Outcome
| Type |
Measure |
Description |
Time frame |
Safety issue |
| Primary |
SDM competency from midwives' perspective |
The SDM competency from a midwife's perspective is defined as the ability perceived by midwives to involve patients in the decision-making process. It is measured using the 9-item Shared Decision-Making Questionnaires for healthcare professionals (SDM-Doc). The questionnaire consists of 9 items, and each item represents a statement that features various aspects of SDM using a 6-point Likert scale from 0 (completely disagree) to 5 (completely agree). A total score ranged from 0~45; higher scores indicate a higher level of SDM competency. |
baseline, week 2, week 4 |
|
| Primary |
SDM competency from observers' perspective |
The SDM competency, from the observers' perspective, is defined as the efforts of healthcare professionals to involve patients in decision-making from blinded observers. It is measured by the Observing Patient Involvement scale (OPTION5). Each item was scored on a 5-point scale from 0 (no effort) to 4 (exemplary effort). A total score ranged from 0~20, with higher scores and higher levels of the extent to which healthcare providers involved patients in decision-making. |
baseline, week 2, week 4 |
|
| Primary |
SDM competency from patients' perspective |
The SDM competency from a patient's perspective is defined as the patient's perceived extent to which SDM has taken place in the encounter with midwives. It is measured using the 9-item Shared Decision-Making Questionnaires for patients (SDM-Q-9). The questionnaire consists of 9 items, and each item represents a statement that features various aspects of SDM using a 6-point Likert scale from 0 (completely disagree) to 5 (completely agree). A total score ranged from 0~45; higher scores indicate a higher level of SDM competency. |
baseline, week 2, week 4 |
|
| Primary |
Decision support skill |
Decision support skill is defined as midwives' competency to support patients during the decision-making process. It is measured from blinded observers using the Decision Support Analysis Tool (DSAT10). DSAT10 has five categories of decision-making status, knowledge of options, values associated with outcomes of options, others' involvement, and next steps plan. Assessing and intervening are differentiated in the scale. Each check item was rated as present (1) or absent (0). Not applicable was used in circumstances when it was not necessary to have met an item. A total score ranged from 0~10, with higher scores for better SDM skills. |
baseline, week 2, week 4 |
|
| Primary |
Communication skill |
Communication skill is defined as midwives' competency to express verbal and non-verbal behaviors of patient- and relationship-centered communication. It is measured from blinded observers using the Four Habits Coding Scheme. The 4HCS consisted of 23 items with four habits of basic medical interview, including invest in the beginning (6 items), elicit the patient's perspective (3 items), demonstrate empathy (4 items), and invest in the end (10 items). Each item was scored on a 5-point scale from 1 (ineffective) to 5 (highly effective). A total score ranged from 23~115, with higher scores for more effective patient-centered communication in consultations. |
baseline, week 2, week 4 |
|
| Secondary |
Level of EBP competency |
The EBP competency is defined as attitude, knowledge, and skill that is perceived by midwives toward evidence-based practice. It is assessed using the Health Sciences-Evidence Based Practice questionnaire (HS-EBP). The 60-item HS-EBP includes five domains of beliefs-attitudes (12 items), results from scientific research (14 items), development of professional practice (10 items), assessment of results (12 items), and barriers-facilitators (12 items). Each item was rated on a 10-point Likert scale (ranging from 1 to 10), with higher scores indicating a greater degree of agreement. |
baseline, week 2, week 4 |
|
| Secondary |
Decision conflict |
Decision conflict is defined as the degree of conflict experienced by patients when making treatment-related decisions. It is measured by the Decision Conflict scale (DCS). DCS had 16 items and is covered by five subscales, including informed (3 items), values clarity (3 items), social support (3 items), uncertainty (3 items), and effective decision (4 items). Each item was scored on a 5-point Likert scale from 0 (strongly agree) to 4 (strongly disagree). In each subscale, the scores of the items were summed up, divided by the number of items, and multiplied by 25, with a possible score ranging from 0 (no decision conflict) to 100 (extremely high decision conflict). A score below 25 indicated the implementation of the decision, and scores exceeding 37.5 signify decision delay or feeling unsure about implementing their decisions. |
baseline, week 2, week 4 |
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