Clients' perspectives on the quality of counseling for prenatal anomaly screening. A comparison between 2011 and 2019

Abstract

Objective: There have been substantial medical developments in prenatal anomaly and aneuploidy screening. However, the quality of counseling about these tests tends to lag behind. Additional quality requirements were therefore implemented in the Netherlands in 2017 to optimize this counseling. We compared clients' counseling preferences and experiences before and after implementation of these requirements.

Methods: We used the validated 57-item QUOTE^prenatal questionnaire, to measure clients' counseling preferences and experiences before and after counseling in 20 obstetric organizations throughout the Netherlands. Clients' preferences and experiences were compared between pregnant women and partners, nulliparous versus multiparous clients and between results of a Dutch survey in 2011 and the current one.

Results: Sixty-five counselors and 649 clients (353 pregnant women and 296 partners) participated in this study. Compared to 2011, slightly more clients considered the three QUOTE^prenatal components of counseling (client-counselor relationship, health education, and decision-making support) to be either important or very important, especially decision-making support. More clients than in 2011 perceived their needs as being well addressed, with the lowest percentages for decision-making support.

Conclusion: Quality requirements seem to benefit the quality of counseling, as perceived by clients.

Practical implications: Counselors should consider tailoring their decision-making support more to clients' needs.

Keywords: Anomaly; Clients” perceptions; Counseling; Experiences; NIPT; Needs assessment; Prenatal screening.