title: Prenatal counseling for congenital anomaly tests: parental preferences and perceptions of midwife performance.
abstract: OBJECTIVE
  Evidence-based instruments to evaluate the preferences and experiences of future parents regarding prenatal counseling for congenital anomaly tests are currently lacking. We developed the quality of care through clients' eyes prenatal questionnaire (QUOTE(prenatal) ), a client-centered instrument, and assessed its components. Furthermore, the QUOTE(prenatal) was used to provide insight into (1) clients' previsit preferences and (2) clients' postvisit experience, that is, perceived care provider performance regarding the counseling they received.
  
  
  METHODS
  In the questionnaire survey, a principal component analysis was used to gain insight into the underlying components of the questionnaire. Regression analysis was performed to examine differences between groups.
  
  
  RESULTS
  In 17 Dutch midwifery practices, 941 pregnant women and their partners (response rate 79%) completed the 59-item QUOTE(prenatal) previsit and postvisit, measuring preferences and perceived performances, respectively. A principal component analysis revealed three counseling components: client-midwife relation, health education and decision-making support. Reponses showed that, previsit, most clients consider the client-midwife relationship and health education to be (very) important. One third of the clients consider decision-making support to be (very) important. Nulliparae had higher preferences for health education and decision-making support than multiparae.
  
  
  CONCLUSIONS
  Clients perceive that their midwives perform well in building the client-midwife relationship and in giving health education. Improvement is needed in decision-making support.
authors: Department of Midwifery Science, AVAG and the EMGO+ Institute for Health and Care Research, VU University Medical Centre, Amsterdam, The Netherlands. linda.martin@inholland.nl
authors: L
authors: L
authors: Martin
authors: S
authors: S
authors: Van Dulmen
authors: E
authors: E
authors: Spelten
authors: A
authors: A
authors: De Jonge
authors: P
authors: P
authors: De Cock
authors: E
authors: E
authors: Hutton
mesh_terms: D000328:Adult; D000013:Congenital Abnormalities / Q000175:diagnosis; D003657:Decision Making; D005260:Female; D005817:Genetic Counseling / Q000523:psychology*; D006266:Health Education; D006801:Humans; D008297:Male; D008880:Midwifery / Q000706:statistics & numerical data*; D057240:Patient Preference / Q000523:psychology / Q000706:statistics & numerical data*; D011247:Pregnancy; D011787:Quality of Health Care; D055815:Young Adult