Women of advanced maternal age undergoing amniocentesis: a period of uncertainty.

AIMS: To generate a descriptive model for understanding patterns and interpretations concerning women's experiences of amniocentesis in Taiwan. BACKGROUND: In light of scientific technology and social change, it would be important to recognise the complexity of a woman's situation and the meaning of her in-depth experience while undergoing amniocentesis. Earlier studies on the experience of these women often relied on quantitative data obtained from questionnaires at only one point in time; however, the changes in older pregnant women, known to be at increased risk for foetal chromosomal abnormalities, from the time of pregnancy until test results of their amniocentesis has not been clearly understood. DESIGN: A grounded theory approach was applied. METHODS: Data were collected through in-depth interviews and participant observation. Sampling and major coding continued from 2002-2003 until theoretical saturation occurred; 20 women (> or =35 years of age) participated in this study; data were analysed using constant comparative and content analysis. RESULTS: A prevailing sense of uncertainty was the core category for describing and guiding the process of this study with five main stages identified: (1) ambivalence toward pregnancy; (2) decision to undergo amniocentesis; (3) concerns regarding maternal and foetal safety during procedure; (4) anxiety while awaiting results and (5) thoughts about a lifetime maternal commitment. CONCLUSIONS: Identification and appreciation for emerging themes enables nurses to address women's concerns in a meaningful way as they undergo amniocentesis. Also, it is hoped that understanding key themes allows nurses to facilitate constructive interactions between women, physicians and other members of the obstetric team. RELEVANCE TO CLINICAL PRACTICE: Women in Taiwan undergoing amniocentesis had concerns about safety and dealt with cultural taboos of pregnancy in advanced age; health education should include coping strategies and decision making in dealing with these issues. To facilitate constructive interactions between clients and health care teams, the ethical guidance of informed consent and respecting the women's autonomy should be emphasised.

[The decision making process of adolescent pregnant women receiving help from Taipei single mother assistance centers].

This research explores the problem of teenage pregnancy through the experiences of individuals receiving help from two single-mother assistance centers in Taipei, Taiwan. In particular, this study attempts to understand the difficult thought processes undergone by these young women from the time that they became aware of their pregnancy to the point at which they decided to carry their baby to term. Grounded theory was employed in designing this research. A total of 10 teenage subjects were involved in this study. After analyzing data, findings were made in the following four core areas: (1) The process through which teenage girls decide to take their unborn babies to term; (2) Feelings of isolation and reaching out for help; (3) The social and cultural pressures faced by single teenage girls who decide to have children out of wedlock; and (4) The self-revival and renewal of teenage girls' beliefs. Through this study, we can better understand the processes and experiences of single teenagers from their initial comprehension of their pregnancy through to the decision to take their pregnancy to term.