Samsami Khatoon, Chananeh Maryam, Kamali Farahnaz, Bagherzadeh Razieh
Bushehr University of Medical Sciences.
Nurs Ethics. 2025 Feb;32(1):222-235. doi: 10.1177/09697330241248736. Epub 2024 May 16.
Although there have been reports of misbehavior and disrespectful maternal care by healthcare providers worldwide, there are few intervention studies aimed at promoting respectful care, particularly among midwives.
The aim of this study was to examine the effect of Moral Case Deliberation (MCD) on the of midwives' knowledge and practice in the field of respectful maternity care.
This semi-experimental study involved 46 midwives working in the maternity departments of two hospitals affiliated with Bushehr University of Medical Sciences in 2023. The two hospitals were randomly divided into control and intervention groups. All midwives from both hospitals were included in the study. The Dilemma Method of MCD was implemented for midwives of intervention hospital. The Midwives' Knowledge and Practice of Respectful Maternity Care scale was used for data collection. It was administered both before and two weeks after the intervention. Data were analyzed using SPSS (version 20).
The study was approved by ethics committee of Bushehr University of Medical Sciences in Bushehr, Iran (ethics code: IR.BPUMS.REC.1402.017). All participants provided written informed consent.
The intervention group showed a significantly greater increase in knowledge scores from pre-test to post-test compared to the control group ( < .001). The intervention group had a significantly higher mean change score in practice self-assessment and practice peer evaluation, from pre-test to post-test, than in the control group ( < .001).
MCD based on the dilemma method can improve practice in the field of respect-oriented midwifery care by increasing knowledge and potentially changing attitudes.
The Dilemma Method of MCD improved midwives' knowledge and practice regarding respectful maternity care. This method can be included in the midwifery care quality improvement program to promote respectful maternity care. It is necessary to develop methods for wider dissemination of MCD in the cultural context of Iran.
尽管全球都有医疗服务提供者行为不当和产妇护理不尊重的报道，但旨在促进尊重性护理的干预研究很少，尤其是在助产士中。
本研究的目的是检验道德案例审议（MCD）对助产士在尊重性产妇护理领域的知识和实践的影响。
这项半实验研究涉及2023年在布什尔医科大学附属的两家医院产科工作的46名助产士。两家医院被随机分为对照组和干预组。两家医院的所有助产士都纳入了研究。对干预医院的助产士实施了MCD的困境法。使用助产士尊重性产妇护理知识与实践量表进行数据收集。在干预前和干预后两周进行施测。使用SPSS（版本20）进行数据分析。
该研究得到了伊朗布什尔布什尔医科大学伦理委员会的批准（伦理代码：IR.BPUMS.REC.1402.017）。所有参与者均提供了书面知情同意书。
与对照组相比，干预组从测试前到测试后的知识得分显著提高（<.001）。干预组在实践自我评估和实践同伴评估中，从测试前到测试后的平均变化得分显著高于对照组（<.001）。
基于困境法的MCD可以通过增加知识和潜在地改变态度来改善以尊重为导向的助产护理领域的实践。
MCD的困境法提高了助产士在尊重性产妇护理方面的知识和实践。这种方法可以纳入助产护理质量改进计划，以促进尊重性产妇护理。有必要在伊朗的文化背景下开发更广泛传播MCD的方法。
