Do pregnant women in Greece make informed choices about antenatal screening for Down's syndrome? A questionnaire survey.
OBJECTIVE
to investigate the knowledge and attitudes towards Down's syndrome screening among pregnant women presenting for prenatal screening in Greece, in order to explore whether Greek women are able to make informed choices.


METHODS
survey using self-administered questionnaires.


METHODS
public hospital in Athens, Greece.


METHODS
135 pregnant women with a gestational age of between 11 and 20 weeks, just before antenatal screening for Down's syndrome.


RESULTS
a total of 96% of women had a positive attitude towards screening and 45% had a good level of knowledge concerning the screening process for Down's syndrome. A standard measure of informed choice was used, which was validated for use in Greek. We found that 44% of women made an informed choice and 56% of women made an uninformed choice. This was because of the low percentage of women with a good level of knowledge. It was also found that knowledge and attitudes were not associated and seemed to be independent of each other. A higher level of informed choice was associated with a higher level of educational achievement and income, time of decision-making and the satisfaction with the decision.


CONCLUSIONS
health professionals should ensure that all women receive appropriate and intelligible information about antenatal screening for Down's syndrome. This information should be suited to women's learning ability in order to increase their knowledge before undergoing screening. Health professionals should educate and increase women's knowledge, and also give women a chance to explore their attitudes and discuss the issues involved.


CONCLUSIONS
on the basis of the current measure of informed choice, we found that knowledge is a weak determinant of uptake of screening. However, the measure focuses on knowledge regarding the screening process, rather than on the condition itself. In addition, informed choice is a far broader concept than the issues covered by the measurement tool. Therefore, it could be concluded that attempts to increase attitude-behaviour consistency (i.e. to increase uptake for women with positive attitudes towards screening and to decrease uptake for women with negative attitudes) could be more successful in increasing informed choice in screening for Down's syndrome in Greece.
Gourounti
Kleanthi
K
Department of Midwifery, Technological Educational Institution, Athens, Greece. clairegourounti@yahoo.gr
Sandall
Jane
J
D000328:Adult; D000739:Anecdotes as Topic; D004314:Down Syndrome / Q000451:nursing / Q000517:prevention & control*; D005260:Female; D006115:Greece; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D008880:Midwifery / Q000458:organization & administration; D009035:Mothers / Q000193:education* / Q000523:psychology; D009723:Nurse-Patient Relations; D015404:Nursing Methodology Research; D010353:Patient Education as Topic / Q000379:methods*; D011247:Pregnancy; D011295:Prenatal Care / Q000379:methods*; D011296:Prenatal Diagnosis / Q000451:nursing* / Q000523:psychology; D011795:Surveys and Questionnaires