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Abordagem psicossocial dos comportamentos orientados para a saúde: estudo dos factores de previsão da aceitação e da rejeição do diagnóstico pré-natal
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Abstract(s)
A presente investigação fundamentou-se nas teorias
relevantes para a compreensão dos comportamentos
orientados para a saúde, nomeadamente o Health Belief
Model desenvolvido por Rosentock (1974), e nos
seus desenvolvimentos aplicados ao contexto específico
do Diagnóstico Pré-Natal (Davies, 1983). Este
modelo foi articulado com a teoria de Ajzen e Fishbein
(1980), o Modelo da Acção Reflectida aplicado ao domínio
da saúde.
As atitudes e comportamentos face ao Diagnóstico
Pré-Natal (DPN) em duas sub-amostras (30 mulheres
que aceitaram a realização do DPN e 30 mulheres que
recusaram a realização do DPN) permitiu discriminar
83% das aceitações, 93% para as rejeições ou seja
88.3% das escolhas. Estes comportamentos reflectem a
influência das variáveis como o grau de instrução, a
avaliação dos custos e dos benefícios inerentes à realização
do DPN, os conhecimentos sobre a síndrome de
Down (e o DPN), as atitudes face ao abortamento, as
atitudes face aos médicos e à medicina, as atitudes face
à procriação e o locus de controlo da saúde. As variáveis
socio-demográficas mais importante foram o
número de filhos e o grau de instrução. Os resultados
vão de encontro com alguns aspectos dos modelos teóricos
psicossociais que lhe serviram de suporte teórico.
As variáveis grau de religiosidade, experiência prévia
com a síndrome de Down e a influência de outros poderosos
no locus de controlo de saúde foram redundantes
para a discriminação dos grupos. Os resultados
evidenciam alguns dos fundamentos das atitudes, decisões
e comportamentos das consulentes, em relação
ao DPN e permitem retirar certas implicações ao nível
da influência dos factores psicossociais na organização
do conhecimento, atitudes e representações, estabelecendo
os limites e o alcance da sua relevância para a
tomada de decisão de rejeição do Diagnóstico Pré-Natal.
ABSTRACT: The framework of this study draws from two social- cognitive and motivational models: Rosenstocks´s (1974) Health Belief Model, that was developed to explain and to predict behaviour in health contexts, and Ajzen and Fishbein´s (1980) Theory of Reasoned Action as applied to the field of prenatal diagnosis (Davies, 1983). The aim of this study is to describe attitudes and behaviours of women who accept or decline prenatal diagnosis. Results of a discriminant function analysis conducted on 60 subjects classified 83% of acceptance group, 93% for the declining group and 88.3% of correct classifications in general. The factors involved in the decision making process, such as education, perceived barriers and advantages of taking the exam, previous knowledge of prenatal diagnosis and of Down´s syndrome, attitudes towards abortion, medicals and medicine, and procriation, and health locus of control significantly discriminated between those who accepted and those who declined prenatal diagnosis. The most important demographic variables were the number of previous children and education level. Religion, previous experience with Down´s syndrome and the influence of powerful others in health locus of control failed to discriminate between the groups. The results appear in line with the theoretical models, and support an attitude based explanation of decision making about prenatal diagnosis and, of more general prenatal health related behaviours.
ABSTRACT: The framework of this study draws from two social- cognitive and motivational models: Rosenstocks´s (1974) Health Belief Model, that was developed to explain and to predict behaviour in health contexts, and Ajzen and Fishbein´s (1980) Theory of Reasoned Action as applied to the field of prenatal diagnosis (Davies, 1983). The aim of this study is to describe attitudes and behaviours of women who accept or decline prenatal diagnosis. Results of a discriminant function analysis conducted on 60 subjects classified 83% of acceptance group, 93% for the declining group and 88.3% of correct classifications in general. The factors involved in the decision making process, such as education, perceived barriers and advantages of taking the exam, previous knowledge of prenatal diagnosis and of Down´s syndrome, attitudes towards abortion, medicals and medicine, and procriation, and health locus of control significantly discriminated between those who accepted and those who declined prenatal diagnosis. The most important demographic variables were the number of previous children and education level. Religion, previous experience with Down´s syndrome and the influence of powerful others in health locus of control failed to discriminate between the groups. The results appear in line with the theoretical models, and support an attitude based explanation of decision making about prenatal diagnosis and, of more general prenatal health related behaviours.
Description
Keywords
Aceitação do diagnóstico pré-natal Rejeição do diagnóstico pré-natal Idade materna avançada Teoria do comportamento planeado Health belief model Uptake prenatal diagnosis Decline prenatal diagnosis Advanced maternal age Theory of reasoned action Health belief model
Citation
Analise Psicológica XVIII(4), 499-521
Publisher
Instituto Superior de Psicologia Aplicada