ArticleBMJ open2022
Autonomy-supportive decision-making in maternity care during prenatal consultations: a qualitative interaction analysis.
Article in BMJ open, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.
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Who cites it
3 citing papers in PubMed.
- Care Providers' and Parents' Experiences with Implementing the Conversational Health Literacy Assessment Tool (CHAT)-Maternity-Care in the Netherlands: A Mixed Methods Study.Healthcare (Basel, Switzerland) · 2025Article
- Autonomy support in prenatal consultation: A quantitative observation study in maternity care.European journal of midwifery · 2025Article
- Adaptation and validation of the encoding of observations using CONSUL-MCC: A self-determination theory-based tool to observe consultations in maternity care.PEC innovation · 2023Article
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Authors and funding
7 authors.
Funding
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Abstract
objectivesThe aim of this study was to identify mechanisms of autonomy-supportive consultation (ASC) that maternity care professionals use during decision-making in prenatal consultations.
designThis study was a descriptive, qualitative analysis of professional-patient interactions in maternity care, using concepts and analytic procedures of conversation analysis.
settingThe prenatal consultations took place in hospitals and midwifery practices in the Netherlands. This study was part of a larger project. For the current study, we selected prenatal consultations concerning three topics in which patients make their own choices.
participantsThe first author invited the patient who was waiting in the waiting room. Participants were not selected a priori.
main outcome measuresThe main outcome measures were mechanisms of ASC.
resultsWe selected 20 consultations which were conducted by 20 different professionals. We found eight mechanisms in the professional-patient interaction which were categorised into three overarching themes. The first theme, 'Lightheartedness', comprises the interactional mechanisms 'minimising language' and 'humour'. The theme 'Orientation to agreement' describes how professionals and patients seem to be oriented towards demonstrating agreement and mutual understanding. The last theme, 'Offering information and options', describes the professional formally giving factual information almost completely without verbal interaction between the professional and the patient.
conclusionThe results of this study show that the model of ASC can be enriched by adding minimising language and humour to the mechanisms that can be used to fulfil the psychological need 'relatedness'. Second, our results show that professionals use only few mechanisms to meet the patients' psychological needs 'competence' and 'autonomy'. They mainly use information giving to meet patients' need competence. To meet patients' need for autonomy, the professionals keep all options open. This suggests that professionals could pay more attention to other mechanisms to meet patients' needs for 'competence' and 'autonomy'.
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