Biomedical Engineering Reference
In-Depth Information
described elsewhere (Georgsson Öhman
et al
. 2006) has also been shown
in some of the few other studies so far carried out on women's reactions to
ultrasound screening for Down syndrome. Women who were informed about
a high risk score after ultrasound screening described feelings of anxiety and
the ways they took 'time-out' and also residual feelings of anxiety even after
confi rmation of a normal result (Baillie
et al
. 2000).
Here, we fi rst want to look in more detail at how the women try to make
sense of the high risk information. All the women talked elaborately about
how they tried to understand the risk score, the fi gure that was presented
to them by the midwife, and came back to this issue through the three
interviews. The analysis reveals some typical ways this is done: the women
try to understand the fi gure as high or low, as compared with other risk
scores and by trying to understand the fi gure in the context of how it is
calculated. The women also try to understand the fi gure (and the risk), by
comparing the fi gure with other fi gures, such as risk expressed in per cent,
by visualizing the risk score and by comparing themselves with other women
with different risk scores. In this process, different words are used, such
as 'fi gure', 'risk score', 'chance', 'probability' and 'risk'. The women often
oscillate between these different ways of trying to understand the risk score
- intertwined with evaluations of how the information about the risk score
was presented to them and also implications of the risk score in the context
of their own lives. The character of the women's accounts can be illustrated
by this fi rst example from an interview with Ann, aged 30, who had a risk
score of 1:208:
ANN:
She did the measurements, and we watched and so on, and when it
was all done and we had our pictures (the paper copies of the ultrasound
picture), we looked at the risk profi le that she had on a piece of paper,
and at that point I was completely unprepared that something like this
could happen. The thought hadn't crossed my mind, in fact. So I was
quite, I mean shocked is a strong word, but I was very, very surprised
that this would happen to me. Somehow, I had never been near the
thought that it could happen, so I was very sad, I thought it was terrible,
because when she explained, in a very good way, that it was a very small
risk, it was a 0.5 per cent chance, and you can have an invasive test,
right then, it felt like a fi fty-fi fty chance, it was so tragic, I thought,
terrible. When we fi rst saw those papers we didn't understand anything
about the meaning of those fi gures, and then she explained that she had
measured, measured the neck, she had measured the back and somehow
multiplied with my age, the age of the foetus and come up with this risk
that means 0.5 per cent probability that something is wrong. So I think
she was very nice and calm. But of course we started to raise a lot of
questions. What is the most common, and how big does the risk have to
be to be dangerous and things like that, and I think she did it very well
because she didn't give any direct answers, of course there aren't, but
