Refining woman-centered care in prenatal screening and diagnosis for thalassemia: A qualitative descriptive study among northeastern thai women

Abstract

When caring for pregnant women at risk for fetal thalassemia, genetic counseling is typically employed to ensure the quality of care and to fulfil individual needs. This qualitative descriptive study aimed to understand women’s experiences and further refine their womancentered care. Through a purposive sampling technique, 20 Thai women in a northeastern province participated in this study, having had undergone prenatal screening and diagnostic tests, and terminated the pregnancy or given birth. Most informants were interviewed in-depth two or three times. Data were analyzed using thematic analysis. Six caregiving themes emerged from their experiences: Theme 1, Amending ambiguity containing sub-themes of Assessing ambiguity in thalassemia, and Making clear the unknown; and Theme 2, Respecting individual difference which described the sub-themes of Assessing and accepting different values; Mother’s heartbreak versus a baby living normally, Safeguarding a baby from suffering versus giving life to a baby, and Facilitating shared decisions, without using directives and coercion. Theme 3 was Prioritizing an unborn baby’s well-being including the subthemes of Nourishing an unborn baby, and Reassuring an unborn baby’s safety, while Theme 4 was Caring beyond courteousness that described the sub-themes of Assistance to regain emotional balance; Enhancing mental strength, and Facilitating religious and spiritual coping. Theme 5, Care given extensively to family and community involved Intervening when ‘My family hurt,’ and ‘I hurt my family,’ and Alleviating concerns over community attitude. The last theme, Reducing negative experiences with service delivery, involved sub-themes of Reducing a sense of prolonged waiting and being rushed, and Reducing a sense of limited expertise and technology. In conclusion, regarding a woman-centered approach for these women, nurses should respond to their unique psychosocial, cultural, ethical, religious, and spiritual needs, respect the woman’s values, dignity, and decisions, as well as extend the care to the fetus, family, and community.