Informed decision making in the context of prenatal screening.
OBJECTIVE
This study aimed to construct a measure of informed decision making that includes knowledge, deliberation, and value-consistency, and to assess the level of informed decision making about prenatal screening, and differences between test acceptors and test decliners.


METHODS
Women attending one of 44 midwifery and gynaecology practices were asked to fill out postal questionnaires before and after the prenatal screening offer. The principal outcome was the level of informed decision making. For this purpose, knowledge about prenatal screening, deliberation about the pros and cons of the alternatives, test uptake, and attitude towards having a prenatal screening test were measured.


RESULTS
Eighty-four percent of the participants were sufficiently knowledgeable about prenatal screening, 75% of the decisions were deliberate, and 82% were value-consistent. Fifty-one percent of the participants made an informed decision. Test acceptors made less informed decisions as compared to test decliners. This difference was mainly caused by the lower rate of deliberation in this group.


CONCLUSIONS
It appears from this study that prenatal screening decisions are often not informed decisions. This is inconsistent with the main objective of offering screening, which is to enable people to make informed decisions.


CONCLUSIONS
Decision makers should be encouraged during the counselling to deliberate about the various alternatives.
van den Berg
Matthijs
M
Institute 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
Timmermans
Danielle R M
DR
ten Kate
Leo P
LP
van Vugt
John M G
JM
van der Wal
Gerrit
G
D000465:Algorithms; D032882:Comprehension; D003657:Decision Making; D003663:Decision Trees; D005260:Female; D006176:Gynecology; D007722:Health Knowledge, Attitudes, Practice; D006301:Health Services Needs and Demand; D006801:Humans; D007258:Informed Consent / Q000523:psychology*; D008403:Mass Screening / Q000523:psychology*; D008960:Models, Psychological; D009426:Netherlands; D009721:Nurse Midwives; D010342:Patient Acceptance of Health Care / Q000523:psychology*; D010353:Patient Education as Topic / Q000458:organization & administration; D011247:Pregnancy; D037841:Pregnant People / Q000523:psychology*; D011295:Prenatal Care; D011296:Prenatal Diagnosis / Q000523:psychology*; D016032:Randomized Controlled Trials as Topic; D012945:Social Values; D011795:Surveys and Questionnaires