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. 2022 Sep 20;22(1):717.
doi: 10.1186/s12884-022-05041-y.

Midwives' empathy and shared decision making from women's perspective - sensitivity of an assessment to compare quality of care in prenatal and obstetric care

Anja Alexandra Schulz  1   2 , Markus Antonius Wirtz  3   4
Affiliations

Midwives' empathy and shared decision making from women's perspective - sensitivity of an assessment to compare quality of care in prenatal and obstetric care

Anja Alexandra Schulz et al. BMC Pregnancy Childbirth. .

Abstract

Background: For quality-oriented evaluation of prenatal and obstetric care, it is important to systematically consider the perspective of the women receiving care in order to comprehensively assess and optimize quality in a woman-centered manner. Empathy and Shared Decision Making (SDM) are essential components of woman-centered midwifery care. The aim of the study was to analyze measurement invariance of the items of the Consultation and Relational Empathy (CARE) and Shared Decision Making-Questionnaire (SDM-Q-9) scales depending on the prenatal versus obstetric care setting.

Methods: One hundred fifty women retrospectively assessed aspects of woman-centered midwifery care in both prenatal and obstetric care setting. The birth of the child was a maximum of 12 months ago. A structural equation modelling approach was adopted to separate true effects from response shift (RS) effects depending on care setting. The latter were analyzed in terms of recalibration (changing women's internal measurement standards), Reprioritization (changing associations of items and construct) as well as Reconceptualization (redefining the target construct).

Results: A response shift model was identified for both assessments (pregnancy/birth: CFI = .96/.96; SRMR = .046/.051). At birth, both scales indicated lower quality of care compared with prenatal care (SDM-Q-9-M/CARE-8-M:|d| = 0.190/0.392). Although no reconceptualization is required for the items of both scales, RS effects are evident for individual items. Due to recalibration and reprioritization effects, the true differences in the items are partly underestimated (SDM-Q-9-M/CARE-8-M: 3/2 items) or overestimated (4/2 items).

Conclusion: The structure of the constructs SDM and Empathy, indicating woman-centered midwifery care, are moderated by the care settings. To validly assess midwives' empathy and shared decision making from women's perspective, setting-dependent response shift effects have to be considered. The proven item-specific response effects contribute to a better understanding of construct characteristics in woman-centered care by midwives during pregnancy and childbirth.

Keywords: Empathy; Midwifery care; Response shift; Shared decision making; Structural equation modelling.

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Conflict of interest statement

The authors declare that they have no competing interests.

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References

    1. Fontein-Kuipers Y, Groot R d, van Staa A. Woman-centered care 2.0: bringing the concept into focus. Eur J Midwifery. 2018. 10.18332/ejm/91492. - PMC - PubMed
    1. Brady S, Lee N, Gibbons K, Bogossian F. Woman-centred care: an integrative review of the empirical literature. Int J Nurs Stud. 2019;94:107–119. doi: 10.1016/j.ijnurstu.2019.01.001. - DOI - PubMed
    1. Ayerle GM, Mattern E. Topics for research by midwives: an analysis of focus groups with pregnant women, mothers and midwives. Zeitschrift für Hebammenwissenschaft. 2017;05:65–73.
    1. Hildingsson I, Andersson E, Christensson K. Swedish women's expectations about antenatal care and change over time - a comparative study of two cohorts of women. Sex Reprod Healthc. 2014;5:51–57. doi: 10.1016/j.srhc.2014.01.001. - DOI - PubMed
    1. Butler MM, Meehan TC, Kemple M, Drennan J, Treacy M, Johnson M. Identifying research priorities for midwifery in Ireland. Midwifery. 2009;25:576–587. doi: 10.1016/j.midw.2007.08.004. - DOI - PubMed

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