RESUMO
The psychological impact of the announcement of a fetal abnormality after ultrasound examinations is examined in relation to the building up of the mother-child attachment. It represents the "psychological cost" of such techniques. Understanding the subjective experience of the patients could increase the effectiveness of clinical practice. We have assumed that the relationship between parents and professionals is a critical element that contributes to the establishment of an emotional link between the mother and her child. Pregnant women, mothers, and professionals were approached for interviews and by questionnaires including anamnestic data, opinions, and projective methods. The results showed that the women with fetopathy were less centered on themselves during the pregnancy. Long-term effects were found to be important. In pregnant women, ultrasound examination was experienced with satisfaction even if some ambivalence remained. In mothers with an impaired child, ultrasound examination was viewed as a technique with low reliability. Professionals reported not having preparation in making such an announcement. We concluded that a need exists for better management of the modalities of ultrasound examinations. Many parents have expressed their need for psychological support.
Assuntos
Anormalidades Congênitas/psicologia , Feto/anormalidades , Mães/psicologia , Médicos/psicologia , Gravidez/psicologia , Adulto , Atitude do Pessoal de Saúde , Atitude Frente a Saúde , Bélgica , Feminino , Ginecologia , Humanos , Mães/estatística & dados numéricos , Obstetrícia , Médicos/estatística & dados numéricos , Gravidez/estatística & dados numéricos , Inquéritos e QuestionáriosRESUMO
Forty-nine patients with chronic wrist pain were examined by radiocarpal arthrography, followed by radiocarpal arthroscopy. One patient had bilateral involvement. None of these patients showed deformities or lesions on standard and dynamic radiographs. Not all patients who underwent arthrography underwent radiocarpal arthroscopy. Sensitivity of arthrography was 52%, specificity 50%, positive predictive value 92%, and negative predictive value 8% compared with arthroscopy. In this patient group, a very low negative predictive value was found: in 92% of the negative arthrographic examinations an arthroscopic lesion was found. Arthrography of the radiocarpal joint is a good examination for confirming a clinical suspected lesion, but is of limited value when negative.