School of Nursing and Midwifery, Deakin University, Burwood, Victoria, Australia.
Centre for Quality and Patient Safety Research in the Institute for Health Transformation, Deakin University, Burwood, Victoria, Australia.
Nurs Health Sci. 2022 Mar;24(1):54-64. doi: 10.1111/nhs.12930. Epub 2022 Mar 6.
This study explored clinician perceptions of women's participation in decision-making about antiemetic treatments during pregnancy, and the suitability of the five Choosing Wisely questions to increase women's involvement. The qualitative interpretive descriptive design used semi-structured interviews to capture data. Participants were six obstetricians and six midwives experienced in providing care for pregnant women seeking support for nausea and vomiting at a single private, obstetrician-led maternity health service in Australia. Thematic analysis revealed four themes that captured clinician perspectives about women's participation in decision-making about antiemetic treatments: (i) information gathering; (ii) developing an understanding; (iii) using knowledge; and (iv) making decisions. Clinician attitudes and perspectives, as well as their self-reported styles of communication and negotiation, influenced how they engaged with women during decision-making. While unfamiliar with the five Choosing Wisely questions, almost all participants considered them potentially useful, but for other clinicians. Strategies to actively involve women in decision-making about antiemetics were inconsistently used. The five Choosing Wisely questions may provide a useful tool for clinicians, but further research is needed to better understand women's perspectives and clinician-related barriers to shared decision-making.
本研究探讨了临床医生对女性在怀孕期间参与止吐治疗决策的看法,以及“选择明智”的五个问题是否适合提高女性的参与度。采用半结构化访谈的定性解释性描述设计来获取数据。参与者为 6 名产科医生和 6 名在澳大利亚一家私人、以产科医生为主导的产妇保健服务机构为寻求恶心和呕吐治疗支持的孕妇提供护理方面经验丰富的助产士。主题分析揭示了四个主题,这些主题捕捉了临床医生对女性参与止吐治疗决策的看法:(i)信息收集;(ii)加深理解;(iii)运用知识;(iv)做出决策。临床医生的态度和观点,以及他们自我报告的沟通和谈判风格,影响了他们在决策过程中与女性的互动方式。虽然不熟悉“选择明智”的五个问题,但几乎所有参与者都认为这些问题可能有用,但对其他临床医生来说可能有用。在决策过程中积极让女性参与止吐治疗的策略使用不一致。“选择明智”的五个问题可能为临床医生提供一个有用的工具,但需要进一步研究以更好地了解女性的观点和与临床医生相关的共同决策障碍。