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Shared decision-making for delivery mode: An OPTION scale observer-based evaluation.

Federica Fersini1, Annamaria Govi1, Maria Livia Rizzo2

  • 1DIMEC, University of Bologna, Department of Medical and Surgical Sciences, Section of Legal Medicine, 40126, Bologna, Italy.

Patient Education and Counseling
|May 14, 2019
PubMed
Summary

Shared decision-making (SDM) in childbirth is low, with pregnant women having limited involvement in choosing between Cesarean Delivery (CD) and Vaginal Delivery (VD). Improving SDM is crucial for patient care and medico-legal protection.

Keywords:
Medical liabilityMode of deliveryOPTION(12) scoresPatient involvementShared decision making

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Area of Science:

  • Obstetrics and Gynecology
  • Health Services Research
  • Patient-Centered Care

Background:

  • Shared decision-making (SDM) is recognized as a key component in improving patient outcomes and satisfaction.
  • Cesarean Delivery (CD) rates are a global concern, and SDM may offer a strategy to optimize delivery mode selection.
  • Evaluating patient involvement in obstetric consultations is essential for identifying areas for improvement.

Purpose of the Study:

  • To assess the level of pregnant women's involvement in shared decision-making regarding the mode of delivery (Cesarean Delivery vs. Vaginal Delivery).
  • To apply the Italian version of the OPTION12 scale to measure patient participation in obstetric consultations.
  • To explore associations between OPTION12 scores and patient/physician sociodemographic data.

Main Methods:

  • Utilized the OPTION12 scale to evaluate 58 outpatient obstetric consultations.
  • Collected sociodemographic data for both patients and physicians.
  • Performed statistical analyses to determine associations between OPTION12 scores and demographic factors.

Main Results:

  • The OPTION12 scale scores were predominantly low, indicating limited patient involvement in decisions about delivery mode.
  • Total scores ranged from 0 to 69% (mean 21.2%, median 13.5%).
  • Mean and median scores for all 12 OPTION12 items fell below the minimum skill level.

Conclusions:

  • A low level of patient involvement in deciding between Cesarean Delivery and Vaginal Delivery was observed.
  • Interventions such as educating obstetricians and implementing decision aids are recommended to enhance SDM.
  • Awareness of low patient involvement is critical for improving SDM and potentially offering medico-legal protection.