Factors affecting the choice of Down screen and acceptance of counseling in pregnant women

• Main Authors: Hui-Ying Chen, 陳惠瑩
• Other Authors: 余家利
• Format: Others
• Language: zh-TW
• Published: 2013
• Online Access: http://ndltd.ncl.edu.tw/handle/51991828242046403880

碩士 === 國立臺灣大學 === 分子醫學研究所 === 101 === Objective Down screen has been widely used in clinical practice for decades. Pregnant women take the test as part of routine antenatal care; however, they only have limited knowledge about Down syndrome and the test they chose. The aims of this study are to (1) investigate factors influencing the choose of Down screen (2) identify the degree of perception about Down syndrome and screening test, and (3) comprehend the impression and demands of pregnant women after completing screening test. Methods A cross-sectional survey was undertaken to collect data from one community hospital and two clinic units. Women at 20 + 0 to 26+0 weeks'' gestation receiving prenatal Down screen or chromosomal study were enrolled in this study. The survey queries include four parts: the demographic characteristics, perception about disease and test, type of tests and reasons of choosing tests, and demands after test. Participants used scales to indicate level of agreement with statement of questions. Demographic data were calculated with descriptive statistics and the correlation study was calculated with Spearman rank correlation analysis. Result In total five hundred pregnant women participated in this study. Women with conditions of multiple pregnancy, abnormal screening result, and known fetal anomaly in current or previous pregnancy were excluded. Three hundred and five women completing the queries were enrolled. Fifty out of seventy-six pregnant women of advanced age (34 years old and over) received chromosomal study without any screening test; two hundred and forty seven women received Down screen tests. Maternal age, parity, occupation, and education level are not correlated with the understanding of Down syndrome or screening test. 73.7% of the women had confident cognition about Down syndrome, and only 56.4% parents understood the etiology and inherit pattern of disease. More women concerned the accuracy of test (81.4%) and most of the participant (82.3%) understood that screen test is not a diagnosis. The quadruple test is most frequently used (46.2%), the next frequent is first trimester combine test (35.2%) and integrate test is less accepted (0.8%). The factors affecting decision making include suggestion from physician (67.2%), accuracy of test (32.8%), more disease can be detected at the time (12.6%), information from internet (12.6%), and introduced by relatives and friends(8.9%). 97.6% of the women reported that their expectation of screening test has been fulfilled. 86.6% of the women can comprehend the result, but 42.1% need more discussion about the detail of report. Though the degree of anxiety was alleviated in 89.5% after receiving test, 45.7% of pregnant women, especially nulliparous, still need counseling. Conclusion Down screen is not offered to all pregnant women. Only 27.6% women of advanced age receiving Down screen; most of them are perceived as being at high risk and encouraged to take chromosomal test directly. Information of disease and theories of tests are not the concern of women. Individual counseling should be provided to all pregnant women. Adequate information and time for consideration should be given by health professionals before conducting test.