2.50
Hdl Handle:
http://hdl.handle.net/10755/163453
Category:
Abstract
Type:
Presentation
Title:
Reproductive decisions of parents of children with metabolic disease
Author(s):
Read, Catherine
Author Details:
Catherine Read, Assistant Professor, Boston College, School of Nursing, Chestnut Hill, Massachusetts, USA, email: catherine.read.1@bc.edu
Abstract:
The purpose of this study was to identify and explain subsequent reproductive decisions of parents of children with inherited metabolic diseases. The Interaction Model of Client Health Behavior served as a guide for selection and analysis of variables with a direct or indirect effect on parents' receptivity to prenatal diagnosis (PND), their likelihood of terminating a future affected pregnancy, and whether they took measures to prevent an affected pregnancy. A retrospective cross-sectional survey was conducted via telephone with 230 parents of children with metabolic disorders. The interview consisted of both forced choice and open-ended items. Fifty-six percent of the respondents were receptive to prenatal diagnosis for the specific metabolic disease in a hypothetical future pregnancy, but only 10% would terminate that pregnancy if the test were positive. Forty-one percent had taken measures to prevent future affected pregnancies. All three outcomes (receptivity to PND, likelihood of terminating a future affected pregnancy, and taking measures to prevent an affected pregnancy) were significantly correlated with higher scores on the Parent Stress Index, lower scores on the Vineland Adaptive Behavior scales, fewer persons in the parent's social support network, greater worry about the living child's future, and greater perceived difficulty meeting the child's extra care needs. Conversely, variables that did not have significant bivariate associations with the outcomes included parent gender, religion, race, age, socioeconomic status, birth order of the affected child or monthly out-of-pocket health related expenses for the child. Using a combination of logistic and multiple regression, models were constructed to explain both the direct and indirect effects of variables on the three outcomes. Parent stress was a strong direct predictor of receptivity to prenatal diagnosis in future pregnancies and willingness to terminate a future affected pregnancy. Greater worry about the living child's future predicted that the parent would take measures to prevent another affected pregnancy. Important indirect predictors, which exerted their effects by increasing stress or worry, included low adaptation level of the affected child, fewer persons in the parent's social support network, lower socioeconomic status, greater perceived difficulty of meeting the child's extra care needs, and poorer perceived capability of making health-related decisions for the child. Clearly, some factors that appear insignificant in bivariate analyses do impact reproductive decisions, albeit indirectly, through their effects on affective responses such as stress and worry. With the rapid increase in the availability of information about one's genotype, prenatal and preimplantation diagnosis, and technology for fetal selection, genetic counseling is emerging as a significant challenge for health professionals in the 21st century. This study highlights the need for nurses who provide genetic counseling to focus intensively on parents' affective responses and the role these factors play in reproductive decision making. Researchers must utilize multivariate and path models to capture the indirect effects of variables on health outcomes.
Repository Posting Date:
27-Oct-2011
Date of Publication:
27-Oct-2011
Conference Date:
2002
Conference Name:
14th Annual Scientific Sessions
Conference Host:
Eastern Nursing Research Society
Conference Location:
University Park, Pennsylvania, USA
Note:
This is an abstract-only submission. If the author has submitted a full-text item based on this abstract, you may find it by browsing the Virginia Henderson Global Nursing e-Repository by author. If author contact information is available in this abstract, please feel free to contact him or her with your queries regarding this submission. Alternatively, please contact the conference host, journal, or publisher (according to the circumstance) for further details regarding this item. If a citation is listed in this record, the item has been published and is available via open-access avenues or a journal/database subscription. Contact your library for assistance in obtaining the as-published article.

Full metadata record

DC FieldValue Language
dc.type.categoryAbstracten_US
dc.typePresentationen_GB
dc.titleReproductive decisions of parents of children with metabolic diseaseen_GB
dc.contributor.authorRead, Catherineen_US
dc.author.detailsCatherine Read, Assistant Professor, Boston College, School of Nursing, Chestnut Hill, Massachusetts, USA, email: catherine.read.1@bc.eduen_US
dc.identifier.urihttp://hdl.handle.net/10755/163453-
dc.description.abstractThe purpose of this study was to identify and explain subsequent reproductive decisions of parents of children with inherited metabolic diseases. The Interaction Model of Client Health Behavior served as a guide for selection and analysis of variables with a direct or indirect effect on parents' receptivity to prenatal diagnosis (PND), their likelihood of terminating a future affected pregnancy, and whether they took measures to prevent an affected pregnancy. A retrospective cross-sectional survey was conducted via telephone with 230 parents of children with metabolic disorders. The interview consisted of both forced choice and open-ended items. Fifty-six percent of the respondents were receptive to prenatal diagnosis for the specific metabolic disease in a hypothetical future pregnancy, but only 10% would terminate that pregnancy if the test were positive. Forty-one percent had taken measures to prevent future affected pregnancies. All three outcomes (receptivity to PND, likelihood of terminating a future affected pregnancy, and taking measures to prevent an affected pregnancy) were significantly correlated with higher scores on the Parent Stress Index, lower scores on the Vineland Adaptive Behavior scales, fewer persons in the parent's social support network, greater worry about the living child's future, and greater perceived difficulty meeting the child's extra care needs. Conversely, variables that did not have significant bivariate associations with the outcomes included parent gender, religion, race, age, socioeconomic status, birth order of the affected child or monthly out-of-pocket health related expenses for the child. Using a combination of logistic and multiple regression, models were constructed to explain both the direct and indirect effects of variables on the three outcomes. Parent stress was a strong direct predictor of receptivity to prenatal diagnosis in future pregnancies and willingness to terminate a future affected pregnancy. Greater worry about the living child's future predicted that the parent would take measures to prevent another affected pregnancy. Important indirect predictors, which exerted their effects by increasing stress or worry, included low adaptation level of the affected child, fewer persons in the parent's social support network, lower socioeconomic status, greater perceived difficulty of meeting the child's extra care needs, and poorer perceived capability of making health-related decisions for the child. Clearly, some factors that appear insignificant in bivariate analyses do impact reproductive decisions, albeit indirectly, through their effects on affective responses such as stress and worry. With the rapid increase in the availability of information about one's genotype, prenatal and preimplantation diagnosis, and technology for fetal selection, genetic counseling is emerging as a significant challenge for health professionals in the 21st century. This study highlights the need for nurses who provide genetic counseling to focus intensively on parents' affective responses and the role these factors play in reproductive decision making. Researchers must utilize multivariate and path models to capture the indirect effects of variables on health outcomes.en_GB
dc.date.available2011-10-27T11:07:51Z-
dc.date.issued2011-10-27en_GB
dc.date.accessioned2011-10-27T11:07:51Z-
dc.conference.date2002en_US
dc.conference.name14th Annual Scientific Sessionsen_US
dc.conference.hostEastern Nursing Research Societyen_US
dc.conference.locationUniversity Park, Pennsylvania, USAen_US
dc.description.noteThis is an abstract-only submission. If the author has submitted a full-text item based on this abstract, you may find it by browsing the Virginia Henderson Global Nursing e-Repository by author. If author contact information is available in this abstract, please feel free to contact him or her with your queries regarding this submission. Alternatively, please contact the conference host, journal, or publisher (according to the circumstance) for further details regarding this item. If a citation is listed in this record, the item has been published and is available via open-access avenues or a journal/database subscription. Contact your library for assistance in obtaining the as-published article.-
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