Healthcare Professionals Attitude And Knowledgeon Double Test And Pregnancy Termination For Down Syndrome

Öz

Aim: This study aimed to evaluate the knowledge levels of physicians, who are not Gynecology & Obstetrics specialist or residents, on the 1st trimester screening test for prenatal screening and their opinions about the double test and continuation-termination of a pregnancy, a patient or their wife, with a definite Down syndrome diagnosis.Material And Methods: A "measure of informed choice" survey was applied to physicians who are not Gynecology & Obstetrics specialist or residents. This survey was developed by Marteau et al.; to evaluate the level of knowledge of the participants on the first trimester screening test and their opinions on the test. Their decision on termination, any pregnancy or their wives’ pregnancy, of the pregnancy in the presence of a Down syndrome diagnosis was assessed. Level of knowledge, opinions on the test and the decision on termination of the pregnancy were assessed.Results: 100 physicians attended the survey and all of them completed the questionnaire. Of the 100 physicians in the study; 45% were female, 55% were male and average age was 35±4.5 27-50 years . While 81% of the participants had sufficient knowledge on the test, 19% had insufficient knowledge. 60% of the physicians had negative and 40% of the physicians had positive attitude on conducting double test. 37% of the physicians indicated that they would want to continue the pregnancy even if the Down syndrome diagnosis was definite, 18% indicated that they would finalize the pregnancy, 45% said that they weren’t sure of what their decision would be.Conclusion: We found in this study that; 81% of the participants had sufficient knowledge on the double test, 60% of the physicians had negative attitude on conducting double test and 37% of the physicians indicated that they would want to continue the pregnancy even if the Down syndrome diagnosis was definite.

Anahtar Kelimeler

• Healthcare providers’ opinions,double test,Down syndrome,termination

Hekimlerin İkili Test Hakkında Bilgi Düzeyi, Düşünceleri ve Down Sendromunda Terminasyon

Öz

Amaç: Prenatal tarama amacıyla yapılan birinci trimester tarama testi hakkında Kadın Doğum Uzmanı veya asistanı olmayan hekimlerin bilgi düzeylerinin ve ikili test hakkındaki düşüncelerinin değerlendirmesi, Prenatal Down Sendromu tanısı kesinleşen çiftlerin gebeliklerinde terminasyon ve gebeliğin devamı kararlarının araştırılması hedeflendi.Gereç ve Yöntemler: Kadın doğum uzmanı veya asistanı olmayan hekimlere "bilinçli seçim" anketi uygulandı. Bu anket Marteau ve arkadaşlarının geliştirdiği, katılanların ilk trimester tarama testi hakkında bilgi düzeyini ve test hakkındaki düşüncelerini değerlendiren bir ankettir. Down Sendromu tanısının kesinleşmesi durumunda çiftlerin gebeliklerinin sonlandırılması yada devamı kararı soruldu. Bilgi düzeyi, test hakkındaki düşünceler ve gebeliğin sonlandırılması kararı incelendi. SPSS tanımlayıcı istatistik yöntemi kullanıldı.Bulgular:100 hekim ankete katıldı, grubun tamamı anketi tamamladı. Çalışmaya alınan 100 hekimin %45’i kadın, % 55’i erkekti, yaş ortalamaları 35±4,5 27-50 yaş idi. İkili test hakkında % 81’inin bilgi düzeyi yeterli, %19’unun bilgi düzeyi yetersizdi. Hekimlerin %60’ının ikili test yaptırma konusunda tutumları olumsuz, %40’ının olumluydu. Hekimlerimizin % 37’si Down Sendromu tanısı kesinleştiğinde gebeliğine devam etmek isteyeceklerini, %18’i gebeliğini sonlandırmak isteyeceklerini, %45’i ise ne karar vereceğine emin olmadığını ifade etti.Sonuç: Çalışmamıza katılan hekimlerin % 81’inin ikili test konusunda bilgi düzeyinin yeterli olduğunu, %60’ının testi yaptırma konusunda tutumlarının olumsuz olduğunu, %37’sinin Down Sendromu tanısı kesinleştiğinde gebeliklerine devam edeceklerini saptadık.

Anahtar Kelimeler

• Sağlık çalışanları düşünceleri,ikili test,Down sendromu,terminasyon

Kaynakça

1. Ahmed S, Bryant LD, Cole P. Midwives' perceptions of their role as facilitators of informedchoice in antenatal screening.Midwifery. 2013;29:745-50.
2. NICE, 2010.National Institute for Health and Clinical Excellence. NICE Clinical Guideline 62. Antenatal Care: Routine Care for the Healthy Pregnant Woman.
3. Strauss A, Heer IM, Spelsberg F, Strauss C.Down Syndrome: What do pregnant women know about the individual risk? A prospectivetrial. Arch Gynecol Obstet 2013;287:1119-23.
4. Gourounti K, Sandall J. Do pregnant women in Greece make informed choices about antenatal screening for Down’ssyndrome? A question naire survey. Mid- wifery 2008;24:153-62.
5. Janvier A, Couture E, Deschenes M, Nadeau S, Barrington K, Lantos J. Health care professionals' attitudes about pregnancy termination for different fetal anomalies. Pediatr Child Health 2012;17:86-8.
6. Marteau TM, Dormandy E, Michie S. A measure of informed choice.HealthEx- pect2001;4:99-108.
7. Walker LV, Miller VJ, Dalton VK. The health-care experiences of families given the prenatal diagnosis of trisomy 18. J Perinatol. 2008;28:9-12 .
8. WertzDC. Drawing lines: notes for policy makers. Prenatal testinganddisabili- tyrights. Washington,DC: Georgetown University Press; 2000. p. 261-87.

9. Helm DT, Miranda S, Chedd NA. Prenatal diagnosis of Down’ssyndrome: moth- ers’ reflections on supports need ed from diagnosis to birth. Ment. Retard. 1998;36:55-61.
10. Hurford E, Hawkins A, Hudgins L, Taylor J. The decision to continue a affected by Down’sSyndrome: timing of decision and satis faction with receiving a pre- natal diagnosis. Gen et. Couns. 2013;22:587-93.
11. Skotko BG. Prenatally diagnosed Down’s syndrome: mothers who contin- ued their pregnancies evaluate their health care providers. Am J Obstet Gy- necol2005;192:670-7.