OBJECTIVE: This study aimed to investigate the level of and reasons underlying decisional conflict in Chinese women during their late pregnancy when making a decision on the use of epidural analgesia in labour.
METHODS: A convergent parallel mixed methods study was undertaken, that included a quantitative survey (n = 323) and qualitative interviews (n = 17) with women recruited from a tertiary general hospital in Hangzhou, China. The quantitative survey assessed the level of and its influencing factors of women\'s decisional conflict, while the qualitative interview further explored experiences of and reasons underlying the conflict.
RESULTS: Participants reported a high level of decisional conflict (mean±SD, 39.59±15.92), which related to decision delay and/or negative perceptions about the decision. Multiple stepwise linear regression analysis identified that highest level of education and knowledge of epidural were negatively associated with decisional conflict (p<0.05). Four decision-making styles (rational, dependant, intuitive and avoidant decision-making) associated with different levels of decisional conflict, and four underlying reasons (personal characteristics, informational provision, emotional support and participation in decision-making) of the conflict were thematized.
CONCLUSIONS: Decisional conflict related to epidural labour analgesia is a noteworthy issue amongst women during their late pregnancy. This study suggests a need for provision of family-centred shared decision-making practice about the use of epidural analgesia in labour.
目的:本研究旨在调查中国妇女在妊娠晚期决定使用硬膜外镇痛分娩时的决策冲突水平和原因。
方法:进行了收敛平行混合方法研究,其中包括对杭州三级综合医院招募的女性进行定量调查(n=323)和定性访谈(n=17),中国。定量调查评估了女性决策冲突的水平及其影响因素,而定性访谈进一步探讨了冲突的经验和原因。
结果:参与者报告了高水平的决策冲突(平均值±SD,39.59±15.92),这与决策延迟和/或对决策的负面看法有关。多元逐步线性回归分析发现,最高的教育水平和硬膜外知识与决策冲突呈负相关(p<0.05)。四种决策风格(理性,依赖者,直觉和回避决策)与不同级别的决策冲突相关,和四个根本原因(个人特征,信息提供,情感支持和参与决策)的冲突被主题化。
结论:与硬膜外分娩镇痛相关的决策冲突是妇女在妊娠晚期的一个值得注意的问题。这项研究表明,有必要提供以家庭为中心的共享决策实践,以在分娩中使用硬膜外镇痛。