Table 3 Overview of categories of pre-counselling and post-counselling groups, within accept or decline groups
Andersen categories | Main categories | ACCEPT | DECLINE | ||
|---|---|---|---|---|---|
Pre-counselling | Post-counselling | Pre-counselling | Post-counselling | ||
Predisposing | Attitude | “for me, Down syndrome is the least severe of all possible disabilities, as far as you should call it a disability, a child could have (F702 pre-accept)” | “if a child is still young, whether it has Down syndrome or any other child with special needs, it is relatively easy to take care of, but if they get older […] and yes… then there is an adult that is unable to live independently (F104 post-accept)” | ||
“such a child can provide so much love and can enjoy life in his or her own special way. That is how I see children with Down syndrome, they enjoy life (F1003 pre accept)” | |||||
“if we accept the birth of a child with Down syndrome, it means that our oldest child will get the responsibility after we have died. Now, we have this opportunity to make a choice and prevent my daughter from being a future family care giver (F302 post-accept)” | |||||
Predisposing | Consequences | “…in the case of a screen positive result, I haven’t decided what to do yet. First, the test, and then we will see what to do next…at least testing doesn’t harm anyone (F707 pre-accept)” | “in the case of a screen positive result I will decide to proceed with invasive diagnostics, needless to say…more knowledge through measurement (F603 post-acc)” | ||
“if you participate in a test you need to be aware of the possible consequences […] yes, we have talked about that extensively. We have decided if the test result is not good we will decide to have a TOP (F101 post-accept)” | |||||
Enabling | Information given by counsellor | “I received information from a couple that had been pregnant before (F701 pre-accept) | “the midwife asked me if I wanted information on DSS. Then I replied that I already had all the information and wanted the test. So that is it… (F602 post-accept)” | “And she (the midwife) gave me that bit of extra confirmation by saying “I would not do it, if I were you” If she had said the contrary I would certainly have reconsidered my decision again…yes” (F405 post-decline)” | |
“first I searched for information on the web, and I also spoke to a friend that recently did the test (F1003 pre-accept)” | |||||
“And then she (the midwife) said, actually she influenced us a bit: “it all looks good and besides the test could also cause a lot of extra stress (F401 post-decline)” | |||||
Need | Risk perception | “the midwife said: ‘you are 35, you could take the combined test’. So we said yes… why not? If it is possible? (F104 post-accept)” | “I am 30 years of age, and I am young, so therefore not at increased risk for Down syndrome. And besides I do not need to know everything in advance (F902 pre-decline)” | “I filled in the intake-questionnaire, that is when the midwife said: ‘normally I do not see such a healthy list’. I don’t smoke, drink. But I am 30 […] first signs were reassuring, the scan looked good (F401 post-decline)” | |
“in the Netherlands women are strongly advised to have children at an early age, not only for Down syndrome, but for your fertility as well….yes… it is strongly advised… not sure by whom… but it is, maybe your doctor or the media (F301post-accept)” | |||||
“for me the decisive reason to decline is my young age and I do not have the feeling I am at risk (F904 pre-decline)” | |||||
“… I have studied the statistics…because I was curious to learn about my personal risk (F204 post-decline)” | |||||
“one of the influencing factors is age, so yes… I do not expect to have an increased risk […]so that is why testing would not add anything (F803 pre-decline) | |||||