School of Health Sciences (HESAV), University of Applied Sciences and Arts, Western Switzerland (HES-SO), Av. de Beaumont 21, 1011 Lausanne, Switzerland.
Institute of Midwifery, School of Health Professions, Zurich University of Applied Sciences, Switzerland.
Midwifery. 2019 Nov;78:97-103. doi: 10.1016/j.midw.2019.08.005. Epub 2019 Aug 9.
To increase understanding of integrative power in decision-making in home-like childbirth from midwives' and women's perspectives.
A qualitative multiple case study.
Two regions of Switzerland, a French and a German-speaking.
Twenty interviews with midwives and 20 with women and some partners who had experienced complications in home-like births.
Data were collected from in-depth interviews relevant for casestudy. Four cases during second stage of labour were carefully selected using literal replication logic. Interview transcripts were analysed in developing case descriptions and in interpreting mechanisms related to perception of power in making decision.
The analysis of each case and a cross-case comparison showed that mechanisms for building integrative power, such as creation of relationships, cooperation, loyalty, legitimacy and respect, were highly visible in midwifery decision-making activities.
The study highlighted the visibility of integrative power mechanisms in decision-making in homelike settings. Until now, mechanisms of positive power in midwifery have been poorly described in literature. Integrative power could be a promising strategy to reinforce decision-making strategies. Therefore, clinical and policy measures explicitly addressing the positive aspects of power should be developed and evaluated.
从助产士和妇女的角度增加对家庭式分娩决策中综合能力的理解。
定性的多案例研究。
瑞士的两个地区，一个说法语，一个说德语。
对经历过家庭式分娩并发症的 20 名助产士和 20 名妇女及其部分伴侣进行了 20 次访谈。
从相关的深入访谈中收集案例研究数据。使用文字复制逻辑仔细选择四个产程第二阶段的案例。对访谈记录进行分析，以描述案例和解释与感知权力相关的机制，从而做出决策。
对每个案例的分析和跨案例比较表明，在助产士决策活动中，建立综合能力的机制，如建立关系、合作、忠诚、合法性和尊重，是非常明显的。
该研究强调了在家庭式环境中决策中综合能力机制的可见性。到目前为止，文献中对助产积极权力机制的描述还很不完善。综合能力可能是加强决策策略的一个有前途的策略。因此，应制定和评估明确针对权力积极方面的临床和政策措施。
