School of Medicine, Leeds Institute of Health Sciences, University of Leeds, 101 Clarendon Road, Leeds LS2 9LJ, UK.
Midwifery. 2013 Jul;29(7):745-50. doi: 10.1016/j.midw.2012.07.006. Epub 2012 Aug 15.
to explore midwives' perceptions of their role as facilitators of informed choice in antenatal screening.
qualitative.
community midwives, Yorkshire and Humber region, UK.
community midwives offering antenatal screening (n=15).
semi-structured interviews analysed using Thematic Analysis.
to facilitate informed choice, midwives highlighted both the importance and challenges of engaging in discussion with women, remaining non-directive, within tight timeframes, sometimes with women unable to communicate in English or with complex social needs.
midwives varied in the degree to which they believed it was their role to (1) discuss rather than just provide information and (2) to check women's understanding of the information provided. Midwives were concerned about the constraints imposed by first trimester combined screening in terms of the limited time in which they had to facilitate informed choice and the women had to make a decision about screening. To ensure that women understand the options available to them and are able to exercise an informed choice, clinical guidelines are needed that set out how midwives can actively facilitate informed screening choices without compromising patient autonomy. This is especially important given the small 'window of opportunity' within which combined first trimester screening is a viable option.
探讨助产士对其在产前筛查中促进知情选择角色的看法。
定性研究。
英国约克郡和亨伯地区的社区助产士。
提供产前筛查的社区助产士(n=15)。
采用主题分析对半结构化访谈进行分析。
为了促进知情选择,助产士强调了与妇女进行讨论的重要性和挑战,同时保持非指导性,在紧张的时间内,有时妇女无法用英语交流或有复杂的社会需求。
助产士在多大程度上认为自己的角色是(1)讨论而不仅仅是提供信息,以及(2)检查妇女对提供的信息的理解程度,存在差异。助产士对早孕期联合筛查所带来的限制感到担忧,包括他们促进知情选择和妇女决定筛查的时间有限。为了确保妇女了解可供选择的方案并能够做出明智的选择,需要制定临床指南,说明助产士如何在不损害患者自主权的情况下积极促进知情筛查选择。鉴于早孕期联合筛查是一个可行的选择,其“机会之窗”非常小,因此这一点尤为重要。