背景:产妇护理中的共享决策(SDM)使妇女积极参与决策,从而减少决策冲突,提高对护理的满意度。
目的:研究SDM及其相关因素,及其与沙特阿拉伯产妇保健中尊重的相关性。
方法:全面,2023年1月至5月进行了全国性的基于在线问卷调查的研究,研究对象为18岁及以上怀孕或在过去12个月内经历过怀孕/分娩的女性.使用了母亲自主决策(MADM)量表和母亲尊重指数(MORi)。低到非常低的SDM被定义为MADM上的得分≤24,低到非常低的尊重被定义为MORi上的得分≤49。
结果:共有505名女性完成了调查。137人报告了低至非常低的SDM(34.1%,95置信区间(CI),29.6%-38.9%)妇女。与低至极低SDM显著相关的因素包括每次就诊时看到不同性别的产科医生(调整后优势比(AOR)2.0,95%CI,1.0-3.9),在整个妊娠期间未与同一位产科医生会面(AOR2.6,95%CI,1.2-5.6),并且有辅助阴道分娩(AOR6.67,95%CI,1.6-28.1).在低至极SDM与低至极低尊重之间存在正相关(χ2=83.8173,p<0.001)。
结论:超过三分之一的妇女在产妇护理中经历了低至非常低的SDM。这应该提醒医疗保健提供者注意沙特阿拉伯护理连续性的重要性。
BACKGROUND: Shared decision-making (SDM) in maternity care involves women actively in decisions, thereby reducing decisional conflicts and enhancing satisfaction with care.
OBJECTIVE: To investigate SDM and the factors associated with it, and its correlation with respect in maternity care in Saudi Arabia.
METHODS: A comprehensive, nationwide online questionnaire-based study was conducted between January to May 2023, involving women aged 18 years and above who were either pregnant or had experienced pregnancy/childbirth in the past 12 months. The Mothers\' Autonomy in Decision-Making (MADM) scale and the Mothers of Respect Index (MORi) were used. Low to very low SDM was defined as a score of ≤ 24 on the MADM and low to very low respected was defined as a score of ≤ 49 on the MORi.
RESULTS: A total of 505 women completed the survey. Low to very low SDM was reported by 137 (34.1 %, 95 confidence interval (CI), 29.6 % - 38.9 %) women. Factors significantly associated with low to very low SDM included seeing different obstetricians of different gender at each visit (adjusted odds ratio (AOR) 2.0, 95 % CI, 1.0 - 3.9), not meeting the same obstetrician throughout the pregnancy (AOR 2.6, 95 % CI, 1.2 - 5.6) and having an instrumental vaginal birth (AOR 6.67, 95 % CI, 1.6 - 28.1). There was a positive association between low to very SDM and feeling of low to very low respect ((χ2 = 83.8173, p < 0.001).
CONCLUSIONS: More than one-third of women experienced low to very low SDM in maternity care. This should alert healthcare providers to the importance of continuity of care in Saudi Arabia.