Department of Nursing & Midwifery, University of Stirling, Stirling FK9 4LA, UK.
Midwifery. 2011 Feb;27(1):104-11. doi: 10.1016/j.midw.2009.12.003.
to explore midwives' intrapartum referral decisions in relation to their dispositional attitude towards risk.
a web-based correlation study examined the association between midwife's personality (personal risk tendency), place of work (location), years of experience and the timing of their decisions to make referrals (referral score) in a series of fictitious case scenarios (vignettes).
102 midwives providing labour care in both consultant-led units (CLU) and community maternity units (CMU) from four Scottish health board areas.
a correlational analysis was carried out to test the association between total risk scores and midwives' referral scores. Between-group comparisons were also conducted for experienced vs inexperienced midwives, midwives practising in CLU vs CMU settings and between the four health board areas.
despite being presented with identical information in the vignettes, midwives made a wide range of referral decisions. There was no association between referral scores and measures of risk, personality or years of experience. No statistically significant difference between the referral scores of midwives working in CLUs or CMUs was observed. However, a statistically significant difference did emerge between the four health board areas, with midwives from one area making referrals at a significantly earlier stage. The maternity services in this area had experienced several high profile adverse events prior to this study; this may have influenced their referral behaviour (the availability heuristic), in terms of making more cautious decisions.
there was no evidence that variability in the range of referral decisions was due to personality factors, risk propensity, experience or whether the midwife worked in a CLU or CMU. Local factors such as recent adverse events may significantly influence subsequent referral behaviour. Further research is required to identify why the midwives showed so much unexplained variability in their responses to the vignettes.
探讨助产士在分娩过程中的转介决策与其对风险的态度倾向之间的关系。
一项基于网络的相关性研究，考察了助产士个性（个人风险倾向）、工作地点（位置）、工作年限与他们在一系列虚构案例情景（情节）中做出转介决策的时间（转介评分）之间的关系。
来自苏格兰四个卫生委员会地区的 102 名在顾问领导的单位（CLU）和社区产妇单位（CMU）提供分娩护理的助产士。
进行了相关性分析，以检验总风险评分与助产士转介评分之间的关联。还对经验丰富与经验不足的助产士、在 CLU 与 CMU 环境中工作的助产士以及四个卫生委员会地区之间进行了组间比较。
尽管在情节中呈现了相同的信息，但助产士做出了广泛的转介决策。转介评分与风险、个性或工作年限的测量值之间没有关联。在 CLU 或 CMU 工作的助产士的转介评分之间没有观察到统计学上的显著差异。然而，四个卫生委员会地区之间确实出现了统计学上的显著差异，一个地区的助产士在更早的阶段做出了转介。在这项研究之前，该地区的产妇服务经历了几起备受瞩目的不良事件；这可能会影响他们的转介行为（可得性启发式），使其做出更谨慎的决策。
没有证据表明转介决策范围的变化是由于个性因素、风险倾向、经验或助产士在 CLU 或 CMU 工作。最近的不良事件等地方因素可能会显著影响随后的转介行为。需要进一步研究以确定为什么助产士对情节的反应表现出如此多的无法解释的差异。
