Prenatal Genetic Testing: An Investigation of Determining Factors Affecting the Decision-Making Process
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ORIGINAL RESEARCH
Prenatal Genetic Testing: An Investigation of Determining Factors Affecting the Decision-Making Process Monica Pivetti & Giannino Melotti
Received: 7 December 2010 / Accepted: 7 March 2012 / Published online: 3 April 2012 # National Society of Genetic Counselors, Inc. 2012
Abstract Despite the increase in popularity of prenatal genetic testing, relatively little is known about the role psychological factors play in the decision-making process. In this analogue study, a sample of Italian female university students was used to investigate determining factors that predict the intention of undergoing prenatal genetic testing. Structural Equation Modelling was used to describe the dynamic interplay between knowledge, beliefs, attitudes and health-related behaviour such as prenatal genetic testing. Following the Theory of Reasoned Action, three dimensions predicted the intention to undergo prenatal genetic testing: the need for more scientific information, a positive attitude towards genetic testing, and the inclination to terminate pregnancy after receiving a positive test result. Results showed that less religious women tended to be more in favour of prenatal tests and in undertaking such tests. This preliminary study provides genetic counsellors and policy makers with a clearer picture of their clients’ motives and attitudes behind the decision-making process of prenatal genetic testing, contributing to improving both the communication process between counsellors and their clients and the organization of genetic services. Keywords Prenatal genetic testing . Decision-making . Belief system . Attitudes . Women . Structural equation modelling . Religion
M. Pivetti (*) University G. d’Annunzio, Chieti-Pescara, Italy e-mail: [email protected] G. Melotti University of Bologna, Bologna, Italy
Introduction The number of inherited disorders and risk factors that can be detected through genetic testing is increasing rapidly. Prenatal genetic testing can be defined as a group of clinical analyses carried out on DNA, RNA, chromosomes, proteins, metabolites or other genetic products, to reveal genotypes, mutations, phenotypes or karyotypes which correlate with human transmissible diseases (Italian National Institute of Health 1998). The Census carried out on genetic testing activity in Italy shows a strong increase in test use from 2000 to 2002, with an increase of 34 % in cytogenetic analyses, and a rise of 30 % in prenatal analyses in particular. The Census also brings to light the increase in the number of laboratories performing prenatal genetic testing and a disproportion between the growing number of performed tests and the clinical needs of the target population as measured by the incidence of genetic diseases in the target population (S.I.G.U. 2004). These data also reflects the growing need in couples to seek further information about the physical health of the foetus. Down syndrome, a chromosomal disorder caused by the presence of all or part of an extra 21st chromosome, is the most frequent chromos
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