Les fondements du pronostic en médecine prénatale : exemple de la trisomie 21

Shojai, R.; Boubli, L.; D’ercole, C.

doi:10.1016/j.gyobfe.2005.05.015

Cited by 9 publications

(3 citation statements)

References 27 publications

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“…If these results, too, are positive, she will have to choose between terminating the pregnancy and preparing for a child who will have special needs throughout his or her life [ 9 ]. Finally, health professionals’ communication of results is often insufficient, misleading, or negative and they may misjudge women’s values and preferences [ 5 , 10 - 12 ]. Without sufficient decision support, women in this position may experience decisional conflict, defined as the uncertainty caused by a decision that involves risk, loss, or a challenge to their personal values [ 13 ].…”

Section: Introductionmentioning

confidence: 99%

Psychosocial Factors of Health Professionals’ Intention to Use a Decision Aid for Down Syndrome Screening: Cross-Sectional Quantitative Study

et al. 2018

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BackgroundDecisions about prenatal screening for Down syndrome are difficult for women, as they entail risk, potential loss, and regret. Shared decision making increases women’s knowledge of their choices and better aligns decisions with their values. Patient decision aids foster shared decision making but are rarely used in this context.ObjectiveOne of the most promising strategies for implementing shared decision making is distribution of decision aids by health professionals. We aimed to identify factors influencing their intention to use a DA during prenatal visit for decisions about Down syndrome screening.MethodsWe conducted a cross-sectional quantitative study. Using a Web panel, we conducted a theory-based survey of health professionals in Quebec province (Canada). Eligibility criteria were as follows: (1) family physicians, midwives, obstetrician-gynecologists, or trainees in these professions; (2) involved in prenatal care; and (3) working in Quebec province. Participants watched a video depicting a health professional using a decision aid during a prenatal consultation with a woman and her partner, and then answered a questionnaire based on an extended version of the theory of planned behavior, including some of the constructs of the theoretical domains framework. The questionnaire assessed 8 psychosocial constructs (attitude, anticipated regret, subjective norm, self-identity, moral norm, descriptive norm, self-efficacy, and perceived control), 7 related sets of behavioral beliefs (advantages, disadvantages, emotions, sources of encouragement or discouragement, incentives, facilitators, and barriers), and sociodemographic data. We performed descriptive, bivariate, and multiple linear regression analyses to identify factors influencing health professionals’ intention to use a decision aid.ResultsAmong 330 health professionals who completed the survey, 310 met the inclusion criteria: family physicians, 55.2% (171/310); obstetrician-gynecologists, 33.8% (105/310); and midwives, 11.0% (34/310). Of these, 80.9% were female (251/310). Mean age was 39.6 (SD 11.5) years. Less than half were aware of any decision aids at all. In decreasing order of importance, factors influencing their intention to use a decision aid for Down syndrome prenatal screening were as follows: self-identity (beta=.325, P<.001), attitude (beta=.297, P<.001), moral norm (beta=.288, P<.001), descriptive norm (beta=.166, P<.001), and anticipated regret (beta=.099, P=.003). Underlying behavioral beliefs significantly related to intention were that the use of a decision aid would promote decision making (beta=.117, 95% CI 0.043-0.190), would reassure health professionals (beta=.100, 95% CI 0.024-0.175), and might require more time than planned for the consultation (beta=−.077, 95% CI −0.124 to −0.031).ConclusionsWe identified psychosocial factors that could influence health professionals’ intention to use a decision aid about Down syndrome screening. Strategies should remind them of the following: (1) using a decision aid for this purpose ...

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Section: Introductionmentioning

confidence: 99%

Psychosocial Factors of Health Professionals’ Intention to Use a Decision Aid for Down Syndrome Screening: Cross-Sectional Quantitative Study

et al. 2018

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“…La trisomie 21 concerne en France une population de 500 000 à 600 000 personnes et touche environ un foetus sur 700 [40]. Elle se manifeste par différentes altérations sur les plans morphologique et organique.…”

Section: L'individu Trisomique Et Ses Possibilitésunclassified

“…Le sujet trisomique va présenter un syndrome dysmorphique associé, à des degrés variables, à des troubles psychomoteurs, neuromoteurs, immunologiques, endocriniens, sensoriels, cardiaques, digestifs, hématologiques, mais également des apnées du sommeil, des problèmes psychologiques et des sur-handicaps [42]. L'intégration à l'école maternelle et primaire leur permet de lire et d'écrire [40].…”

Section: L'individu Trisomique Et Ses Possibilitésunclassified

Interrompre ou poursuivre la grossesse lors d’un diagnostic de Trisomie 21 : réflexions éthiques

Stricher¹

2014

La Revue Sage-Femme

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Parental decisions to abort or continue a pregnancy following prenatal diagnosis of chromosomal abnormalities in a setting where termination of pregnancy is not legally available

Quadrelli

Mechoso

et al. 2006

Prenatal Diagnosis

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Les fondements du pronostic en médecine prénatale : exemple de la trisomie 21

Cited by 9 publications

References 27 publications

Psychosocial Factors of Health Professionals’ Intention to Use a Decision Aid for Down Syndrome Screening: Cross-Sectional Quantitative Study

Psychosocial Factors of Health Professionals’ Intention to Use a Decision Aid for Down Syndrome Screening: Cross-Sectional Quantitative Study

Interrompre ou poursuivre la grossesse lors d’un diagnostic de Trisomie 21 : réflexions éthiques

Parental decisions to abort or continue a pregnancy following prenatal diagnosis of chromosomal abnormalities in a setting where termination of pregnancy is not legally available

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