RESUMEN
This study examines women's psychological responses to prenatal group genetic counseling, and to subsequent individualized risk counseling. All women (N=123) aged 35 and older underwent nuchal translucency screening (NTS), a prenatal ultrasound screening test. After group counseling, decisional conflict decreased significantly among those reporting at baseline having made a decision about invasive testing (t(222)=2.0, P=0.014) and for those who were uncertain (t(222)=5.74, P <0.0005). After receiving NT-adjusted risks, decisional conflict decreased further for those uncertain about testing at baseline (t(222)=4.64, P <0.0005). There was no change in risk perception and anxiety after group counseling. After NT-adjusted risks were communicated, risk perception decreased significantly (t(230)=5.02, P <0.0005), as did anxiety (t(115)=7.91, P <0.005). Despite reassuring NTS results, the uptake rate for prenatal invasive testing was 78.4%. Risk perception, anxiety, and decisional conflict decreased after individual counseling for reassuring NTS results, but the uptake of invasive testing remained high.
Asunto(s)
Asesoramiento Genético , Edad Materna , Madres , Aceptación de la Atención de Salud/psicología , Embarazo de Alto Riesgo , Ultrasonografía Prenatal/psicología , Adulto , Factores de Edad , Análisis de Varianza , Ansiedad/etiología , Ansiedad/psicología , Conflicto Psicológico , Toma de Decisiones , Escolaridad , Retroalimentación Psicológica , Femenino , Asesoramiento Genético/métodos , Asesoramiento Genético/psicología , Conocimientos, Actitudes y Práctica en Salud , Hospitales de Enseñanza , Humanos , Madres/educación , Madres/psicología , Ontario , Servicio Ambulatorio en Hospital , Aceptación de la Atención de Salud/estadística & datos numéricos , Embarazo , Evaluación de Programas y Proyectos de Salud , Medición de Riesgo , Encuestas y Cuestionarios , Ultrasonografía Prenatal/estadística & datos numéricosRESUMEN
This study evaluates the effects of prenatal genetic group counselling on women's anxiety, decisional conflict and levels of knowledge. Participants (N=271) were aged 35 years and older. ANOVA results indicated that pre/postcounselling scores for anxiety did not change significantly, while decisional conflict decreased significantly (P<0.001). Pre/postcounselling scores on two different knowledge measures were analysed using 2x3 mixed ANOVAs for time by highest level of education and by having discussed prenatal diagnosis with one's health care provider. No potential interactions were statistically significant; time alone had a strong significant effect for both knowledge measures (P<0.01); P<0.01, respectively), suggesting that the effects of the counselling intervention were robust. Group genetic counselling is an effective method for education and decision support in the prenatal context, and may serve as a model for other clinical populations facing genetic screening decisions.