Women's perceptions of informed choice in maternity care
Women's perceptions of informed choice in maternity care
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DOI：
10.1054/midw.2002.0301
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发表时间：
2002-06-01
期刊：
影响因子：
2.7
通讯作者：
Kirkham, M
中科院分区：
文献类型：
--
作者：
O'Cathain, A;Thomas, K;Kirkham, M
目的：描述使用产科服务的妇女认为她们行使了知情选择的程度。环境：威尔士有12个产科单位。设计：对使用产科服务的妇女进行邮政调查，包括妇女对她们在总体上行使知情选择的程度的看法，以及在护理期间的八个决策点。参与者：1386名怀孕约28周的妇女（产前样本）和1741名分娩后约8周的妇女（产后样本）。测量结果和发现：54%的妇女认为她们在产前样本中总体上行使了知情选择（95% CI: 51-57%），在产后样本中总体上54% （95% CI: 52-56%）。对知情选择的看法因决策点而异，分娩过程中胎儿心脏监测的比例为31%，婴儿唐氏综合征和脊柱裂筛查试验的比例为73%。即使考虑到产妇的特点，各产妇单位的情况也有所不同。多胎妇女、从事体力劳动的妇女和受教育程度较低的妇女更有可能认为她们在产前保健中行使了知情选择。这些妇女亚组也更有可能报告说，她们倾向于不与卫生专业人员分享决策。结论：为数众多的少数妇女认为，她们在产妇护理方面总体上没有行使知情选择。对知情选择的感知因决策点、分娩单位和妇女特征而异。对实践的影响：获得知情的选择是更大的挑战，在一些决策点在产妇护理比其他，特别是胎儿监测。产科单位之间知情选择水平的差异突出了产科单位政策在促进知情选择方面的重要性。(C) 2002年Elsevier Science Ltd.出版
Objective: to describe the extent to which women using maternity services perceive that they have exercised informed choice.Setting: twelve maternity units in Wales.Design: postal survey of women using maternity services, covering women's views of the extent to which they exercised informed choice overall, and at eight decision points during their care.Participants: 1386 women at approximately 28 weeks gestation (antenatal sample) and 1741 women at approximately 8 weeks post delivery (postnatal sample).Measurements and findings: 54% of women perceived that they exercised informed choice overall in the antenatal sample (95% CI: 51-57%) and 54% overall in the postnatal sample (95% CI: 52-56%). Perceptions of informed choice differed by decision point, varying between 31% for fetal heart monitoring during labour and 73% for the screening test for Down's syndrome and Spina bifida in the baby. There were differences by maternity unit, even when the characteristics of women attending these units were taken into account. Multiparous women, women from manual occupations and women with lower educational status were more likely to feel that they exercised informed choice during antenatal care. These sub-groups of women were also more likely to report a preference for not sharing decision-making with health professionals.Conclusions: a large minority of women felt that they had not exercised informed choice overall in their maternity care. The perception of informed choice differed by decision point, maternity unit and characteristics of the woman.Implications for practice: attaining informed choice is more of a challenge for some decision points in maternity care than others, particularly fetal monitoring. The difference in levels of informed choice between maternity units highlights the importance of maternity unit policy in the promotion of informed choice. (C) 2002 Published by Elsevier Science Ltd.