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Informed decision making in the context of prenatal screening
Matthijs van den Berg1, Danielle R M Timmermans, Leo P ten Kate
1Institute for Research in Extramural Medicine, Department of Public and Occupational Health, VU University Medical Center, Van der Boechorststraat 7, NL-1081 BT Amsterdam, The Netherlands. m.vandenberg@vumc.nl
Patient Education and Counseling
|October 26, 2005
Summary
Many prenatal screening decisions are not fully informed, lacking sufficient deliberation. Encouraging thoughtful consideration during counseling can improve informed decision-making for expectant parents.
Area of Science:
- Reproductive Health
- Medical Decision Making
- Patient Education
Background:
- Informed decision-making is crucial for prenatal screening.
- Current decision-making processes may not fully equip patients with adequate knowledge or encourage deliberation.
- Assessing the level of informed decision-making is essential to understand patient experiences.
Purpose of the Study:
- To develop a comprehensive measure of informed decision-making, incorporating knowledge, deliberation, and value-consistency.
- To evaluate the extent of informed decision-making among women offered prenatal screening.
- To compare informed decision-making levels between prenatal test acceptors and decliners.
Main Methods:
- A postal questionnaire was administered to women before and after the prenatal screening offer across 44 practices.
- Key outcome measures included knowledge of prenatal screening, deliberation on pros and cons, test uptake, and attitude towards screening.
- Informed decision-making was assessed based on knowledge, deliberation, and value-consistency.
Main Results:
- 84% of participants demonstrated sufficient knowledge, 75% of decisions were deliberate, and 82% were value-consistent.
- Overall, 51% of participants made an informed decision regarding prenatal screening.
- Test acceptors exhibited less informed decision-making compared to test decliners, primarily due to lower deliberation rates.
Conclusions:
- Prenatal screening decisions frequently fall short of being fully informed.
- This finding contrasts with the primary goal of prenatal screening, which is to facilitate informed choices.
- Counseling should actively encourage deliberation on screening alternatives to enhance informed decision-making.