Needs of parents and professionals to improve shared decision-making in interprofessional maternity care practice: A qualitative study.
BACKGROUND
Shared decision-making (SDM) is a critical but challenging component of high quality maternity care. In co-creation with parents and professionals, we are developing an intervention to improve SDM. As a first step we aimed to explore the experiences and needs of parents and professionals regarding shared decision-making in interprofessional antenatal, natal, and postnatal care.


METHODS
We organized 11 focus groups in the Netherlands in November and December 2016. Parents, primary care midwives, hospital-based midwives, obstetricians, obstetric nurses, and maternity care assistants participated.


RESULTS
Parents and professionals recognized the SDM steps of introducing a decision (choice talk) and discussing options (option talk), but most parents did not seem to discuss preferences and weigh options with professionals before making their final decision (decision talk). Barriers to SDM were often related to interprofessional collaboration, while good communication skills of parents and professionals facilitated SDM. An intervention to improve SDM would need to: (a) increase awareness and offer insight into the SDM process and roles and responsibilities of parents and professionals, (b) develop good communication skills, and (c) encourage interprofessional collaboration. The preferred design of the intervention was online, interactive, and practical.


CONCLUSIONS
Parents and professionals will benefit from an intervention designed to improve SDM. A practical e-learning for all maternity care providers and e-health information for parents seems most appropriate. Key elements for the e-learning are raising awareness of the roles and responsibilities of parents and professionals, developing good communication skills and encouraging interprofessional collaboration. This requires a variety of educational strategies.
['Molenaar|Joyce|J|0000-0002-8025-040X', 'Korstjens|Irene|I|', 'Hendrix|Marijke|M|', 'de Vries|Raymond|R|', 'Nieuwenhuijze|Marianne|M|']
D000328:Adult D001291:Attitude of Health Personnel D003142:Communication D003657:Decision Making D005260:Female D017144:Focus Groups D006801:Humans D007400:Interprofessional Relations D008297:Male D008427:Maternal Health Services D008875:Middle Aged D009426:Netherlands D009774:Obstetrics D010290:Parents D010353:Patient Education as Topic D010358:Patient Participation D036301:Qualitative Research D017216:Telemedicine D055815:Young Adult
parents shared decision-making maternity care interprofessional collaboration needs assessment