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The couple relationship and adjustment following prenatal genetic testing for advanced maternal age in women with normal test results

Two studies were undertaken to explore how aspects of the couple relationship might play a role in women's experience of prenatal diagnosis (PND). Both studies involved women referred to the Children's Hospital of Eastern Ontario (CHEO) for prenatal genetic counseling due to advanced maternal age (AMA). The first study examined the role of the partner during the genetic counseling session by comparing 123 women who attended the session alone with 222 women accompanied by their partners, on the basis of self-report measures completed immediately prior to and following the session. Accompanied women reported somewhat higher levels of state anxiety and PND-related decisional conflict before the session than did those who attended alone (p < .05). The presence of the partner could thus reflect a support-seeking coping strategy employed by women to cope with feelings of indecision and anxiety surrounding the issue of prenatal diagnosis. Alternatively, it is possible that attendance by the partner contributed to anxiety and uncertainty among women.
The second study sought to clarify the reasons for partner attendance or non-attendance at the genetic counseling and testing appointments, and to explore how certain relationship variables might relate to women's individual and marital adjustment following PND. Ninety-five women completed self-report measures prior to genetic counseling (Time 1), during the waiting period for PND test results (Time 2), and after normal results were known (Time 3). Many women reported that their partners attended the appointments on the basis of the couple's view of PND as a shared experience, or to provide emotional and decisional support for the women. The most common reason for partner non-attendance was work-related conflicts. At Time 2, distress was predicted by the degree to which women approached the PND decision jointly with their partners, and marital adjustment was predicted by women's satisfaction with the support received from their partners. Marital adjustment at Time 3 was predicted by earlier levels of partner agreement about PND-related issues. The association between pre-counseling partner agreement and Time 3 well-being was mediated by women's use of relationship-focused coping (partner support seeking and empathic responding) and moderated by women's satisfaction with their partners' support. Joint decision-making at Time 1 was linked to Time 3 adjustment indirectly, through women's satisfaction with their partners' support. Finally, women's use of avoidant coping strategies mediated the association between perceived partner support and Time 3 adjustment outcomes. Results suggest that aspects of the couple relationship have the potential to facilitate or hinder women's experience of PND counseling and testing, thus highlighting the potential benefits of focusing at least a portion of the genetic counseling session on couple-related issues.

Identiferoai:union.ndltd.org:uottawa.ca/oai:ruor.uottawa.ca:10393/29116
Date January 2004
CreatorsHumphreys, Lauren R
PublisherUniversity of Ottawa (Canada)
Source SetsUniversité d’Ottawa
LanguageEnglish
Detected LanguageEnglish
TypeThesis
Format195 p.

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