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Psychologische Aspekte pränataler diagnostischer Untersuchungen

  • J. A. Weinman
Part of the Jahrbuch der medizinischen Psychologie book series (MEDPSYCHOL, volume 6)

Zusammenfassung

Dieser Beitrag liefert eine Übersicht über die mit verschiedenen Stadien pränataler diagnostischer Untersuchungen verbundenen psychologischen Probleme. Es gibt relativ wenige Studien der Faktoren, die die Entscheidung beeinflussen, an den Untersuchungen teilzunehmen. Neuere Arbeiten haben aber gezeigt, daß spezielle einstellungsmäßige Faktoren dabei eine Rolle spielen. Im Gegensatz dazu konzentrierten sich einige Studien auf die Belastungen des Untersuchungsverfahrens. Sie ergaben, daß zusätzlich zur Angst vor den einzelnen Vorgängen unvermeidlicherweise große Bedenken hinsichtlich des Ausgangs der Untersuchungen bestehen. Faktoren wie zeitliche Gestaltung und Qualität der Rückmeldungen sind wichtig bei der Bestimmung des Angstniveaus und der Angstreduzierung. Bei Frauen, bei denen sich ein pathologischer Befund ergibt, sind erhebliche psychologische Probleme zu bearbeiten. Diese schließen die Bewältigung der „schlechten Nachrichten“ ein, die Entscheidung über die eventuelle Beendigung der Schwangerschaft, die Bewältigung des Abbruchverfahrens und den Verlust des ungeborenen Kindes. Zusätzlich zur Hervorhebung der verschiedenen psychologischen Fragestellungen und Probleme zeigt das Material hier die Bedeutung guter Beratung und Unterstützung in jeder Phase. Zum Schluß werden kurz psychologische Studien zu genetischer Beratung betrachtet, wobei die Unterschiede in der Risikoeinschätzung zwischen Beratern und Klienten sowie deren Implikationen für spätere Absichten hinsichtlich Familienplanung und Vorhalten aufgezeigt werden.

Summary

This paper provides an overview of the psychological issues associated with different stages of diagnostic screening. There are relatively few studies of factors influencing the decision to attend for screening but recent work has indicated the contribution of particular attitudinal factors. In contrast, a number of studies have focused on the stressfulness of the screening procedures. These have shown that, in addition to anxieties about the various procedures, there are inevitably major concerns with the outcome of the investigations. Factors such as the timing and quality of feedback are important in determining levels of anxiety and anxiety reduction. With women in whom an abnormality is found, there are major psychological issues to be dealt with. These include coping with the “bad news”, deciding whether to terminate the pregnancy, coping with the termination procedure and the loss of the fetus. In addition to highlighting the different psychological concerns and issues, the evidence here points to the importance of providing good counselling and support at each stage. Finally psychological studies of genetic counselling are briefly considered, indicating the differences in perceptions of risk between counsellor and client and the implications of this for subsequent reproductive intentions and behaviour.

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Copyright information

© Springer-Verlag Berlin Heidelberg 1991

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  • J. A. Weinman

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