Graduate School of Biomedical and Sciences, Hiroshima University, Hiroshima, Japan.
Nurs Health Sci. 2020 Dec;22(4):1186-1196. doi: 10.1111/nhs.12791.
This study aimed to explore the competencies of health care practitioners who promote shared decision-making (SDM)-based care for women facing an unplanned pregnancy in Japan. We conducted semistructured interviews with 12 care providers who are pioneers in care for women facing an unplanned pregnancy and adopted a modified grounded theory approach for data analysis. A three-step model for shared decision making in practice (team talk, option talk, and decision talk) was used as a reference. The answers given by the care providers were analyzed to identify the competencies involved in shared decision making. We identified three stages: (i) building trust and promoting women's expression; (ii) discussing women's real needs; and (iii) exploring the intentions and goals expressed by women and finding the best choices while promoting women's autonomy in decision-making. The coordination between the support of partners, families, and professionals, and the care provided to strengthen women's identities facilitated shared decision making. Women facing an unplanned pregnancy can benefit from interventions designed to improve shared decision making. A key component of shared decision making-based care relates to practitioners' raised awareness toward their roles and responsibilities: developing good communication skills and fostering collaboration between all stakeholders.
本研究旨在探讨日本为意外怀孕女性提供以共享决策(SDM)为基础的护理的医疗保健从业者的能力。我们对 12 名从事意外怀孕女性护理的先驱者进行了半结构化访谈,并采用了改良的扎根理论方法进行数据分析。参考了实践中共享决策的三个步骤模型(团队讨论、方案讨论和决策讨论)。分析了护理提供者的回答,以确定共享决策中涉及的能力。我们确定了三个阶段:(i)建立信任和促进女性表达;(ii)讨论女性的真实需求;(iii)探索女性表达的意图和目标,并在促进女性决策自主性的同时寻找最佳选择。合作伙伴、家庭和专业人员的支持与加强女性身份的护理之间的协调促进了共享决策。意外怀孕的女性可以从旨在改善共享决策的干预措施中受益。基于共享决策的护理的一个关键组成部分涉及从业者对其角色和责任的意识提高:发展良好的沟通技巧,并促进所有利益相关者之间的合作。