Psychological Intervention to Improve Communication and Patient Safety in Obstetrics: Examination of the Health Action Process Approach

Kötting, Lukas; Keller, Franziska Maria; Schmiedhofer, Martina; Lippke, Sonia

doi:10.3389/fpsyg.2022.771626

Cited by 8 publications

(11 citation statements)

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“…This study demonstrated such a categorization approach which should be implemented in practice and used for research. Future trainings can make use of this categorization approach [ 12 ] but also the training used in this study [ 21 ].…”

Section: Discussionmentioning

confidence: 99%

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Reducing preventable adverse events in obstetrics by improving interprofessional communication skills – Results of an intervention study

Hüner

Schmiedhofer

Lippke

et al. 2023

BMC Pregnancy Childbirth

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Background Progress in medicine involves the structured analysis and communication of errors. Comparability between the individual disciplines is only possible to a limited extent and obstetrics plays a special role: the expectation of a self-determined and joyful event meets with possibly serious complications in highly complex care situations. This must be managed by an interdisciplinary team with an increasingly condensed workload. Adverse events cannot be completely controlled. However, taking controllable risk factors into account and with a focused communication a reduction of preventable adverse events is possible. In the present study, the effect of interprofessional team training on preventable adverse events in an obstetric department was investigated. Methods The training consisted of a 4-h interdisciplinary training session based on psychological theories. Preventable adverse events were defined in six categories according to potential patterns of causation. 2,865 case records of a refence year (2018) and 2,846 case records of the year after the intervention (2020) were retrospectively evaluated. To determine the communication training effect, the identified preventable adverse events of 2018 and 2020 were compared according to categories and analyzed for obstetrically relevant controllable and uncontrollable risk factors. Questionnaires were used to identify improvements in self-reported perceptions and behaviors. Results The results show that preventable adverse events in obstetrics were significantly reduced after the intervention compared to the reference year before the intervention (13.35% in the year 2018 vs. 8.83% in 2020, p < 0.005). Moreover, obstetrically controllable risk factors show a significant reduction in the year after the communication training. The questionnaires revealed an increase in perceived patient safety (t(28) = 4.09, p < .001), perceived communication behavior (t(30) = -2.95, p = .006), and self-efficacy to cope with difficult situations (t(28) = -2.64, p = .013). Conclusions This study shows that the communication training was able to reduce preventable adverse events and thus increase patient safety. In the future, regular trainings should be implemented alongside medical emergency trainings in obstetrics to improve patient safety. Additionally, this leads to the strengthening of human factors and ultimately also to the prevention of second victims. Further research should follow up implementing active control groups and a randomized-controlled trail study design. Trial registration The study was approved by the Ethics Committee of University Hospital (protocol code 114/19-FSt/Sta, date of approval 29 May 2019), study registration: NCT03855735.

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Section: Discussionmentioning

confidence: 99%

“…Additionally, N = 4 midwives who had not been trained before took part in the microteaching sessions. A detailed overview of the training content, exercises, and goals as well as the behavior planning intervention and microteaching have been published elsewhere [ 21 ].…”

Section: Methodsmentioning

confidence: 99%

Reducing preventable adverse events in obstetrics by improving interprofessional communication skills – Results of an intervention study

Hüner

Schmiedhofer

Lippke

et al. 2023

BMC Pregnancy Childbirth

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“…Criticism about unclear information, such as uncertainty about the progress of the birth, a lack of important information for decision making or unsettling statements, was also voiced. A recently published study emphasized the importance of communication during birth and the postpartum stage to improve women’s satisfaction [ 33 ]. In this study, the provision of clear information by the HCWs was seen as the most helpful aspect of verbal communication [ 50 ].…”

Section: Discussionmentioning

confidence: 99%

“…The semistructured interview guide ( Table 2 ) includes the main topics to stimulate a detailed description of the birth experience with a focus on communication, perceived support and the subjective impact of the communication training. It was flexibly adapted to the narrative flow and developed on the basis of our previous research results and project planning [ 19 , 25 , 32 , 33 ].…”

Section: Methodsmentioning

confidence: 99%

The Impact of a Communication Training on the Birth Experience: Qualitative Interviews with Mothers after Giving Birth at Obstetric University Departments in Germany

Schmiedhofer

Dietl

Haeussler³

et al. 2022

IJERPH

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(1) Background: Patient safety is a pressing issue in healthcare. Besides economical and organizational issues, human factors play a crucial role in providing safe care. Safe and clear communication on both the healthcare workers’ and patients’ sides contribute to the avoidance of medical errors and increase patients’ and healthcare workers’ satisfaction. Globally, the incidence of experiencing at least one adverse event in obstetrics is about 10%, of which half are classified as preventable. According to international research, improving communication skills may decrease preventable adverse events. The research question was to what extent communication training for pregnant women impacts the quality of communication and mutual understanding during birth. (2) Methods: Communication interventions with pregnant women were conducted in two German university obstetric departments in a mixed methods research design, based on the Health Action Process Approach. The online classes covered the awareness of personal wishes, the understanding and usage of communication strategies, self-efficacy and empathy. This study presents the qualitative results. Out of 142 mothers who answered two questionnaires before the communication training and after the birth, 24 in-depth semistructured interviews were conducted to explore the subjective impact of the communication training. The results were analyzed with qualitative content analysis. (3) Results: The majority of participants felt incentivized to be aware of their personal wishes for birth and to express them. Perceived positive experiences with sufficient competency in communication, empathy and mutual understanding outweighed negative treatments and experiences in the hospital, some of which could be attributed to structural problems. (4) Discussion: The reported positive effects of the communication training underline the need but also the potential for communication lessons to reflect and improve communication skills in obstetrics. However, negative experiences due to structural problems in the healthcare system may be facilitated by communication skills but not solved.

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“…Safe communication can be described as a multilateral process that involves sharing emotions, cognitions, and actions on a verbal and nonverbal level [ 14 ]. Although previous literature has mainly focused on communication competencies among HCWs, the literature is lacking in understanding safe communication behavior from the perspective of pregnant women and their families [ 15 , 16 ]. Previous research [ 9 ] showed that more than one-third of pregnant women reported that they felt unsure to ask questions or raise concerns while giving birth [ 17 ].…”

Section: Introductionmentioning

confidence: 99%

Comparing the Effectiveness of a Web-Based Application With a Digital Live Seminar to Improve Safe Communication for Pregnant Women: 3-Group Partially Randomized Controlled Trial

Kötting

Keller

Lippke

2023

JMIR Pediatr Parent

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Background Medical internet interventions such as asynchronous apps and synchronous digital live seminars can be effective behavior change interventions. The research question of this study was whether digital interventions based on the Health Action Process Approach can improve pregnant women’s safe communication and patient safety in obstetric care. Objective This study aims to compare a digital live seminar with a web-based application intervention and a passive control group and to identify which social cognitive variables determine safe communication behavior and patient safety. Methods In total, 657 pregnant women were recruited, and hereof, 367 expectant mothers from 2 German university hospitals participated in the pre-post study (live seminar: n=142; web-based app: n=81; passive control group: n=144). All interventions targeted intention, planning, self-efficacy, and communication of personal preferences. The 2.5-hour midwife-assisted live seminar included exercises on empathy and clear communication. The fully automated web-based application consisted of 9 consecutive training lessons with the same content as that of the live seminar. Results Controlled for sociodemographic characteristics, repeated measures analyses of covariance revealed that pregnant women significantly improved their self-reported communication behavior in all groups. The improvement was more pronounced after the digital live seminar than after the web-based application (P<.001; ηp2=0.043). Perceived patient safety improved more for pregnant women participating in the live seminar than for those participating in the web-based application group (P=.03 ηp2=0.015). A regression analysis revealed that social cognitive variables predicted safe communication behavior. Conclusions Overall, the web-based application intervention appeared to be less effective than the digital live training in terms of communication behavior. Application interventions addressing communication behaviors might require more face-to-face elements. Improving intention, coping planning, and coping self-efficacy appeared to be key drivers in developing safe communication behavior in pregnant women. Future research should include social learning aspects and focus on the practical application of medical internet interventions when aiming to improve pregnant women’s communication and patient safety in obstetrics. Trial Registration ClinicalTrials.gov NCT03855735; https://clinicaltrials.gov/ct2/show/NCT03855735

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Psychological Intervention to Improve Communication and Patient Safety in Obstetrics: Examination of the Health Action Process Approach

Cited by 8 publications

References 50 publications

Reducing preventable adverse events in obstetrics by improving interprofessional communication skills – Results of an intervention study

Reducing preventable adverse events in obstetrics by improving interprofessional communication skills – Results of an intervention study

The Impact of a Communication Training on the Birth Experience: Qualitative Interviews with Mothers after Giving Birth at Obstetric University Departments in Germany

Comparing the Effectiveness of a Web-Based Application With a Digital Live Seminar to Improve Safe Communication for Pregnant Women: 3-Group Partially Randomized Controlled Trial

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