Kishimoto Yaya, Ueda Kayo, Igarashi Toshiko, Tanaka Yuu, Kawaguchi Masahiko
Department of Nursing Women's Health and Midwifery, Faculty of Nursing, Nara Medical University School of Medicine, Kashihara, Japan.
Department of Anesthesiology, Heisei Mahoroba Hospital, Kashihara, Japan.
Eur J Midwifery. 2025 May 30;9. doi: 10.18332/ejm/204274. eCollection 2025.
This scoping review aimed to identify effective methods used for decision-making support and their effects on women considering choosing epidural analgesia in labor.
A literature search was conducted using CHNAHL, the Web version of the , and PubMed, and articles were extracted based on the eligibility criteria in September 2024. The PRISMA-ScR was followed. Studies that compared two groups of women considering epidural anesthesia for labor (subject), decision-making support (intervention), and standard care (control) were eligible.
The search identified a total of 732 articles, of which 15 were eligible. Among these, 10 were randomized controlled trials (RCTs), 1 was a non-RCT, and 4 were cohort studies. The most common decision support approach was the distribution of leaflets, which were often given in the second to third trimester of pregnancy. Outcome measurements varied, limiting the identification of the most effective approach. However, most interventions, including controls, showed some effect on improving satisfaction and knowledge. Specifically, interventions incorporating shared decision-making (SDM) influenced satisfaction with the intervention, satisfaction with the birth experience, the feeling of being supported by others, and controlling emotions and attitudes.
This study found that decision support methods include both expert intervention and media-based approaches. However, given the scarcity of related studies and the variability in evaluation measures, the most effective method could not be identified. Nevertheless, an SDM approach may enhance effectiveness. These findings may help those who support pregnancy and childbirth in choosing more effective decision support methods.
本范围综述旨在确定用于决策支持的有效方法及其对考虑选择分娩硬膜外镇痛的女性的影响。
使用CHNAHL、《护理学与健康研究》网络版和PubMed进行文献检索，并根据2024年9月的纳入标准提取文章。遵循PRISMA-ScR。比较两组考虑分娩硬膜外麻醉的女性（受试者）、决策支持（干预）和标准护理（对照）的研究符合要求。
检索共识别出732篇文章，其中15篇符合要求。其中，10篇为随机对照试验（RCT），1篇为非随机对照试验，4篇为队列研究。最常见的决策支持方法是发放传单，通常在妊娠中期至晚期发放。结果测量各不相同，限制了最有效方法的确定。然而，大多数干预措施，包括对照措施，在提高满意度和知识方面都显示出一定效果。具体而言，纳入共同决策（SDM）的干预措施影响了对干预的满意度、对分娩经历的满意度、被他人支持的感觉以及情绪和态度的控制。
本研究发现决策支持方法包括专家干预和基于媒体的方法。然而，鉴于相关研究的稀缺性和评估措施的变异性，无法确定最有效的方法。尽管如此，SDM方法可能会提高有效性。这些发现可能有助于那些支持妊娠和分娩的人选择更有效的决策支持方法。
