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A new tool to assess understanding of Down syndrome screening information presented by midwives

02 November 2019
13 min read
Volume 27 · Issue 11



To identify factors that could influence women's understanding of Down syndrome (DS) screening information presented by midwives.


Current literature was scrutinised. Components that could influence women's understanding were identified and a new framework was developed and refined. Measures were selected and developed to create a tool to assess the framework.


A new framework and assessment tool, measuring understanding of screening information and communication (MUSIC), was developed to assess women's understanding of DS screening information, their cognitive status and the midwives' communicative style.


This framework is the first of its kind, encompassing both women's cognitive status and midwife communication as an influence on women's understanding. Applying the framework and tool could inform midwifery practice by providing an insight into whether, to what extent and how, cognitive status influences understanding of DS screening information, the importance of tailoring information to each woman and highlighting areas of communication that are most effective.

In England, Wales and Scotland, all pregnant women are routinely offered antenatal screening for Down syndrome (DS) at the booking appointment, according to the UK National Screening Committee ([UKNSC], 2007). Screening information should increase knowledge in order for women to make informed decisions (de Jong et al, 2014). However, some women undergo screening even though they have relatively little knowledge of the test or the condition (Dormandy et al, 2006; Skirton and Barr, 2010).

Advances in genetic/genomic technology are revolutionising antenatal screening and the UK NSC, (2016) has recommended introducing non-invasive prenatal testing (NIPT) into the National Health Service (NHS) which is more accurate than current forms of screening (Norton et al, 2015). The way healthcare professionals present information is likely to influence screening uptake. Midwives should counsel women about NIPT in the same way as invasive testing because the tests carry similar diagnostic implications. If midwives can effectively communicate current screening information and support women's informed decision making, then it is anticipated that it will be easier to incorporate NIPT into practice.

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