Department of Public and Occupational Health, Amsterdam Public Health, Amsterdam UMC, University of Amsterdam, 1105 AZ Amsterdam, The Netherlands.
Department of Public and Occupational Health, Amsterdam Public Health, Amsterdam UMC, Vrije Universiteit Amsterdam, 1081 HV Amsterdam, The Netherlands.
Int J Environ Res Public Health. 2021 Jan 27;18(3):1130. doi: 10.3390/ijerph18031130.
Shared decision-making requires adequate functional health literacy (HL) skills from clients to understand information, as well as interactive and critical HL skills to obtain, appraise and apply information about available options. This study aimed to explore women's HL skills and needs for support regarding shared decision-making in maternity care. In-depth interviews were held among women in Dutch maternity care who scored low ( = 10) and high ( = 13) on basic health literacy screening test(s). HL skills and perceived needs for support were identified through thematic analysis. Women appeared to be highly engaged in the decision-making process. They mentioned searching and selecting general information about pregnancy and labor, constructing their preferences based on their own pre-existing knowledge and experiences and by discussions with partners and significant others. However, women with low basic skills and primigravida perceived difficulties in finding reliable information, understanding probabilistic information, constructing preferences based on benefit/harm information and preparing for consultations. Women also emphasized dealing with uncertainties, changing circumstances of pregnancy and labor, and emotions. Maternity care professionals could further support clients by guiding them towards reliable information. To facilitate participation in decision-making, preparing women for consultations (e.g., agenda setting) and supporting them in a timely manner to understand benefit/harm information seem important.
共享决策需要客户具备足够的功能性健康素养 (HL) 技能来理解信息，以及互动和批判性 HL 技能来获取、评估和应用有关可用选项的信息。本研究旨在探讨女性在母婴保健中共享决策方面的 HL 技能和支持需求。在荷兰母婴保健中，对基本健康素养筛查测试得分较低（= 10）和较高（= 13）的女性进行了深入访谈。通过主题分析确定了 HL 技能和感知到的支持需求。女性似乎高度参与决策过程。她们提到搜索和选择有关怀孕和分娩的一般信息，根据自己预先存在的知识和经验以及与伴侣和重要他人的讨论来构建自己的偏好。然而，基本技能较低和初产妇的女性在寻找可靠信息、理解概率信息、根据受益/危害信息构建偏好以及为咨询做准备方面遇到了困难。女性还强调了应对不确定性、怀孕和分娩情况的变化以及情绪。母婴保健专业人员可以通过指导客户获取可靠信息来进一步为客户提供支持。为了促进参与决策，为咨询做好准备（例如，设定议程）并及时支持女性理解受益/危害信息似乎很重要。
