons. The aim of this study was to describe views about prenatal screening among couples who had not taken part in an extended information visit, to increase understanding of the perspectives of prenatal screening in this group.

Method: Qualitative interviews were performed with seven couples not participating in an extended information visit about prenatal screening. Data were analysed using Interpretive Description. Results: The results showed two themes. In the theme “From an individual view”, with the subthemes Declining further information and, Position taken against prenatal screening, the couples saw the invitation and prenatal screening from their own points of view. They refrained because they did not want to receive any more information. In the other theme, “From a societal view”, with the subthemes Society has a hidden agenda and, The health care service’s responsibilities, the couples perceived the offer as part of a societal view on prenatal screening, that they could not support.

Conclusion: The findings in this group of couples shows that couples’ perceptions of prenatal screening are multidimensional and influenced by different views, from both an individual perspective and a more societal one.

Practice Implications: Health care professionals should be aware that some persons could be reluctant to accept health care service, and that the challenge is to meet all individuals, without violating their autonomy. Person-centred care could assist with an approach to meeting the person as an individual.

Keyword
prenatal screening, extended information
National Category
Nursing
Research subject
Caring sciences
Identifiers
urn:nbn:se:oru:diva-38382 (URN)
Available from: 2014-11-06 Created: 2014-11-06 Last updated: 2017-10-17Bibliographically approved
4. Decision-making about prenatal screening: are pregnant women and partners satisfied with their decision?
Open this publication in new window or tab >>Decision-making about prenatal screening: are pregnant women and partners satisfied with their decision?
(English)Article in journal (Refereed) Submitted
Abstract [en]

Objective The combined test for Down syndrome is offered to pregnant women. Qualitative studies have shown that the decision, whether or not to accept the test,is a rational one for most couples, although for some it may be difficult. Little is known about the couples’ satisfaction with the decision afterwards; the aim of this study was to extend that knowledge

Method Pregnant women and their partners were invited to fill out a questionnaire at approximately pregnancy week 20. The questionnaire, which covered aspects of their decision on prenatal testing, was based on the Decision Regret Scale, with additional questions

Results The response rate was 77% (295/359 women and 223/315 partners). The decision whether or not to participate in the combined test was seen as mutual by 95% of the women and 96% of the partners, and was perceived as uncomplicated by 93% of both women and partners. The decision was considered as difficult/very difficult by 6%. With a range of 93% – 99% women and partners were satisfied with their decision afterwards, but 1%–7% were not

Conclusion The majority of the participants were satisfied wither their decision. However, a small minority were not, which is important to recognize.

National Category
Nursing
Research subject
Caring sciences
Identifiers
urn:nbn:se:oru:diva-38383 (URN)
Available from: 2014-11-06 Created: 2014-11-06 Last updated: 2017-10-17Bibliographically approved

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