METHODS: In this paper, we explore how professionals in England and France support patient decision-making in the provision of NIPT and critically compare professional practices and values. We draw on data from semi-structured interviews with healthcare professionals.
RESULTS: Both English and French professionals emphasised values relating to patient choice and consent. However, understandings and application of these values into the practice of NIPT provision differed. English interviewees placed a stronger emphasis on interpreting and describing the process of counselling patients and clinical care through a \"principle\" lens. Their focus was on non-directiveness, standardisation, and the healthcare professional as \"decision-facilitator\" for patients. French interviewees described their approach through a \"procedural\" lens. Their focus was on formal consent, information, and the healthcare professional as \"information-giver\". Both English and French professionals indicated that insufficient resources were a key barrier in effectively translating their values into practice.
CONCLUSIONS: Our findings illustrate that supporting patient choice in the provision of NIPT may be held as an important value in common on a surface level, but can be understood and translated into practice in different ways. Our findings can guide further research and beneficially inform practice and policy around NIPT provision.
方法:在本文中,我们探讨了英国和法国的专业人员如何在提供NIPT时支持患者决策,并批判性地比较专业实践和价值观.我们利用半结构化的医疗保健专业人员访谈数据。
结果:英国和法国专业人士都强调与患者选择和同意有关的价值观。然而,这些价值观在NIPT规定实践中的理解和应用是不同的。英语受访者更加强调通过“原则”镜头解释和描述咨询患者和临床护理的过程。他们专注于非指向性,标准化,以及医疗保健专业人员作为患者的“决策促进者”。法国受访者通过“程序”镜头描述了他们的方法。他们的重点是正式同意,信息,和医疗保健专业人员作为“信息提供者”。英语和法语专业人员都表示,资源不足是有效将其价值观转化为实践的关键障碍。
结论:我们的研究结果表明,在提供NIPT时支持患者选择可能在表面水平上被认为是一个重要的共同价值,但可以以不同的方式理解并转化为实践。我们的发现可以指导进一步的研究,并为NIPT规定的实践和政策提供有益的信息。