BACKGROUND: Shared decision-making enables women to make informed decisions in partnership with clinicians where there are varied clinical options in relation to indications for and timing of planned birth.
OBJECTIVE: We aimed to develop a shared decision-making training intervention and evaluate its feasibility and acceptability to midwives and obstetricians.
METHODS: The intervention was co-designed by midwifery and medical clinician-researchers, and a consumer representative. Online training and demonstration videos were distributed to midwives and obstetricians in three Sydney hospitals, followed by two online workshops in 2021 and 2022 where participants practised shared decision-making in roleplaying scenarios tailored to timing of birth. Training was evaluated using post-workshop and post-training surveys and semi-structured qualitative interviews.
RESULTS: The training workshop format, duration and content were well received. Barriers to the uptake of shared decision-making were time, paternalistic practices and fear of repercussions of centring women in the decision-making process.
CONCLUSIONS: The intervention enabled midwifery and medical colleagues to learn communication repertoires from each other in woman-centred discussions around timing of birth. Roleplay scenarios enabled participants to observe and provide feedback on their colleagues\' shared decision-making practices, while providing a space for collective reflection on ways to promote, and mitigate barriers to, its implementation in practice.
CONCLUSIONS: Shared decision-making training supports maternity clinicians in developing skills that implement woman-centred care in the timing of planned birth.
背景:共享决策使妇女能够与临床医生合作做出明智的决定,因为在计划分娩的适应症和时机方面有多种临床选择。
目的:我们的目的是开发一种共享的决策培训干预措施,并评估其可行性和对助产士和产科医生的可接受性。
方法:干预措施由助产士和医学临床医生研究人员共同设计,和消费者代表。向悉尼三家医院的助产士和产科医生分发了在线培训和示范视频,随后是2021年和2022年的两个在线研讨会,参与者在根据出生时间量身定制的角色扮演场景中进行共享决策。使用讲习班后和培训后调查以及半结构化定性访谈对培训进行了评估。
结果:培训研讨会形式,持续时间和内容都很受欢迎。接受共同决策的障碍是时间,家长式做法和对将妇女集中在决策过程中的影响的恐惧。
结论:干预措施使助产士和医学同事能够在围绕分娩时机的以女性为中心的讨论中相互学习交流方式。Roleplay场景使参与者能够观察并提供对其同事共享决策实践的反馈,在提供集体反思促进方式的空间的同时,并减轻障碍,在实践中实施。
结论:共享决策培训支持产妇临床医生发展技能,在计划分娩时实施以妇女为中心的护理。