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产科医生在复杂病例中对剖宫产的态度。

Attitudes of Obstetricians toward Cesarean Delivery in Challenging Cases.

作者信息

Samadi Sareh, Gholizadeh Naeimeh, Shoar Nasrin, Shoar Saeed

机构信息

Department of Obstetrics and Gynecology, Mashhad University of Medical Sciences, Mashhad, Iran.

School of Medicine, Kashan University of Medical Sciences, Kashan, Iran.

出版信息

J Obstet Gynaecol India. 2013 Oct;63(5):301-5. doi: 10.1007/s13224-013-0401-7. Epub 2013 May 15.

DOI:10.1007/s13224-013-0401-7
PMID:24431663
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC3798444/
Abstract

OBJECTIVE

To assess the behavior and preferred delivery method among Iranian obstetricians in challenging cases.

METHOD

Using the revised Jackson personality inventory questionnaire, the attitudes of obstetricians toward cesarean delivery were assessed in challenging childbirth cases. The study was conducted at the Mashhad University of Medical Sciences in Mashhad, Iran.

RESULT

Seventy-five obstetricians answered each item reflecting varying levels of preference and risk attitudes. However, a significant number of respondents avoided the risk of requesting a cesarean because of legislation and legal issues.

CONCLUSION

Iranian obstetricians prefer low-risk behavior for managing ambiguous delivery cases. Fear of legislation and medicolegal issues appear to be of great importance in this cohort primarily comprising female physicians.

摘要

目的

评估伊朗产科医生在具有挑战性的病例中的行为及首选分娩方式。

方法

采用修订后的杰克逊人格问卷,在具有挑战性的分娩病例中评估产科医生对剖宫产的态度。该研究在伊朗马什哈德的马什哈德医科大学进行。

结果

75名产科医生回答了反映不同偏好和风险态度水平的每个项目。然而,相当数量的受访者因立法和法律问题而避免要求剖宫产的风险。

结论

伊朗产科医生在处理不明确的分娩病例时倾向于低风险行为。对立法和法医学问题的担忧在这个主要由女医生组成的群体中似乎非常重要。

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引用本文的文献

1
Behavioural factors associated with fear of litigation as a driver for the increased use of caesarean sections: a scoping review.与诉讼恐惧相关的行为因素是剖宫产增加的驱动因素:范围综述。
BMJ Open. 2023 Apr 19;13(4):e070454. doi: 10.1136/bmjopen-2022-070454.
2
Clinicians' views of factors influencing decision-making for caesarean section: A systematic review and metasynthesis of qualitative, quantitative and mixed methods studies.临床医生对影响剖宫产决策因素的看法:定性、定量和混合方法研究的系统评价和荟萃分析。
PLoS One. 2018 Jul 27;13(7):e0200941. doi: 10.1371/journal.pone.0200941. eCollection 2018.
3
Decision-making during trial of labour after caesarean; a qualitative study with gynaecologists.剖宫产术后分娩试验期间的决策制定:一项对妇科医生的定性研究。
PLoS One. 2018 Jul 18;13(7):e0199887. doi: 10.1371/journal.pone.0199887. eCollection 2018.

本文引用的文献

1
Effect of fear of litigation on obstetric care: a nationwide analysis on obstetric practice.畏惧诉讼对产科护理的影响:一项针对产科实践的全国性分析。
Am J Perinatol. 2011 Apr;28(4):277-84. doi: 10.1055/s-0030-1271213. Epub 2011 Jan 19.
2
Relationship between malpractice litigation pressure and rates of cesarean section and vaginal birth after cesarean section.医疗事故诉讼压力与剖宫产率及剖宫产术后阴道分娩率之间的关系。
Med Care. 2009 Feb;47(2):234-42. doi: 10.1097/MLR.0b013e31818475de.
3
Obstetricians' choice of cesarean delivery in ambiguous cases: is it influenced by risk attitude or fear of complaints and litigation?产科医生在情况不明时选择剖宫产:这是受风险态度影响,还是害怕投诉和诉讼?
Am J Obstet Gynecol. 2009 Jan;200(1):48.e1-8. doi: 10.1016/j.ajog.2008.07.021. Epub 2008 Oct 30.
4
Association between rising professional liability insurance premiums and primary cesarean delivery rates.职业责任保险保费上涨与剖宫产率之间的关联。
Obstet Gynecol. 2007 Dec;110(6):1264-9. doi: 10.1097/01.AOG.0000287294.89148.23.
5
Why obstetrics/gynecology, and what if it were not an option? A survey of resident applicants.为什么选择妇产科?如果不选它会怎样?一项针对住院医师申请者的调查。
Am J Obstet Gynecol. 2007 Nov;197(5):538.e1-4. doi: 10.1016/j.ajog.2007.07.024.
6
A review of issues surrounding medically elective cesarean delivery.关于医学选择性剖宫产相关问题的综述。
J Obstet Gynecol Neonatal Nurs. 2007 Nov-Dec;36(6):605-15. doi: 10.1111/j.1552-6909.2007.00196.x.
7
Overview of professional liability.职业责任概述。
Clin Perinatol. 2007 Jun;34(2):227-32, v. doi: 10.1016/j.clp.2007.03.002.
8
Cesarean delivery and the risk-benefit calculus.剖宫产与风险效益评估
N Engl J Med. 2007 Mar 1;356(9):885-8. doi: 10.1056/NEJMp068290.
9
Maternal mortality and severe morbidity associated with low-risk planned cesarean delivery versus planned vaginal delivery at term.足月时低风险计划剖宫产与计划阴道分娩相关的孕产妇死亡率和严重发病率。
CMAJ. 2007 Feb 13;176(4):455-60. doi: 10.1503/cmaj.060870.
10
Maternal request for cesarean section due to fear of birth: can it be changed through crisis-oriented counseling?因害怕分娩而提出剖宫产的产妇:能否通过以危机为导向的咨询来改变?
Birth. 2006 Sep;33(3):221-8. doi: 10.1111/j.1523-536X.2006.00107.x.