TY - JOUR
T1 - Health literate-sensitive shared decision-making in maternity care
T2 - needs for support among maternity care professionals in the Netherlands
AU - Murugesu, Laxsini
AU - Damman, Olga C.
AU - Timmermans, Danielle R. M.
AU - de Wit, Sanne
AU - Nieuwenhuijze, Marianne
AU - Smets, Ellen M. A.
AU - Fransen, Mirjam P.
N1 - Funding Information: This study is funded by ZonMW, the Netherlands Organization for Health Research and Development, grant number 543003303. Funding Information: The authors wish to thank all participating maternity care professionals for their valuable contributions to the study. The authors would also like to thank Kristel Boekhorst and Eefje van Gorkum for acting in the simulated consultations, and Mijra Koning and Maaike Schuurman for their assistance in coding the video-observations. Publisher Copyright: © 2023, BioMed Central Ltd., part of Springer Nature.
PY - 2023/12/1
Y1 - 2023/12/1
N2 - Background: Shared decision-making (SDM) in maternity care is challenging when clients have insufficient health literacy (HL) skills. This study gained insight in how professionals apply HL-sensitive SDM in Dutch maternity care and their needs for support therein. Methods: Maternity care professionals (n = 30) completed a survey on SDM and the role of HL. Midwives (n = 13) were observed during simulated conversations discussing pain relief options and interviewed afterwards. The client-actors were instructed to portrait specific inadequate HL skills. Observation items focused on adapting communication to HL, and SDM (OPTION-5). Results: In the survey, professionals indicated experiencing most challenges when estimating clients’ information comprehension. Observations showed that most midwives created choice awareness and informed clients about options, whereas exploring preferences and actual decision-making together with clients were observed less frequently. Their perceived HL-related obstacles and needs for support related to clients’ information comprehension. In the interviews, midwives reported putting much effort into explaining available options in maternity care, but also that decisions about pain relief are often postponed until the moment of labour. Conclusion: Professionals’ self-reported needs focus on clients’ information comprehension. However, observations indicate that it is not the stage of informing, but rather value clarification and actual decision-making that need improvement in HL-sensitive SDM.
AB - Background: Shared decision-making (SDM) in maternity care is challenging when clients have insufficient health literacy (HL) skills. This study gained insight in how professionals apply HL-sensitive SDM in Dutch maternity care and their needs for support therein. Methods: Maternity care professionals (n = 30) completed a survey on SDM and the role of HL. Midwives (n = 13) were observed during simulated conversations discussing pain relief options and interviewed afterwards. The client-actors were instructed to portrait specific inadequate HL skills. Observation items focused on adapting communication to HL, and SDM (OPTION-5). Results: In the survey, professionals indicated experiencing most challenges when estimating clients’ information comprehension. Observations showed that most midwives created choice awareness and informed clients about options, whereas exploring preferences and actual decision-making together with clients were observed less frequently. Their perceived HL-related obstacles and needs for support related to clients’ information comprehension. In the interviews, midwives reported putting much effort into explaining available options in maternity care, but also that decisions about pain relief are often postponed until the moment of labour. Conclusion: Professionals’ self-reported needs focus on clients’ information comprehension. However, observations indicate that it is not the stage of informing, but rather value clarification and actual decision-making that need improvement in HL-sensitive SDM.
KW - Health literacy
KW - Maternity care professionals
KW - Needs assessment
KW - Shared decision-making
UR - http://www.scopus.com/inward/record.url?scp=85168412612&partnerID=8YFLogxK
U2 - https://doi.org/10.1186/s12884-023-05915-9
DO - https://doi.org/10.1186/s12884-023-05915-9
M3 - Article
C2 - 37605153
SN - 1471-2393
VL - 23
JO - BMC pregnancy and childbirth
JF - BMC pregnancy and childbirth
IS - 1
M1 - 594
ER -