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产妇选择引产的共同决策体验。

The experiences of shared decision-making of women who had an induction of labour.

机构信息

University of Technology Sydney, Faculty of Health, Centre for Midwifery and Child and Family Health, Sydney, Australia.

School of Women's and Children's Health, UNSW Medicine, UNSW, Australia.

出版信息

Patient Educ Couns. 2021 Mar;104(3):489-495. doi: 10.1016/j.pec.2020.08.020. Epub 2020 Aug 18.

DOI:10.1016/j.pec.2020.08.020
PMID:32843263
Abstract

OBJECTIVES

The importance of shared decision-making (SDM) in relation to induction of labour (IOL) is recognised, little is known about women's experiences of and satisfaction with decision-making and how this can be improved. The aim of this study was to 1) gain insight into women's experiences of SDM in relation to IOL, 2) understand the factors associated with satisfaction versus dissatisfaction during SDM, and 3) identify recommendations for service improvement.

METHODS

Qualitative semi-structured telephone interviews were conducted with 32 women who had a recent IOL at one of eight public hospitals in Sydney, Australia. An inductive approach to coding and categorisation of themes was used.

RESULTS

While women reported varied experiences with SDM, many reported not feeling that they had a choice about IOL, not being presented with the risks and benefits of different birth options, and receiving insufficient information about the IOL process and methods. Satisfaction versus dissatisfaction with SDM appeared more closely related to a woman's willingness to have an IOL and their willingness to defer decision-making, rather than the process of SDM. Recommendations for improvement included improved SDM practices, access to guidelines and continuity of care.

CONCLUSION

There is a need to improve SDM processes around IOL.

PRACTICE IMPLICATIONS

Particular areas for improvement include more comprehensive discussions surrounding the pros and cons of different birth methods and the IOL process. Decision aids and clinician training may assist with SDM.

摘要

目的

人们已经认识到共同决策(SDM)在引产(IOL)中的重要性,但对于女性在决策过程中的体验和满意度,以及如何改进这一过程,我们知之甚少。本研究旨在:1)深入了解女性在 IOL 方面的 SDM 体验;2)了解与 SDM 满意度相关的因素;3)确定服务改进的建议。

方法

对澳大利亚悉尼 8 家公立医院最近接受 IOL 的 32 名女性进行了定性半结构式电话访谈。采用归纳法对主题进行编码和分类。

结果

虽然女性报告了不同的 SDM 体验,但许多人表示她们对 IOL 没有选择,没有被告知不同分娩选择的风险和益处,也没有收到关于 IOL 过程和方法的足够信息。SDM 的满意度与女性是否愿意接受 IOL 以及是否愿意推迟决策有关,而与 SDM 过程关系不大。改进的建议包括改进 IOL 的 SDM 实践、获得指南和护理的连续性。

结论

需要改进 IOL 方面的 SDM 流程。

实践意义

需要改进的特定领域包括更全面地讨论不同分娩方法和 IOL 过程的优缺点。决策辅助工具和临床医生培训可能有助于 SDM。

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