Decision-Making Theories and their usefulness to the midwifery profession both in terms of midwifery practice and the education of midwives (original) (raw)
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International Journal of Medical Studies, 2020
Aim: The aim of this concept analysis is to explore the concept clinical dec relation to midwifery care. Methods: The Walker and Avant, (2005) model of concept analysis was used to conduct the analysis by following steps used in the model from the purpose, definitions of the concept, antecedents, consequences, empirical reference and attributes. Results: Clinical reasoning was found to be an important element in clinical decision making as it helps to boost midwives' level of confidence and competence to save lives of mothers and their babies.
A review of the literature: Midwifery decision-making and birth
Women and Birth, 2010
Clinical decision-making was initially studied in medicine where hypotheticodeductive reasoning is the model for decision-making. The nursing perspective on clinical decision-making has largely been shaped by Patricia Benner's ground breaking work. Benner claimed expert nurses use humanistic-intuitive ways of making clinical decisions not just rationally as claimed by medicine. Clinical decisionmaking in midwifery is not the same as either nursing or medical decision-making because of the woman-midwife partnership where the woman is the ultimate decision-maker.
Factors Influencing Midwifery Clinical Decision-making
International Annals of Science
Clinical decision-making is an important element in midwifery practice. Midwives are required to have a sound knowledge to manage complications during childbirth. Any misjudgement by a midwife may lead to adverse birth outcomes. The aim of this paper is to review factors that contribute to clinical decision-making of midwives. This was achieved by reviewing published research articles. Studies have shown that shortage of human and material resources, poor skill mix, absence of mentors and lack of autonomy are some of the contributing factors that may affect midwives’ decision-making.
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International journal of nursing studies, 2012
Decision making embedded in clinical situations is studied to inform nursing and midwifery practice and to enhance clinical effectiveness. To date this knowledge has mainly been derived from classical decision-making research approaches that are limited in capturing cognition in rapidly changing 'real-world' clinical environments. A naturalistic decision making approach can strengthen the ecological validity of descriptive investigations in certain dynamic clinical decision situations that include urgency and complexity. This paper presents a discussion about naturalistic decision making, its relevance for studying certain clinical decision situations in the 'real world' of nursing and midwifery practice and its application in a midwifery decision-making situation. In conclusion classical decision-making research approaches can be extended to include the naturalistic decision making approach that can capture decision making in dynamic clinical situations and show the...
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Journal of Advanced Nursing, 1997
Clinical decision-making by midwives: managing case complexity In making clinical judgements, it is argued that midwives use 'shortcuts' or heuristics based on estimated probabilities to simplify the decision-making task. Midwives (n=30) were given simulated patient assessment situations of high and low complexity and were required to think aloud. Analysis of verbal protocols showed that subjective probability judgements (heuristics) were used more frequently in the high than low complexity case and predominated in the last quarter of the assessment period for the high complexity case. 'Representativeness' was identified more frequently in the high than in the low case, but was the dominant heuristic in both. Reports completed after each simulation suggest that heuristics based on memory for particular conditions affect decisions. It is concluded that midwives use heuristics, derived mainly from their clinical experiences, in an attempt to save cognitive effort and to facilitate reasonably accurate decisions in the decision-making process.
Women and birth : journal of the Australian College of Midwives, 2018
Dutch maternity care is based on the principle that pregnancy and childbirth are physiological processes. However, the last decade an increase of intra-partum referrals to obstetric-led care has been observed. Most of these referrals are among nulliparous women, non-urgent and occur during the first stage of labour. The increase in referrals seems not associated with better perinatal outcomes. Gain understanding of underlying factors in the decision-making process prior to referral to obstetric-led care among midwives attending childbirth in midwifery-led care. A qualitative study based on in-depth interviews with Dutch midwives (n=10) working in midwifery-led care. We performed a thematic analysis based on the hypothetico-deductive and the intuitive-humanist theory. Midwives mentioned knowledge as the basis of a reasoned decision. This included both theoretical knowledge, and knowledge from clinical experience. Influences of others, like the needs and wishes of labouring women were...