Department Health Care, Brussels Centre for Healthcare Innovation, Erasmus Brussels University of Applied Sciences and Arts, Brussels, Belgium.
Faculty of Medicine and Pharmacy, Department of Public Health, Biostatistics and Medical Informatics Research group, Vrije Universiteit Brussel (VUB), Brussels, Belgium.
J Adv Nurs. 2022 Sep;78(9):2849-2860. doi: 10.1111/jan.15209. Epub 2022 Mar 9.
Although there is substantial literature on autonomy of midwifery, the concept remains vague, and what it exactly constitutes is little clear. Attempts to define this have been carried out, but did not result in a communal understanding. The aim of this study therefore was to define a consistent definition of midwifery autonomy in Belgium.
A modified Delphi survey with content experts.
Critical components of the available definitions on midwifery autonomy were retrieved from the literature, and translated into Dutch and French. An online Delphi panel of content expert assessed components of autonomy in midwifery on clarity and relevance between June and October 2021. From the validated components, a preliminary consolidated definition was generated, which was validated in a final Delphi round.
After round one, content experts (n = 27) evaluated 10 out of 17 components to be clear and relevant. Two components were judged inappropriate and therefore removed. After further adaptation four additional components were identified appropriate after the second round, and one component after a third Delphi round. Experts' suggestions for improving the clarity and relevance were taken into account. Finally, experts assessed the preliminary definition. After minor modifications the definition of midwifery autonomy in Belgium was confirmed valid.
We established a communal definition of midwifery autonomy in Belgium, the creation of such a definition results in a joint understanding of the concept of midwifery autonomy.
If midwives internationally want to successfully achieve autonomy, a clear understanding of the concept of midwifery autonomy is needed. The consensus definition of midwifery autonomy in Belgium comprises 15 components related to midwives' work content, professionalism and relationship with others. Our definition of midwifery autonomy has the potential to encourage an international dialogue, grounded in a common understanding of autonomy, enabling stakeholders in maternity care to strengthen professional midwifery autonomy.
尽管有大量关于助产自主性的文献，但该概念仍然模糊不清，其具体构成也不太清楚。人们已经尝试对其进行定义，但并未达成共识。因此，本研究的目的是在比利时为助产自主性定义一个一致的定义。
一项使用内容专家的改良 Delphi 调查。
从文献中检索到助产自主性现有定义的关键组成部分，并将其翻译成荷兰语和法语。一个在线 Delphi 小组的内容专家于 2021 年 6 月至 10 月评估了助产自主性的自主性组成部分的清晰度和相关性。根据经过验证的组成部分，生成了一个初步的综合定义，并在最终的 Delphi 轮中进行了验证。
在第一轮之后，内容专家（n=27）评估了 17 个组成部分中的 10 个，认为它们清晰且相关。两个组成部分被认为不恰当，因此被删除。经过进一步调整，第二轮又确定了四个适当的组成部分，第三轮又确定了一个组成部分。专家们对提高清晰度和相关性的建议进行了考虑。最后，专家评估了初步定义。经过一些修改，比利时助产自主性的定义得到了确认。
我们在比利时建立了助产自主性的共识定义，这一定义的制定促成了对助产自主性概念的共同理解。
如果国际助产士要成功实现自主性，就需要清楚地了解助产自主性的概念。比利时助产自主性的共识定义包括与助产士工作内容、专业性和与他人关系相关的 15 个组成部分。我们对助产自主性的定义有可能鼓励国际对话，以共同理解自主性为基础，使产妇护理利益相关者能够加强专业助产自主性。
