Clinicians’ views of factors influencing decision-making for caesarean section: A systematic review and metasynthesis of qualitative, quantitative and mixed methods studies

IntroductionGlobally, about half of all pregnancies are unintended and/or unwanted and three-fifths of these end in induced abortion. When faced with a choice to terminate pregnancy, women’s abortion decision-making processes are often complex and multiphasic and maybe amplified in low- and middle-income countries (LMICs) which bear the major burden of abortion-related morbidity and mortality. Our review aims to (1) describe abortion decision-making trajectories for women in LMICs and (2) investigate factors influencing the choice of abortion decision-making trajectories in LMICs.Methods and analysisWe will search and retrieve published and unpublished qualitative, quantitative and mixed-methods, community and/or hospital-based studies conducted in LMICs from 1 January 2000 up to 16 February 2021. We will search Ovid Medline, Ovid EMBASE, Ovid PsycInfo, Ovid Global Health, Web of Science (including Social Science Citation Index), Scopus, IBSS, CINAHL via EBSCO, WHO Global Index Medicus, the Cochrane Library, WHO website, ProQuest and Google Scholar. We will search reference lists of eligible studies and contact experts for additional data/information, if required. We will extract all relevant data to answer our research questions and assess study quality using the appropriate appraisal tools. Depending on the extracted data, our analysis will use sequential or convergent synthesis methods proposed by Hong et al. For qualitative studies, we will synthesise evidence using thematic synthesis, meta-ethnography or ‘best-fit’ framework synthesis; and for quantitative findings, we will provide a narrative synthesis and/or meta-analysis. We will do sensitivity analyses and assess confidence in our findings using Grades of Recommendation, Assessment, and Evaluation –Confidence in Evidence from Reviews of Qualitative Research (GRADE-CERQUal) for qualitative findings and Grades of Recommednation, Assessment, and Evaluation (GRADE) for quantitative findings.Ethics and disseminationWe did not require ethics approval for this systematic review. We will publish our findings in an open-access peer-reviewed journal with global and maternal health readership. We will also present our findings at national and international scientific conferences.

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Factors influencing the negotiation of ethnic identity among 1.5 and second-generation Asian migrants: A mixed methods systematic review

Journal of Adolescence ◽

10.1016/j.adolescence.2021.04.005 ◽

2021 ◽

Vol 89 ◽

pp. 95-112

Author(s):

Lovely Dizon ◽

Vanessa Selak ◽

Rodrigo Ramalho ◽

Roshini Peiris-John

Keyword(s):

Systematic Review ◽

Ethnic Identity ◽

Mixed Methods ◽

Second Generation ◽

Factors Influencing

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Factors influencing decision-making to accept elective caesarean section: A descriptive cross-sectional study

Heliyon ◽

10.1016/j.heliyon.2021.e07755 ◽

2021 ◽

pp. e07755

Author(s):

Victoria Bam ◽

Alberta Yemotsoo Lomotey ◽

Abigail Kusi-Amponsah Diji ◽

Hayford Isaac Budu ◽

Dorothy Bamfo-Ennin ◽

...

Keyword(s):

Decision Making ◽

Caesarean Section ◽

Elective Caesarean Section ◽

Cross Sectional Study ◽

Sectional Study ◽

Cross Sectional ◽

Factors Influencing

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A qualitative systematic review of factors influencing parents’ vaccination decision-making in the United Kingdom

SSM - Population Health ◽

10.1016/j.ssmph.2016.07.005 ◽

2016 ◽

Vol 2 ◽

pp. 603-612 ◽

Cited By ~ 14

Author(s):

Alice S. Forster ◽

Lauren Rockliffe ◽

Amanda J. Chorley ◽

Laura A.V. Marlow ◽

Helen Bedford ◽

...

Keyword(s):

Systematic Review ◽

Decision Making ◽

United Kingdom ◽

The United Kingdom ◽

Factors Influencing ◽

Qualitative Systematic Review ◽

Vaccination Decision

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P077 What matters to Ulcerative Colitis patients when they make treatment decisions? A systematic review

Journal of Crohn s and Colitis ◽

10.1093/ecco-jcc/jjab076.206 ◽

2021 ◽

Vol 15 (Supplement_1) ◽

pp. S180-S180

Author(s):

A M Folan ◽

G Jones ◽

D Baker ◽

S Brown ◽

M Lee ◽

...

Keyword(s):

Systematic Review ◽

Ulcerative Colitis ◽

Decision Making ◽

Mixed Methods ◽

Elective Surgery ◽

Treatment Decisions ◽

Physical Symptoms ◽

Adherence To Medication ◽

What Matters

Abstract Background The decision for ulcerative colitis (UC) patients to opt for elective surgery or continue medical treatment is dependent on patient preferences taking into account a range of factors. In addition to choosing between medical and surgical treatment, patients undergoing elective surgery are presented with a further decision regarding which operation to choose. The aim of this systematic review is to identify and understand what matters to UC patients when they are making these decisions. Methods Five electronic databases (PubMed, Scopus, CINAHL, Medline, and Embase) were searched for relevant literature up to 15 October 2020. Qualitative, quantitative and mixed-methods studies were included in this review. Studies reporting on what was important to UC patients (over 16 years of age) when they make treatment decisions were included. The Mixed Methods Appraisal Tool was used to assess the quality of the papers. Thematic analysis was used to analyse the data. Results The searches identified 6,917 papers and a final 19 (eight quantitative, seven qualitative, four mixed methods) papers were included. All studies were published since 2007 and included a total of 3,328 participants from nine countries. Five overarching themes (and their associated 20 sub-themes) were generated to describe the factors reported as important to UC patients in making treatment decisions. These were: 1. Information provision (information content, knowledge about their illness, quality of information); 2. Impact of the treatment upon daily life (controlling physical symptoms, quality of life); 3. Levels of risk (trade-off, high risk, concern and worry); 4. Burden of treatment (the need to see benefits of medication, route and size of medication, side effects, dosing frequency, costs, effort of being the patient, adherence to medication, surgery concerns, timing of surgery); and 5. Patient-clinician relationship (shared decision-making, communication, mismatch between what clinicians and patients consider to be important). Conclusion Communication between patients and their IBD teams should take into account the range of factors that influence their treatment decision making. Decision support interventions that incorporate such factors may better support the patient-clinician relationship and improve knowledge of treatment options and how these impact on what matters to them. Future studies are needed to determine which factors identified in this review are dominant.

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