Prenatal Counseling – Implications of the Cultural Background of Pregnant Women on Information Processing, Emotional Response and Acceptance

Zusammenfassung

Ziel: Die Beratung vor pränatalen Untersuchungen (PND) im Hinblick auf eine informierte Entscheidung ist ethisch und psychologisch anspruchsvoll, besonders im interkulturellen Kontext. Ziel der Studie war es, kulturelle Unterschiede in der Informationsverarbeitung, der Ergebnisinterpretation, der Beurteilung des Informationsblattes, der emotionalen Reaktion während des Screenings und in der Akzeptanz der PND zu untersuchen. Material und Methoden: 30 schwangere Migrantinnen aus der Türkei wurden prospektiv mit 30 Schwangeren aus der Schweiz und Ländern der EU verglichen. Sie beantworteten vor (T1) und nach (T2) dem Ersttrimestertest (ETT), sowie nach Erhalt des Testresultates (T3) einen Fragebogen zu Informations- und Wissenstand bezüglich ETT und Erfahrungen mit der Beratung, ebenso je die Hospital Anxiety and Depression Scale (HADS). Neben χ² Tests für dichotome Variablen und Student’s t-Tests für Scores zu Information, Wissen, Erfahrung, Angst und Depression wurde mittels 2-factorieller ANOVA auf Unterschiede bei den Gruppen im Zeitverlauf geprüft. Ergebnisse: Bei den 6 Fragen zum Wissensstand lag die Rate korrekter Antworten zwischen 32,2 und 62,5 % bei T 1 und 35,1 und 75,0 % bei T 2. Die Kenntnisse der Türkinnen waren signifikant geringer. Sie stuften das Informationsblatt als weniger hilfreich ein und fühlten sich eher verunsichert durch die Beratung. Die Akzeptanz der PND bei den Türkinnen war höher. Schlussfolgerung: In Anbetracht des Informations- und Wissensdefizits sind die Voraussetzungen für eine informierte Entscheidung vor allem bei den Türkinnen kaum gegeben. Die Akzeptanz der PND erwies sich gleichwohl als gut. Zukünftige Studien sollten den Fokus auf die spezifischen Bedürfnisse und Erwartungen von Schwangeren mit unterschiedlichem kulturellen Hintergrund richten.

Abstract

Purpose: 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. Materials and 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). χ² 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 T 1 and 35.1 % and 75.0 % at T 2. 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. Conclusion: 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.

prenatal counseling - prenatal tests - informed consent - migration - cultural factors

References

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