What women want: women's preferences of caregiver behavior when prenatal sonography findings are abnormal

Alkazaleh, Fawaz; Thomas, M.; Grebenyuk, J.; Glaude, L.; Savage, Diane; Johannesen, J; Caetano, Marcos Roberto; Windrim, Rory

doi:10.1002/uog.906

Cited by 50 publications

(47 citation statements)

References 15 publications

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“…The women identified lack of attention to their physical comfort and lack of interaction with the examiner as contributing to feeling objectified to the point of anger and frustration. Similar to the study of Alkazaleh et al 20 the women in our study valued the presence of a personal support person during prenatal US examination.…”

Section: Discussionsupporting

confidence: 86%

“…19 Other researchers have focused on specific aspects of breaking bad news in perinatal situations and the sequelae of such an action. Alkazaleh et al 20 surveyed 117 women with pregnancy complications detected sonographically. Sixty-seven women responded to their survey of broad characteristics of bad news transmission, reporting what women found helpful after being given bad news.…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Seeing baby: women's experience of prenatal ultrasound examination and unexpected fetal diagnosis

Zalm

Byrne

2006

J Perinatol

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Objective: Although prenatal ultrasound (US) is a common clinical undertaking today, little information is available about women's experience of the procedure from the perspective of women themselves. The objective of this study was to explore women's experience of undergoing a routine prenatal US examination associated with an unexpected fetal diagnosis.Study Design: Qualitative methods were used to explore the prenatal US experience of 13 women. Five women were given unexpected news of multiple pregnancy and eight women were given unexpected news of congenital fetal abnormality. One in-depth audio-taped interview was conducted with each woman. Content analysis of interview data identified themes common to women's experience of US.Results: Identified themes of women's experience of routine prenatal US examination associated with an unexpected fetal diagnosis are: experiencing the setting, sensing information, feeling connected/ disconnected, the power of the image, and communication rules. Conclusions:Women's experience of prenatal US examination is influenced by physical and environmental factors and by the behaviors of the US examiner. Behaviors of the examiner contribute to a woman's labeling of the US experience as positive or negative. Women identify being objectified by the examination and experience poor communication patterns after a fetal US diagnosis. Women's description of the US screen image as a baby suggests it is a powerful influence on subsequent clinical and ethical decision-making about the pregnancy. Journal of Perinatology (2006Perinatology ( ) 26, 403-408. doi:10.1038 Keywords: prenatal care; sonography; maternal experience; antenatal diagnosis; fetal anomaly Introduction Although routine ultrasound examination (US) in low-risk pregnancy has not been proven to be advantageous in terms of perinatal mortality and morbidity, its use has become standard during pregnancy.1,2 Diagnoses resulting from prenatal US include multiple gestation, congenital fetal abnormalities, fetal growth problems and amniotic fluid or placental abnormalities. Study of US as a perinatal diagnostic tool has focused on whether US improves perinatal outcomes, 3-6 the psychological effect on women and men of such an examination, 7-9 perception and receipt of information, 10-14 and the experiences of staff who perform US examinations.15,16 A 1998 Cochrane review of routine US 17 focused only on physical outcomes, as did a later work. 18Reviewers of the work suggested a lack of research on women's experience of this type of procedure. 19Other researchers have focused on specific aspects of breaking bad news in perinatal situations and the sequelae of such an action. Alkazaleh et al.20 surveyed 117 women with pregnancy complications detected sonographically. Sixty-seven women responded to their survey of broad characteristics of bad news transmission, reporting what women found helpful after being given bad news. These researchers recommend further research into the area of bad news transmission using other research designs....

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Section: Discussionsupporting

confidence: 86%

Section: Introductionmentioning

confidence: 99%

Seeing baby: women's experience of prenatal ultrasound examination and unexpected fetal diagnosis

Zalm

Byrne

2006

J Perinatol

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“…Leithner et al 24 also found a high degree of dissatisfaction with 'the information provided by physicians' among prenatal diagnosis patients. Our study and others 23 have suggested that families desire both written and oral information, which could be easily adopted in perinatal settings. We were particularly struck by the frequent reports of being overly reassured by providers after initial abnormal serum screening results and of not having prompt access to the ultrasound results even when they suspected something was wrong.…”

Section: Discussionmentioning

confidence: 58%

“…[23][24][25][26] Leithner et al 24 reported that 42% of women given an abnormal prenatal diagnosis were dissatisfied with their physician's attitude. Further, our study found that a perceived lack of health-care provider's empathy was associated with overall dissatisfaction with care and was specifically cited as a contributing factor.…”

Section: Discussionmentioning

confidence: 99%

The health-care experiences of families given the prenatal diagnosis of trisomy 18

Walker

Miller²,

Dalton

2007

J Perinatol

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Objective: The objective of this study was to examine parent-reported experiences in the health care system after receiving the prenatal diagnosis of trisomy 18 and to identify factors that contribute to satisfaction with care.Study Design: Nineteen families who received the diagnosis between 2002 and 2005 were given semistructured telephone interviews. Of the 19 families, 11 continued the pregnancy while the remaining 8 chose induced abortion. Classical content analysis was utilized to identify themes among subject responses. Result:We identified several specific aspects of care as key in either being highly satisfied or dissatisfied: expressions of empathy from provider, continuity of care, communication, valuing the fetus and participation in medical decision-making.Conclusions: Aspects of care that were identified as reasons for dissatisfaction are potentially modifiable by training, education or teambased approaches. Further studies are necessary to determine how we can improve the quality of services during prenatal diagnosis.

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“…The sonographic representation of the unborn child may well lead to a preformed idea of the perceived autonomy of the unborn child. A particular study [20] shows that women are in favour of the term baby instead of foetus.…”

Section: Discussionmentioning

confidence: 99%

Pregnant Women’s Cognitive Concept concerning Their Unborn prior to Prenatal Diagnosis

Kowalcek

Gembruch

2008

Fetal Diagn Ther

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Objective: We examined pregnant women’s expectations concerning their unborn babies prior to prenatal diagnosis and also the possible correlations with emotional characteristics such as anxiety and depression. Methods: The consecutive sampling consisted of 324 pregnant women presenting themselves between the 11th and 29th weeks of pregnancy for detection of foetal anomalies. The pregnant women noted their thoughts and expectations concerning their unborn using a choice of 18 adjectives in a 5-point Likert scale in a standardized questionnaire. Anxiety was recorded with the State-Trait Anxiety Inventory and depression with a depression scale. Results: By means of factor analysis (analysis of the main components by varimax rotation), it was possible to determine 4 factors (inherent value criterion >1) from the 18 items (adjectives). Those 4 factors indicate a total of 58.3% of the variance. The first factor scale, well-being, is characterized by 4 items, ‘happy’, ‘glad’, ‘carefree’ and ‘light-hearted’. The second factor scale, nervous, is identified mainly by the items ‘fidgety’, ‘excitable’, ‘restless’ and ‘excited’. The third factor scale, passive, is marked by the items ‘anxious’, ‘disheartened’ and ‘sleepy’. The fourth factor scale, vulnerable, is indicated by 3 items, ‘in need of protection’, ‘vulnerable’ and ‘clinging’. Scales 1, 2 and 3 gave evidence of significant correlations with trait intensity in the state and trait anxiety scale and in the scale for the assessment of depressive mood prior to prenatal diagnosis and state anxiety after prenatal diagnosis. Conclusion: The individual characteristics and attributes of the unborn child are differentiated prior to prenatal diagnosis. There is most certainly a link between the well-being of the pregnant woman and the effect it has on the emotional characteristics of her unborn child.

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What women want: women's preferences of caregiver behavior when prenatal sonography findings are abnormal

Abstract: Objective To determine what women value when receiving news of a pregnancy abnormality detected by ultrasound. Methods

Cited by 50 publications

References 15 publications

Seeing baby: women's experience of prenatal ultrasound examination and unexpected fetal diagnosis

Seeing baby: women's experience of prenatal ultrasound examination and unexpected fetal diagnosis

The health-care experiences of families given the prenatal diagnosis of trisomy 18

Pregnant Women’s Cognitive Concept concerning Their Unborn prior to Prenatal Diagnosis

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