孕妇产前筛查与诊断决策冲突现状及影响因素分析  

Current situation of conflict between prenatal screening and diagnosis decision of pregnant women and its influencing factors

作　　者：李长娥 王君芝[1] 李辛 褚梁梁[1] 于洁 程雪 季红[1] LI Chang'e;WANG Junzhi;LI Xin;CHU Liangliang;YU Jie;CHENG Xue;JI Hong(The First Hospital Of Shandong First Medical University&Shandong Provincial Qianfoshan Hospital,Ji'nan 250014,Shandong,China;Shanghai Children's Medical Center,School of Medicine,Shanghai Jiao Tong University,Shanghai 200127,China)

机构地区：[1]山东第一医科大学第一附属医院山东省千佛山医院,山东济南250014 [2]上海交通大学医学院附属上海儿童医学中心,上海200127

出　　处：《护士进修杂志》2022年第16期1453-1458,1464,共7页Journal of Nurses Training

基　　金：上海市卫生健康委员会临床研究专项青年项目(编号:20204Y0346)。

摘　　要：目的了解孕妇对产前筛查与诊断认知状况和决策意愿,以及孕妇产前筛查与诊断决策冲突现状,并探讨其影响因素。方法采用便利抽样法,选取2020年2-10月在山东第一医科大学第一附属医院产科拟行或已行产前筛查或诊断的孕妇350例,采用孕妇一般资料问卷、产前筛查与诊断认知与决策问卷及决策冲突量表(DCS)进行调查并分析。结果(1)孕妇对产前筛查与诊断认知普遍不足,绝大多数(95.7%)的孕妇能够接受无创DNA,但由于产前诊断可能存在操作风险,导致62.3%的孕妇不能接受该项目;65.7%的孕妇在产前筛查与诊断决策方式方面表达了强烈的共享决策意愿;孕妇产前筛查与诊断决策冲突总均分为(15.04±14.80)分。(2)单因素分析结果显示:不同居住地、家庭月收入、对产前筛查与诊断有无了解途径、唐氏筛查/无创DNA/产前诊断结果准确程度认知正确数的孕妇产前筛查与诊断决策冲突有明显差异(P≤0.05);多元线性回归分析结果显示:唐氏筛查/无创DNA/产前诊断结果准确程度认知正确数及家庭月收入是影响孕妇产前筛查与诊断决策冲突的重要因素。结论孕妇产前筛查与诊断认知状况偏低,孕妇希望通过共享决策的方式做出相关决定,提示相关部门应加强产前筛查与诊断宣传教育,规范遗传咨询过程,减轻孕妇经济负担,从而提高孕妇产前筛查与诊断依从性,确保母婴安全。Objective To investigate and analyze the cognitive status and decision-making intention of pregnant women regarding prenatal screening and diagnosis,as well as the current situation of conflict between prenatal screening and diagnosis,and to explore its influencing factors.Methods A total of 350 pregnant women who planned to receive or had received prenatal screening or diagnosis in the obstetrics department of the First Affiliated Hospital of Shandong First Medical University from February to October in 2020 were surveyed by using convenience sampling method.The questionnaire contents included general information of pregnant women,questionnaires on cognition and decision-making of prenatal screening and diagnosis,and Decision-Making Conflict Scale(DCS).Results The results of this study showed that pregnant women generally lacked awareness of prenatal screening and diagnosis,an absolute majority(95.7%)of pregnant women could accept non-invasive DNA,but 62.3%of pregnant women could not accept the program due to the possible operational risks of prenatal diagnosis;65.7%of pregnant women expressed a strong willingness to share decision-making in the decision-making mode of prenatal testing and diagnosis;The total average score of prenatal screening and diagnosis decision conflict in pregnant women was(15.04±14.80)points.The results of univariate analysis showed that there were significant differences in decision conflicts between prenatal screening and diagnosis among pregnant women with different residence,monthly family income,understanding of way to prenatal screening and diagnosis,accurate degree of Down's syndrome screening/non-invasive DNA/prenatal diagnosis results and the correct number of cognition(P≤0.05).The results of multiple linear regression analysis showed that the accuracy of Down's syndrome screening/non-invasive DNA/prenatal diagnosis results and the correct number of cognition and family monthly income were the important factors affecting the decision-making conflict between prenatal screening

关 键 词：孕妇 产前筛查 唐氏筛查 无创DNA 产前诊断 决策冲突 护理 

分 类 号：R473.71[医药卫生—护理学] R169.1[医药卫生—临床医学]