Facilitating autonomous, confident and satisfying choices : a mixed-method study of women's choice-making in prenatal screening for common aneuploidies
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Chen , A , Tenhunen , H , Torkki , P , Peltokorpi , A , Heinonen , S , Lillrank , P & Stefanovic , V 2018 , ' Facilitating autonomous, confident and satisfying choices : a mixed-method study of women's choice-making in prenatal screening for common aneuploidies ' , BMC Pregnancy and Childbirth , vol. 18 , 119 . https://doi.org/10.1186/s12884-018-1752-y
| Title: | Facilitating autonomous, confident and satisfying choices : a mixed-method study of women's choice-making in prenatal screening for common aneuploidies |
| Author: | Chen, An; Tenhunen, Henni; Torkki, Paulus; Peltokorpi, Antti; Heinonen, Seppo; Lillrank, Paul; Stefanovic, Vedran |
| Contributor organization: | Clinicum Department of Public Health Department of Obstetrics and Gynecology HUS Gynecology and Obstetrics |
| Date: | 2018-05-02 |
| Language: | eng |
| Number of pages: | 13 |
| Belongs to series: | BMC Pregnancy and Childbirth |
| ISSN: | 1471-2393 |
| DOI: | https://doi.org/10.1186/s12884-018-1752-y |
| URI: | http://hdl.handle.net/10138/235265 |
| Abstract: | Background: Population-based prenatal screening has become a common and widely available obstetrical practice in majority of developed countries. Under the patient autonomy principle, women should understand the screening options, be able to take their personal preferences and situations into account, and be encouraged to make autonomous and intentional decisions. The majority of the current research focuses on the prenatal screening uptake rate, women's choice on screening tests, and the influential factors. However, little attention has been paid to women's choice-making processes and experiences in prenatal screening and their influences on choice satisfaction. Understanding women's choice-making processes and experiences in pregnancy and childbirth is the prerequisite for designing women-centered choice aids and delivering women-centered maternity care. This paper presents a pilot study that aims to investigate women's experiences when they make choices for screening tests, quantify the choice making experience, and identify the experiential factors that affect women's satisfaction on choices they made. Method: We conducted a mixed-method research at Helsinki and Uusimaa Hospital District (HUS) in Finland. First, the women's choice-making experiences were explored by semi-structured interviews. We interviewed 28 women who participated in prenatal screening. The interview data was processed by thematic analysis. Then, a cross-sectional self-completion survey was designed and implemented, assessing women's experiences in choice-making and identifying the experiential factors that influence choice satisfaction. Of 940 distributed questionnaires, 185 responses were received. Multivariable linear regression analysis was used to detect the effects of the variables. Results: We developed a set of measurements for women's choice-making experiences in prenatal screening with seven variables: activeness, informedness, confidence, social pressure, difficulty, positive emotion and negative emotion. Regression revealed that activeness in choice-making (beta = 0.176; p = 0.023), confidence in choice-making (beta = 0.388; p <0.001), perceived social pressure (beta = -0.306; p <0.001) and perceived difficulty (beta = -0.274; p <0.001) significantly influenced women's choice satisfaction in prenatal screening. Conclusions: This study explores the experiential dimension of women's choice-making in prenatal screening. Our result will be useful for service providers to design women-centered choice environment. Women's willingness and capabilities of making active choices, their preferences, and social reliance should be well considered in order to facilitate autonomous, confident and satisfying choices. |
| Subject: |
Women's choice
Choice-making experience Choice satisfaction Prenatal screening DOWNS-SYNDROME DECISION-MAKING PLANNED BEHAVIOR INFORMED CHOICE PREFERENCE KNOWLEDGE ATTITUDES PATIENT INFORMATION PHARMACISTS 3123 Gynaecology and paediatrics |
| Peer reviewed: | Yes |
| Rights: | unspecified |
| Usage restriction: | openAccess |
| Self-archived version: | publishedVersion |
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(BioMed Central, 2018)Abstract Background Population-based prenatal screening has become a common and widely available obstetrical practice in majority of developed countries. Under the patient autonomy principle, women should understand the screening options, be able to take their personal preferences and situations into account, and be encouraged to make autonomous and intentional decisions. The majority of the current research focuses on the prenatal screening uptake rate, women’s choice on screening tests, and the influential factors. However, little attention has been paid to women’s choice-making processes and experiences in prenatal screening and their influences on choice satisfaction. Understanding women’s choice-making processes and experiences in pregnancy and childbirth is the prerequisite for designing women-centered choice aids and delivering women-centered maternity care. This paper presents a pilot study that aims to investigate women’s experiences when they make choices for screening tests, quantify the choice-making experience, and identify the experiential factors that affect women’s satisfaction on choices they made. Method We conducted a mixed-method research at Helsinki and Uusimaa Hospital District (HUS) in Finland. First, the women’s choice-making experiences were explored by semi-structured interviews. We interviewed 28 women who participated in prenatal screening. The interview data was processed by thematic analysis. Then, a cross-sectional self-completion survey was designed and implemented, assessing women’s experiences in choice-making and identifying the experiential factors that influence choice satisfaction. Of 940 distributed questionnaires, 185 responses were received. Multivariable linear regression analysis was used to detect the effects of the variables. Results We developed a set of measurements for women’s choice-making experiences in prenatal screening with seven variables: activeness, informedness, confidence, social pressure, difficulty, positive emotion and negative emotion. Regression revealed that activeness in choice-making (β = 0.176; p = 0.023), confidence in choice-making (β = 0.388; p < 0.001), perceived social pressure (β = − 0.306; p < 0.001) and perceived difficulty (β = − 0.274; p < 0.001) significantly influenced women’s choice satisfaction in prenatal screening. Conclusions This study explores the experiential dimension of women’s choice-making in prenatal screening. Our result will be useful for service providers to design women-centered choice environment. Women’s willingness and capabilities of making active choices, their preferences, and social reliance should be well considered in order to facilitate autonomous, confident and satisfying choices.