School of Nursing and Midwifery, Deakin University, Geelong, Victoria, Australia.
Centre for Quality and Patient Safety Research - Western Health Partnership, Sunshine, Victoria, Australia.
Health Expect. 2024 Dec;27(6):e70107. doi: 10.1111/hex.70107.
Shared decision-making is recommended as a person-centred approach to decision-making in antenatal care. Little is known about the implementation of shared decision-making in antenatal care.
An exploratory study to understand how shared decision-making is implemented in antenatal clinics and whether body mass index influences maternity clinicians' use of shared decision-making when providing antenatal care for women.
Twenty-six antenatal clinic consultations were audio-recorded with maternity clinicians and women with body mass index ≥ 35 kg/m, and a comparison group of women with body mass index 18.5-24.9 kg/m. Data were analysed quantitatively using the OPTION12 scale. Narrative case studies are presented to compare shared decision-making behaviour related to induction of labour.
Twelve clinicians and 26 pregnant women were recruited to the study. The total scores ranged from 0 to 24, with a mean score of 9 and a median of 9.5 indicating low implementation of shared decision-making by clinicians and limited involvement of women in decision-making. No difference was observed in OPTION12 scores in decision-making for women by body mass index.
This study suggests that shared decision-making is limited in the antenatal clinic setting for all women, regardless of body mass index. Further research is required to confirm the findings of this exploratory study.
The perspectives of women with body mass index ≥ 35 kg/m informed many aspects of this study including the language/terminology adopted by researchers. A consumer group reviewed the language used in the study materials, to ensure readability and avoidance of stigmatising terminology.
共享决策被推荐为一种以患者为中心的产前保健决策方法。对于产前保健中共享决策的实施情况知之甚少。
本探索性研究旨在了解共享决策如何在产前诊所实施，以及体重指数（BMI）是否会影响产科临床医生在为 BMI≥35kg/m2 的女性提供产前护理时使用共享决策。
对 26 次有产科临床医生和 BMI≥35kg/m2 的女性以及 BMI 为 18.5-24.9kg/m2 的女性参加的产前诊所咨询进行录音，并使用 OPTION12 量表对数据进行定量分析。通过叙述性案例研究比较与引产相关的共享决策行为。
本研究共招募了 12 名临床医生和 26 名孕妇。总分为 0-24 分，平均得分为 9 分，中位数为 9.5 分，表明临床医生的共享决策实施程度较低，女性参与决策的程度有限。BMI 对决策无影响。
本研究表明，无论 BMI 如何，共享决策在产前诊所的实施都受到限制。需要进一步研究来证实这项探索性研究的结果。
BMI≥35kg/m2 的女性的观点为这项研究的许多方面提供了信息，包括研究人员采用的语言/术语。一个消费者小组审查了研究材料中使用的语言，以确保易读性并避免使用污名化术语。
