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Autonomy-supportive decision-making in maternity care during prenatal consultations: a qualitative interaction
Joyce Kors1,2,3, Anne de la Croix4,3, Linda Martin2
1Faculty of Medicine, Amsterdam UMC location Vrije Universiteit Amsterdam, Amsterdam, Netherlands j.kors@amsterdamumc.nl.
BMJ Open
|November 17, 2022
Summary
Maternity care professionals can enhance autonomy-supportive consultations (ASC) by using humor and minimizing language. However, they use limited strategies to foster patient competence and autonomy during prenatal decision-making.
Area of Science:
- Maternal Health
- Communication in Healthcare
- Psychology
Background:
- Autonomy-supportive consultation (ASC) is crucial for effective prenatal care.
- Understanding the specific mechanisms used by maternity care professionals is essential to improve patient decision-making.
- Previous research has not fully elucidated the interactional strategies employed in prenatal consultations.
Purpose of the Study:
- To identify and analyze the mechanisms of autonomy-supportive consultation (ASC) utilized by maternity care professionals during prenatal decision-making.
- To explore how these mechanisms support or hinder patients' psychological needs for relatedness, competence, and autonomy.
Main Methods:
- Descriptive, qualitative analysis of professional-patient interactions in maternity care.
- Utilized conversation analysis to examine 20 prenatal consultations concerning patient choice topics.
- Consultations were conducted in hospitals and midwifery practices in the Netherlands.
Main Results:
- Eight mechanisms of ASC were identified, categorized into three themes: 'Lightheartedness' (minimizing language, humor), 'Orientation to agreement', and 'Offering information and options'.
- 'Lightheartedness' mechanisms contribute to the psychological need for relatedness.
- Professionals primarily used information giving for competence and keeping options open for autonomy, indicating potential for improvement.
Conclusions:
- The model of ASC can be enriched by incorporating minimizing language and humor to support patient relatedness.
- Maternity care professionals could benefit from employing a wider range of mechanisms to foster patients' psychological needs for competence and autonomy.
- Further attention to diverse communication strategies is recommended to enhance patient-centered prenatal care and decision-making.
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