scholarly journals Shared decision‐making and maternity care in the deep learning age: Acknowledging and overcoming inherited defeaters

Author(s):  
Keith Begley ◽  
Cecily Begley ◽  
Valerie Smith
Author(s):  
Laxsini Murugesu ◽  
Olga C. Damman ◽  
Marloes E. Derksen ◽  
Danielle R. M. Timmermans ◽  
Ank de Jonge ◽  
...  

Shared decision-making requires adequate functional health literacy (HL) skills from clients to understand information, as well as interactive and critical HL skills to obtain, appraise and apply information about available options. This study aimed to explore women’s HL skills and needs for support regarding shared decision-making in maternity care. In-depth interviews were held among women in Dutch maternity care who scored low (n = 10) and high (n = 13) on basic health literacy screening test(s). HL skills and perceived needs for support were identified through thematic analysis. Women appeared to be highly engaged in the decision-making process. They mentioned searching and selecting general information about pregnancy and labor, constructing their preferences based on their own pre-existing knowledge and experiences and by discussions with partners and significant others. However, women with low basic skills and primigravida perceived difficulties in finding reliable information, understanding probabilistic information, constructing preferences based on benefit/harm information and preparing for consultations. Women also emphasized dealing with uncertainties, changing circumstances of pregnancy and labor, and emotions. Maternity care professionals could further support clients by guiding them towards reliable information. To facilitate participation in decision-making, preparing women for consultations (e.g., agenda setting) and supporting them in a timely manner to understand benefit/harm information seem important.


2018 ◽  
Vol 1 (1) ◽  
Author(s):  
Fontein-Kuipers Yvonne

Objective: This study aims to explore women’s traumatic childbirth experiences in order to make maternity care professionals more aware of women’s intrapartum care needs to prevent traumatic experiences. Methods: A qualitative exploratory study with a constant comparison/ grounded theory design was performed. Thirty-six interviews were conducted with women who had given birth in a Dutch birth setting. Findings: Four themes, playing a profound role in the occurrence of traumatic birth experiences, emerged: 1 Midwife-LED care – Maternity care professionals’ unilateral decision making during intrapartum care. 2. Alienation – Women’s experiences of feeling distant and estranged from the childbirth event and the experience. 3. Situatedness – The difference of the impact of interventions in situations when complications or emergencies are present in contrast to when interventions are performed without an emergency reason. 4. Discrepancies - Paradoxes between expectations (ought self) and reality (actual self) - on an interpersonal (woman) and intrapersonal (woman-midwife) level. Implications for practice: Intrapartum care needs to include informed-consent and shared-decision making. Practitioners need to continuously evaluate if the woman is consistently part of her own childbearing process. Practitioners need to provide personalised care, make an effort to explain (emergency) situations, be conscious of their non-verbal communication and maintain an ongoing dialogue with the woman. Conclusion: Intrapartum care can be adapted, adopting a woman-centred approach, in order to prevent women’s traumatic childbirth experiences. This study can serve as a valuable assistance for maternity services, midwifery practice, research and for developing guidance in the field of midwifery practitioners’ education. Keywords: Traumatic birth experience, Maternity care, Intrapartum care, Informed-consent, Shared-decision making, Woman-centred care, Qualitative research.


Birth ◽  
2018 ◽  
Vol 45 (3) ◽  
pp. 245-254 ◽  
Author(s):  
Joyce Molenaar ◽  
Irene Korstjens ◽  
Marijke Hendrix ◽  
Raymond de Vries ◽  
Marianne Nieuwenhuijze

2019 ◽  
Vol 25 (6) ◽  
pp. 1113-1120 ◽  
Author(s):  
Keith Begley ◽  
Deirdre Daly ◽  
Sunita Panda ◽  
Cecily Begley

Birth ◽  
2015 ◽  
Vol 42 (4) ◽  
pp. 299-308 ◽  
Author(s):  
Kim J. Cox ◽  
Marit L. Bovbjerg ◽  
Melissa Cheyney ◽  
Lawrence M. Leeman

2014 ◽  
Vol 14 (1) ◽  
Author(s):  
Marianne J Nieuwenhuijze ◽  
Irene Korstjens ◽  
Ank de Jonge ◽  
Raymond de Vries ◽  
Antoine Lagro-Janssen

2014 ◽  
Vol 21 (1) ◽  
pp. 15-23 ◽  
Author(s):  
Helen Pryce ◽  
Amanda Hall

Shared decision-making (SDM), a component of patient-centered care, is the process in which the clinician and patient both participate in decision-making about treatment; information is shared between the parties and both agree with the decision. Shared decision-making is appropriate for health care conditions in which there is more than one evidence-based treatment or management option that have different benefits and risks. The patient's involvement ensures that the decisions regarding treatment are sensitive to the patient's values and preferences. Audiologic rehabilitation requires substantial behavior changes on the part of patients and includes benefits to their communication as well as compromises and potential risks. This article identifies the importance of shared decision-making in audiologic rehabilitation and the changes required to implement it effectively.


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