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Reducing decisional conflict in decisions about prenatal genetic testing: the impact of a dyadic intervention at the start of prenatal care.
Collart, Christina; Craighead, Caitlin; Yao, Meng; Rose, Susannah; Chien, Edward K; Frankel, Richard M; Coleridge, Marissa; Hu, Bo; Edmonds, Brownsyne Tucker; Ranzini, Angela C; Farrell, Ruth M.
Afiliación
  • Collart C; Obstetrics and Gynecology Institute, Cleveland Clinic, Cleveland, OH, USA.
  • Craighead C; Obstetrics and Gynecology Institute, Cleveland Clinic, Cleveland, OH, USA.
  • Yao M; Quantitative Health Sciences, Cleveland Clinic, Cleveland, OH, USA.
  • Rose S; Department of Biomedical Informatics and Center for Biomedical Ethics and Society, Vanderbilt University Medical Center, Nashville, TN, USA.
  • Chien EK; Obstetrics and Gynecology Institute, Cleveland Clinic, Cleveland, OH, USA.
  • Frankel RM; Lerner College of Medicine, Cleveland Clinic, Cleveland, OH, USA.
  • Coleridge M; Obstetrics and Gynecology Institute, Cleveland Clinic, Cleveland, OH, USA.
  • Hu B; Genomic Medicine Institute, Cleveland Clinic, Cleveland, OH, USA.
  • Edmonds BT; Quantitative Health Sciences, Cleveland Clinic, Cleveland, OH, USA.
  • Ranzini AC; Indiana University School of Medicine, 1772 Indiana University , Indianapolis, IN, USA.
  • Farrell RM; Division of Maternal Fetal Medicine, Department of Obstetrics and Gynecology, The MetroHealth System, Cleveland, OH, USA.
J Perinat Med ; 52(5): 467-477, 2024 Jun 25.
Article en En | MEDLINE | ID: mdl-38669584
ABSTRACT

OBJECTIVES:

Decisional conflict and regret about prenatal genetic screening and diagnostic tests may have important consequences in the current pregnancy and for future reproductive decisions. Identifying mechanisms that reduce conflict associated with the decision to use or decline these options is necessary for optimal patient counseling.

METHODS:

We conducted a cluster-randomized controlled trial of a shared decision-making tool (NEST) at the beginning of prenatal care. Enrolled patients completed follow-up surveys at the time of testing (QTT) and in the second-third trimester (QFF), including the Decision Conflict Scale (DCS). Total DCS scores were analyzed using a multivariate linear mixed-effect model.

RESULTS:

Of the total number of participants (n=502) enrolled, 449 completed the QTT and QFF surveys. The mean age of participants was 31.6±3.8, with most parous at the time of study participation (n=321; 71.7 %). Both the NEST (the intervention) and control groups had lower median total DCS scores at QFF (NEST 13.3 [1.7, 25.0] vs. control 16.7 [1.7, 25.0]; p=0.24) compared to QTT (NEST 20.8 [5.0, 25.0] vs. control 18.3 [3.3, 26.7]; p=0.89). Participants exposed to NEST had lower decisional conflict at QFF compared to control (ß -3.889; [CI -7.341, -0.437]; p=0.027).

CONCLUSIONS:

Using a shared decision-making tool at the start of prenatal care decreased decisional conflict regarding prenatal genetic testing. Such interventions have the potential to provide an important form of decision-making support for patients facing the unique type of complex and preference-based choices about the use of prenatal genetic tests.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Atención Prenatal / Diagnóstico Prenatal / Pruebas Genéticas / Conflicto Psicológico Límite: Adult / Female / Humans / Pregnancy Idioma: En Revista: J Perinat Med Año: 2024 Tipo del documento: Article País de afiliación: Estados Unidos Pais de publicación: Alemania
Texto completo
Añadir a Mi BVS
Imprimir
XML
PubMed Links
Buscar en Google

Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Atención Prenatal / Diagnóstico Prenatal / Pruebas Genéticas / Conflicto Psicológico Límite: Adult / Female / Humans / Pregnancy Idioma: En Revista: J Perinat Med Año: 2024 Tipo del documento: Article País de afiliación: Estados Unidos Pais de publicación: Alemania