Exploring informed choice in the context of prenatal testing: findings from a qualitative study.
OBJECTIVE
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.
Potter
Beth K
BK
Department of Epidemiology & Community Medicine, University of Ottawa, Ottawa, ON, Canada. bpotter@uottawa.ca
O'Reilly
Natasha
N
Etchegary
Holly
H
Howley
Heather
H
Graham
Ian D
ID
Walker
Mark
M
Coyle
Doug
D
Chorny
Yelena
Y
Cappelli
Mario
M
Boland
Isabelle
I
Wilson
Brenda J
BJ
D000025:Abortion, Eugenic; D000328:Adult; D002755:Choice Behavior; D003955:Diagnostic Tests, Routine; D005260:Female; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D007258:Informed Consent / Q000523:psychology / Q000706:statistics & numerical data*; D008875:Middle Aged; D009014:Morals; D009864:Ontario; D010342:Patient Acceptance of Health Care / Q000523:psychology* / Q000706:statistics & numerical data; D011247:Pregnancy; D011264:Pregnancy Trimesters; D037841:Pregnant People / Q000523:psychology*; D011295:Prenatal Care; D011296:Prenatal Diagnosis / Q000379:methods / Q000706:statistics & numerical data*; D011369:Professional-Patient Relations; D036301:Qualitative Research; D012307:Risk Factors; D055815:Young Adult
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