OBJECTIVES: to explore midwives' intrapartum referral decisions in relation to their dispositional attitude towards risk. DESIGN: a web-based correlation study examined the association between midwife's personality (personal risk tendency), place of work (location), years of experience and the timing of their decisions to make referrals (referral score) in a series of fictitious case scenarios (vignettes). PARTICIPANTS: 102 midwives providing labour care in both consultant-led units (CLU) and community maternity units (CMU) from four Scottish health board areas. ANALYSIS: a correlational analysis was carried out to test the association between total risk scores and midwives' referral scores. Between-group comparisons were also conducted for experienced vs inexperienced midwives, midwives practising in CLU vs CMU settings and between the four health board areas. FINDINGS: despite being presented with identical information in the vignettes, midwives made a wide range of referral decisions. There was no association between referral scores and measures of risk, personality or years of experience. No statistically significant difference between the referral scores of midwives working in CLUs or CMUs was observed. However, a statistically significant difference did emerge between the four health board areas, with midwives from one area making referrals at a significantly earlier stage. The maternity services in this area had experienced several high profile adverse events prior to this study; this may have influenced their referral behaviour (the availability heuristic), in terms of making more cautious decisions. KEY CONCLUSIONS: there was no evidence that variability in the range of referral decisions was due to personality factors, risk propensity, experience or whether the midwife worked in a CLU or CMU. Local factors such as recent adverse events may significantly influence subsequent referral behaviour. Further research is required to identify why the midwives showed so much unexplained variability in their responses to the vignettes.
OBJECTIVES: to explore midwives' intrapartum referral decisions in relation to their dispositional attitude towards risk. DESIGN: a web-based correlation study examined the association between midwife's personality (personal risk tendency), place of work (location), years of experience and the timing of their decisions to make referrals (referral score) in a series of fictitious case scenarios (vignettes). PARTICIPANTS: 102 midwives providing labour care in both consultant-led units (CLU) and community maternity units (CMU) from four Scottish health board areas. ANALYSIS: a correlational analysis was carried out to test the association between total risk scores and midwives' referral scores. Between-group comparisons were also conducted for experienced vs inexperienced midwives, midwives practising in CLU vs CMU settings and between the four health board areas. FINDINGS: despite being presented with identical information in the vignettes, midwives made a wide range of referral decisions. There was no association between referral scores and measures of risk, personality or years of experience. No statistically significant difference between the referral scores of midwives working in CLUs or CMUs was observed. However, a statistically significant difference did emerge between the four health board areas, with midwives from one area making referrals at a significantly earlier stage. The maternity services in this area had experienced several high profile adverse events prior to this study; this may have influenced their referral behaviour (the availability heuristic), in terms of making more cautious decisions. KEY CONCLUSIONS: there was no evidence that variability in the range of referral decisions was due to personality factors, risk propensity, experience or whether the midwife worked in a CLU or CMU. Local factors such as recent adverse events may significantly influence subsequent referral behaviour. Further research is required to identify why the midwives showed so much unexplained variability in their responses to the vignettes.
Authors: Pien M Offerhaus; Caroline Geerts; Ank de Jonge; Chantal W P M Hukkelhoven; Jos W R Twisk; Antoine L M Lagro-Janssen Journal: BMC Pregnancy Childbirth Date: 2015-02-21 Impact factor: 3.007
Authors: Mary Amoakoh-Coleman; Irene Akua Agyepong; Nicolaas P A Zuithoff; Gbenga A Kayode; Diederick E Grobbee; Kerstin Klipstein-Grobusch; Evelyn K Ansah Journal: PLoS One Date: 2016-06-20 Impact factor: 3.240
Authors: Darie O A Daemers; Evelien B M van Limbeek; Hennie A A Wijnen; Marianne J Nieuwenhuijze; Raymond G de Vries Journal: BMC Pregnancy Childbirth Date: 2017-10-06 Impact factor: 3.007