Mode of delivery in the context of periviable birth: informed deference and shared decision-making.
Mode of delivery in the context of periviable birth: informed deference and shared decision-making.
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围产期的分娩方式：知情尊重和共同决策。
DOI：
10.1038/s41372-022-01537-9
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发表时间：
2023
期刊：
影响因子：
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通讯作者：
TuckerEdmonds,Brownsyne
中科院分区：
文献类型：
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作者：
Bode,LeahM;Jager,ShannonM;Panoch,Janet;Hoffman,ShelleyM;Laitano,Tatiana;Kavanaugh,Karen;TuckerEdmonds,Brownsyne
目的定性评价妇女对围生期（22 ~ 25周）分娩方式共同决策的看法。研究设计：在2016年9月至2018年1月期间，在中西部两家学术医院对30名因难产而住院的妇女进行了访谈。分娩前（T1）和产后3个月（T2），采用提示法探讨mod相关决策。访谈使用NVivo 12进行编码和分析。结果大多数妇女认为剖宫产或阴道分娩是分娩方式。大多数人最终选择了“对孩子最好的”。对MOD风险的了解有限，医生同样推荐每种选择。16名参与者在T1时认为自己是决策者，而在T2时，只有9名参与者认为自己是决策者。结论知情服从作为一个新概念被引入到可持续性MOD决策中，即母亲将决策权服从于提供者、婴儿、更高权力或环境本身。
ObjectiveTo qualitatively evaluate women’s perspectives on shared decision-making for periviable (22–25 weeks’ gestational age) mode of delivery (MOD).Study DesignInterviews were conducted at two Midwestern academic hospitals with 30 women hospitalized for threatened periviable delivery between September 2016 and January 2018. Prior to delivery (T1) and at 3-months postpartum (T2), MOD-related decision-making was explored using prompts. Interviews were coded and analyzed using NVivo 12.ResultThe majority of women perceived the MOD options as cesarean section or vaginal delivery. Most ultimately preferred “whatever’s best for baby.” Understanding of MOD risks was limited, and physicians recommended each option equally. Sixteen participants perceived themselves as decision-makers at T1, while at T2, only nine participants identified themselves as such.ConclusionInformed deference is introduced as a novel concept in the setting of periviable MOD decision-making, whereby the mother defers decisional authority to the provider, the baby, a higher power, or the circumstance itself.