Needs of parents and professionals to improve shared decision‐making in interprofessional maternity care practice: A qualitative study

Molenaar, J Jaap; Korstjens, Irene; Hendrix, Marijke; Vries, Raymond De; Nieuwenhuijze, Marianne

doi:10.1111/birt.12379

Cited by 40 publications

(41 citation statements)

References 39 publications

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“…It has been found that such requests can also create difficult situations for clinicians who may find it difficult to refuse a woman's requests for postterm IOL. Our findings pointed to the lack of information given to women, which aligns with studies of IOL information leaflets showing that pregnant women (even within the same country) received very different, sometimes even contradictory, information about IOL 51,52 and that decision aids 29,52,53 and/or shared decision-making interventions 54 are required. Our findings show that room for such an adjustment was not always provided and indicate that induced women may need supported opportunities to re-evaluate their hopes and expectations for the labor process, for example, the opportunity to review their birth plans in collaboration with their clinicians.…”

Section: Discussionsupporting

confidence: 82%

“…49,50 This nuanced information and time to reflect on it is particularly important because the bias toward IOL acceptance is very strong. Our findings pointed to the lack of information given to women, which aligns with studies of IOL information leaflets showing that pregnant women (even within the same country) received very different, sometimes even contradictory, information about IOL 51,52 and that decision aids 29,52,53 and/or shared decision-making interventions 54 are required.…”

Section: Discussionsupporting

confidence: 82%

“…Moreover, only one included study 36 mentioned the role of the partner. However, as Molenaar et al 54 found, prospective parents considered it of vital importance that both partners were always involved in shared decision making; thus, future studies should investigate the partners' involvement in and experience of IOL.…”

Section: Discussionmentioning

confidence: 99%

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Women‘s experiences of postterm induction of labor: A systematic review of qualitative studies

Lou

Hvidman

Uldbjerg

et al. 2018

Birth

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Background: Over the last decade, induction of labor (IOL) in postterm pregnancies has increased. Studies have shown the medical advantages of postterm IOL, but less is known about the perspectives of the pregnant women. This review aimed to summarize the current qualitative evidence on women's experience of postterm IOL. Methods: A systematic literature search was performed in three databases. A total of 3193 publications were identified, but only eight studies met the inclusion criteria.Thematic analysis guided the data extraction and synthesis. The Confidence in the Evidence for Reviews of Qualitative research (CERQual) approach was used to assess confidence in the findings. Results: Three major findings were identified. First, for some women, IOL required a shift in expectations because the hope of spontaneous labor had to be given up.Second, the IOL decision was considered a recommendation from health care professionals and was experienced as a nondecision. Finally, the induction process was experienced as a sequential set of steps where the women were expected to fit into the existing hospital organization. The CERQual assessment suggested moderate confidence in all findings. Discussion: The negative experiences identified in this review can be greatly reduced by a communicative and patient-centered approach. To support informed choice and shared decision making, women need high-quality, unbiased information about IOL, alternative options, and potential outcomes, in addition to time for reflection on their personal values and preferences. Women may need a professionally initiated and supported opportunity to re-evaluate their hopes and expectations before IOL. K E Y W O R D Sexperience, induction of labor, postterm pregnancy, qualitative research, systematic review

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Section: Discussionsupporting

confidence: 82%

Section: Discussionsupporting

confidence: 82%

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Women‘s experiences of postterm induction of labor: A systematic review of qualitative studies

Lou

Hvidman

Uldbjerg

et al. 2018

Birth

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“…8,23,24 Little is known about maternity care practitioners' attitudes about doulas and whether they view doulas as interprofessional team members. 8,23,24 Little is known about maternity care practitioners' attitudes about doulas and whether they view doulas as interprofessional team members.…”

mentioning

confidence: 99%

“…Interprofessional care teams reduce clinical errors, improve outcomes, and enhance patient satisfaction on labor and delivery floors. 8,23,24 Little is known about maternity care practitioners' attitudes about doulas and whether they view doulas as interprofessional team members. Conflict between doulas and maternity care practitioners has been documented, especially around medical decision-making.…”

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confidence: 99%

Hospital‐based maternity care practitioners’ perceptions of doulas

Neel

Goldman

Marte

et al. 2019

Birth

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Introduction A birth doula provides continuous informational, physical, and emotional support during pregnancy, labor, and immediately postpartum. Existing data on the benefits of doulas, especially for low‐resource, high‐need patients, do not address how and why individual practitioners decide to recommend this model of care. This project aims to describe best practices of integrating doulas into hospital‐based maternity care teams to facilitate access to this evidence‐based service for improving maternal health outcomes. Methods Semi‐structured interviews using open‐ended questions were conducted in person with 47 maternity care practitioners—OB/GYNs, family medicine physicians, RNs, and nurse‐midwives—across three hospitals. Interview analysis was conducted using the Template Organizing Style qualitative analysis approach. Results Results demonstrated varied support for doula care given practitioners’ experiences. Positive experiences centered on doulas’ supportive role and strong relationships with patients. Some conflicts between practitioners and doulas may stem from a cross‐cultural divide between mainstream obstetric/physician culture and a natural birth “counter culture.” Suggestions to facilitate good working relationships centered on three overlapping themes: mutual respect between doulas and hospital staff, education about doulas’ training, and clarification of roles on maternity care teams especially among staff with overlapping roles. Conclusions Among maternity care practitioners, some frustration, anger, and resentment persist with respect to work with doulas. Adequate staff training in the doula model of care, explicit role definition, and increasing practitioner exposure to doulas may promote effective integration of doulas into hospital maternity care teams.

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Patient engagement practice within perinatal eHealth: A scoping review

et al. 2023

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Background There is a gap in knowledge about how perinatal eHealth programs function to support autonomy for new and expectant parents from pursuing wellness goals. Objectives To examine patient engagement (access, personalization, commitment and therapeutic alliance) within the practice of perinatal eHealth. Design Scoping review. Methods Five databases were searched in January 2020 and updated in April 2022. Reports were vetted by three researchers and included if they documented maternity/neonatal programs and utilized World Health Organization (WHO) person‐centred digital health intervention (DHI) categories. Data were charted using a deductive matrix containing WHO DHI categories and patient engagement attributes. A narrative synthesis was conducted utilizing qualitative content analysis. Preferred Reporting Items for Systematic Reviews and Meta‐Analyses ‘extension for scoping reviews’ guidelines were followed for reporting. Results Twelve eHealth modalities were found across 80 included articles. The analysis yielded two conceptual insights: (1) The nature of perinatal eHealth programs: (1) emergence of a complex structure of practice and (2) practising patient engagement within perinatal eHealth. Conclusion Results will be used to operationalize a model of patient engagement within perinatal eHealth.

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Needs of parents and professionals to improve shared decision‐making in interprofessional maternity care practice: A qualitative study

Cited by 40 publications

References 39 publications

Women‘s experiences of postterm induction of labor: A systematic review of qualitative studies

Women‘s experiences of postterm induction of labor: A systematic review of qualitative studies

Hospital‐based maternity care practitioners’ perceptions of doulas

Patient engagement practice within perinatal eHealth: A scoping review

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