Obtaining consent for prenatal testing from Southeast Asian women
Author(s):
Zuk, Jeannie
Format:
Thesis
Degree granted:
Ph.D.
Publisher:
Ann Arbor : University of Colorado Health Sciences Center, 2002.
Pages:
231
Language:
English
Abstract:
The purpose of this focused ethnographic study was to examine the relationship between the information nurses provide to pregnant women about prenatal testing and how that information is used by Southeast Asian women to inform their decision about maternal serum alpha fetoprotein (MSAFP) testing. The study was guided by the following research questions: (1) What do nurses consider important to teach women about MSAFP? (2) What are nurses able to teach Southeast Asian women about MSAFP? and (3) What do Southeast Asian women want to know about MSAFP? A sample of 16 nurses was recruited to participate in structured interviews using a pile sort technique. A second sample of six Hmong and two Vietnamese women participated in semi-structured interviews. The pile sort information was analyzed using multidimensional scaling (MDS) and a ranking of pile sort items and compared with the results from the interviews. Interview data from the sample of Southeast Asian women were analyzed for categories, domains and themes. The results from the nurses were triangulated on results from the Southeast Asian women yielding three themes: (1) The Value of Information, (2) Attitudes about Patient Autonomy, and (3) Information Guides Decision Making. First, nurses in this study obtained consent for MSAFP testing based on their attitudes about the value of information. The amount of information was controlled by nurses and was dependent on their evaluation of the relevance of that information to a particular patient. Second, nurses' attitudes about patient autonomy guided the consent process. Third, the Hmong and Vietnamese women in this study made their decisions about prenatal testing after considering all the pertinent available information. Information belongs to and is controlled by the women. For prenatal tests such as MSAFP, obtaining consent persists as a priority because of the implications of test results. Consent is based on information. The nurses provided patients with information they considered important for women to know, while the Southeast Asian women wanted as much information about testing, and its implications, as possible. Information was filtered through the woman's cultural lens and applied to the woman's own life.