title: Prenatal counseling--implications of the cultural background of pregnant women on information processing, emotional response and acceptance.
abstract: OBJECTIVE
  Providing information about prenatal diagnosis (PND) that leads to an informed decision is ethically and psychologically challenging, especially in an intercultural context. The aim was to investigate cultural differences in information processing, test interpretation, evaluation of an established information leaflet, emotional response during screening and acceptance of PND.
  
  
  METHODS
  This prospective study compared 30 pregnant Turkish immigrants with 30 women from Switzerland and countries within the European Union (EU). They completed a questionnaire prior to (T1) and after risk assessment between 11-14 weeks (T2) and after receiving the results (T3). The questionnaire focused on the perception of, experiences with and knowledge about the risk assessment and included the hospital anxiety and depression scale (HADS). χ(2) tests were used for dichotomous variables and Student's t-tests for scores on perception, experience, knowledge, depression and anxiety. Groups were compared over time by 2-factorial ANOVA.
  
  
  RESULTS
  Regarding the 6 questions on knowledge, the rate of correct answers was between 32.2% and 62.5% at T1 and 35.1% and 75.0% at T2. The Turkish women's knowledge level was significantly lower. They rated the information leaflet as less helpful and found the counseling significantly more unsettling. The acceptance of PND was higher in Turkish women.
  
  
  CONCLUSIONS
  Considering the information and knowledge deficits, informed consent was not given in every case, especially in Turkish women. Nevertheless, the acceptance of PND was good. Further studies will have to focus on counseling strategies that take into account the specific needs and expectations of pregnant women with different cultural backgrounds.
authors.affiliation: University Hospital Basel, Basel, Switzerland. stschudin@uhbs.ch
authors.forename: S
authors.initials: S
authors.lastname: Tschudin
authors.forename: D
authors.initials: D
authors.lastname: Huang
authors.forename: H
authors.initials: H
authors.lastname: Mor-Gültekin
authors.forename: J
authors.initials: J
authors.lastname: Alder
authors.forename: J
authors.initials: J
authors.lastname: Bitzer
authors.forename: S
authors.initials: S
authors.lastname: Tercanli
mesh_terms: D000223:Adaptation, Psychological; D000328:Adult; D001007:Anxiety / Q000208:ethnology / Q000523:psychology; D003376:Counseling; D003431:Cross-Cultural Comparison; D003863:Depression / Q000208:ethnology / Q000523:psychology; D054242:Emigrants and Immigrants / Q000523:psychology*; D004644:Emotions; D005060:Europe / Q000208:ethnology; D005260:Female; D005817:Genetic Counseling / Q000523:psychology*; D007722:Health Knowledge, Attitudes, Practice / Q000208:ethnology; D006801:Humans; D007258:Informed Consent / Q000523:psychology; D019303:Multilingualism; D010342:Patient Acceptance of Health Care / Q000208:ethnology* / Q000523:psychology*; D010353:Patient Education as Topic; D011247:Pregnancy / Q000208:ethnology* / Q000523:psychology*; D011262:Pregnancy Trimester, Second; D011295:Prenatal Care / Q000523:psychology*; D011296:Prenatal Diagnosis / Q000523:psychology*; D011446:Prospective Studies; D018570:Risk Assessment; D012959:Socioeconomic Factors; D011795:Surveys and Questionnaires; D013557:Switzerland; D014421:Turkey / Q000208:ethnology; D016216:Ultrasonography, Prenatal / Q000523:psychology*