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61.

Background

Decision-making in midwifery, including a claim for shared decision-making between midwives and women, is of major significance for the health of mother and child. Midwives have little information about how to share decision-making responsibilities with women, especially when complications arise during birth.

Aim

To increase understanding of decision-making in complex home-like birth settings by exploring midwives’ and women’s perspectives and to develop a dynamic model integrating participatory processes for making shared decisions.

Methods

The study, based on grounded theory methodology, analysed 20 interviews of midwives and 20 women who had experienced complications in home-like births.

Findings

The central phenomenon that arose from the data was “defining/redefining decision as a joint commitment to healthy childbirth”. The sub-indicators that make up this phenomenon were safety, responsibility, mutual and personal commitments. These sub-indicators were also identified to influence temporal conditions of decision-making and to apply different strategies for shared decision-making. Women adopted strategies such as delegating a decision, making the midwife’s decision her own, challenging a decision or taking a decision driven by the dynamics of childbirth. Midwives employed strategies such as remaining indecisive, approving a woman’s decision, making an informed decision or taking the necessary decision.

Discussion and conclusion

To respond to recommendations for shared responsibility for care, midwives need to strengthen their shared decision-making skills. The visual model of decision-making in childbirth derived from the data provides a framework for transferring clinical reasoning into practice.  相似文献   
62.
复合主体决策在中国现有研究文献中存在一组"家族相似性"的概念,包括"群体决策"、"集体决策"、"公共决策"、"组织决策"等,这些概念虽然都意指复合主体决策,但皆有不同的研究界域。国内许多学者并没有对这些概念进行明确区分和界定,在使用中也存在普遍的混淆情况,这种研究现状并不利于学者之间的学术对话或交流。因此,有必要对这一概念谱系中的各个概念进行区分,对其不同的研究界域,包括研究理论、研究侧重和研究内容进行规范性和学理性的梳理和分析。  相似文献   
63.
浙江省温岭市泽国镇的民主恳谈实践在农村公共产品供给的决策机制安排上作出了积极的、比较规范的探索.它充分显示了,倡导平等对话为农民真实显示对公共产品的偏好奠定了基础,鼓励公共参与为农村公共产品供给的决策机制所需的信息沟通提供了动力,实现理性沟通为农村公共产品供给的民主决策破除了技术上的障碍,促进偏好转换为农村公共产品供给的科学决策提供了关键性的支持条件.泽国实践为我们提供了解读农村公共产品供给制度的新视角,值得人们理性关注和研究.  相似文献   
64.
《易经》是中国古人的智慧结晶,是古人为预知自然、社会和人生的变化而创立的独特预卜神秘符号系统,一直是后人在日常决策时的重要依据。近年来,国内外盛行将《易经》思想运用于企业的经营管理实务中。从现代管理决策的学术角度来解析《易经》,其中蕴藏了具有管理意义的个体管理决策模式。  相似文献   
65.
科学地选择和决策支付条件是出口商保证收汇安全、及时、经济并与进口伙伴共同实现交易目标的重要工作,它可以最大程度地避免因签约时的考虑不周而引起的合同履行中的纠纷和损失问题。出口商应当正确确定支付条件的决策内容和决策评价标准,寻找可行方案,利用定性与定量分析的科学方法,结合经验分析,找到在该贸易环境下的最优选择,并对结果在实施中的效果进行评价和反馈。决策中,还需要注意若干管理问题,以保证决策工作的效用和效率。  相似文献   
66.
Birth order supposedly influences individuals’ cooperative attitudes: firstborns are more family-oriented and favor their kin, while laterborns are more likely to turn to non-kin. However little direct experimental evidence exists concerning costly resource sharing between full siblings. The present study investigates sharing decisions with respect to a monetary resource by full sisters when either: (i) interacting with an unknown individual or (ii) their sister. A total of 112 sisters from 56 different families participated in an economic experiment regarding the distribution of an actual monetary reward. In line with kin selection theory, the results showed that participants favor their sister over strangers. Additionally, firstborns invested more costly resources in their sister (than laterborns) while they knew that the latter did not.  相似文献   
67.
賭徒參與賭博其實質有如消费者購買一項商品。只不過這項商品較為特殊,它不僅具有娛樂功能(效用),而且還包含風險和不確定性。風險(事件)具有令參與人的財富意外增加或減少的作用。所以愛好風險的人會參與賭博,而不喜愛風險的人若預期從風險事件中獲得足夠多的風險溢價(Risk premium)也願意參與一博。不確定性具有吸引人類不斷研究、探索、進步的一種魅力。  相似文献   
68.
Mental health social workers have a central role in providing support to people with mental health problems and in the use of coercion aimed at dealing with risk. Mental health services have traditionally focused on monitoring symptoms and ascertaining the risks people may present to themselves or others. This well-intentioned but negative focus on deficits has contributed to stigma, discrimination, and exclusion experienced by service users. Emerging understandings of risk also suggest that our inability to accurately predict the future makes risk a problematic foundation for compulsory intervention. Therefore it is argued that alternative approaches are needed to make issues of power and inequality transparent. This article focuses on two areas of practice: the use of recovery-based approaches, which promote supported decision-making and inclusion; and the assessment of a person's ability to make decisions, their mental capacity, as a less discriminatory gateway criterion than risk for compulsory intervention.  相似文献   
69.
Applied demography has recently gained recognition as an emergent specialization among practicing demographers. We argue that applied demography is intrinsically distinct from basic demography because it exhibits the value-orientation and empirical characteristics of a decision-making science while the latter exhibits the value-orientation and empirical hallmarks of a basic science. Distinguishing characteristics of applied demography are based on the context in which it places precision and explanatory power relative to time and resources as well as the fact its substantive problems are largely exogenously-defined, usually by customers. The substantive problems of basic demography, on the other hand, are largely endogenously-defined, usually by academic demographers. Moreover, basic demography is primarily concerned with offering convincing explanations of demographic phenomena and tends to view time and resources as barriers to surmount in order to maximize precision and explanatory power. This context is very different from the one in which applied demography is embedded, which views explanatory power and precision in terms of doing what is necessary to support practical decision-making while minimizing time and resources. We examine this conceptualization of applied demography in terms of the methods and materials that fall within its purview and discuss some important consequences, including research agendas and training programs. We conclude by posing several important but unanswered questions about the actual and potential scope of applied demography and discuss some of the implications inherent in these questions.An earlier version of this paper was presented at the annual meeting of the Southern Demographic Association, 20 October 1995, Richmond, Virginia, USA.  相似文献   
70.
论江泽民决策思想对优化我国行政决策的指导意义   总被引:1,自引:0,他引:1  
江泽民决策思想揭示了行政决策的实质与宗旨 ,反映了行政决策活动的内在规律 ,是优化我国行政决策的理论指南。它主要体现在四个方面 :深入了解民情是制定正确的行政决策的基础 ;充分反映民意是实现行政决策民主化的保证 ;广泛集中民智是提高行政决策水平的关键 ;切实珍惜民力是确保行政决策质量的重要原则  相似文献   
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