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Exploring informed choice in the context of prenatal testing: findings from a qualitative study
Author(s) -
Potter Beth K.,
O’Reilly Natasha,
Etchegary Holly,
Howley Heather,
Graham Ian D.,
Walker Mark,
Coyle Doug,
Chorny Yelena,
Cappelli Mario,
Boland Isabelle,
Wilson Brenda J.
Publication year - 2008
Publication title -
health expectations
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.314
H-Index - 74
eISSN - 1369-7625
pISSN - 1369-6513
DOI - 10.1111/j.1369-7625.2008.00493.x
Subject(s) - informed consent , context (archaeology) , psychology , directive , prenatal care , test (biology) , qualitative research , sample (material) , health care , nursing , medicine , social psychology , applied psychology , medical education , alternative medicine , population , paleontology , social science , environmental health , pathology , sociology , computer science , economics , biology , programming language , economic growth , chemistry , chromatography
Purpose  This study explored whether and how a sample of women made informed choices about prenatal testing for foetal anomalies; its aim was to provide insights for future health policy and service provision. Methods  We conducted semi‐structured interviews with 38 mothers in Ottawa, Ontario, all of whom had been offered prenatal tests in at least one pregnancy. Using the Multi‐dimensional Measure of Informed Choice as a general guide to analysis, we explored themes relevant to informed choice, including values and knowledge, and interactions with health professionals. Results  Many, but not all, participants seemed to have made informed decisions about prenatal testing. Values and knowledge were interrelated and important components of informed choice, but the way they were discussed differed from the way they have been presented in scientific literature. In particular, ‘values’ related to expressions of women’s moral views or ideas about ‘how life should be lived’ and ‘knowledge’ related to the ways in which women prioritized and interpreted factual information, through their own and others’ experiences and in ‘thinking through’ the personal implications of testing. While some women described non‐directive discussions with health professionals, others perceived testing as routine or felt pressured to accept it. Conclusions  Our findings suggest a need for maternity care providers to be vigilant in promoting active decision making about prenatal testing, particularly around the consideration of personal implications. Further development of measures of informed choice may be necessary to fully evaluate decision support tools and to determine whether prenatal testing programmes are meeting their objectives.

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