Midwifery and decision-making theories
Elaine Jefford, Julie Jomeen in Empowering Decision-Making in Midwifery, 2019
The explicit aim of maternity care is to promote the safety of women and babies, irrespective of whether that care provider is a midwife or medical health professional. We are accountable for the decisions we make, their resultant actions and any related outcomes. Yet midwives and doctors view childbirth through different lenses, which impact upon decision-making and care options (Dove, 2013; Dannaway and Dietz, 2014; Scamell, 2014). Earlier in this chapter the inference was that only doctors have a risk lens and was generically applied to all doctors. It is, however, not necessarily true. Neither is the assumption that all midwives use the ‘normality’ lens necessarily true. Some midwives and doctors are risk-takers and some are risk-averse. Multiple factors influence decision-making including psychological characteristics such as impulsivity and risk tolerance, observed or learnt behaviours, own childbirthing experiences or vicarious experiences. Some of these are discussed towards the end of this book, as is the contested space a midwife must engage in when trying to meet the needs of the woman and her birthing experience and those of the regulatory and legal systems (Chapters 2 and 3). No decision-making theory, model, tool or framework at the moment takes into consideration all these elements, variables and influencing factors, and one wonders if it is actually possible.
Nurses as decision makers: where next?
Russell Gurbutt in Nurses’ Clinical Decision Making, 2018
A factor in nurses’ acceptance of responsibility for errors, and the implied labelling of these as good or poor, has been associated with their interpretation of the Code of Professional Conduct.1 Demonstration of good, safe and demonstrable decisions by justifying the actions taken requires self-evaluation. It has been argued that a ‘feeling of having made the right decision, irrespective of outcome in terms of action’ was a part of the process.4 A small-scale study of 12 expert nurse decision makers (5 years post registration) supported the use of a problem-solving process and identified a cluster of objective and subjective factors that included a personal philosophy of care as influences on decision making. In the study referred to in this book, one of the subjective factors was the doctor–nurse interaction. There were occasions when nurses had a preferred decision which they considered was in the patient’s best interests, but they sometimes had to lay this aside in order to conform with a medical way of knowing the patient. This highlighted the influence of context on judging decision making as good or poor. This has been reported elsewhere in a claim that it was difficult to hold nurses accountable for specific patients, and it was recognised that they sometimes placed ‘employers’ priorities above patient priorities’.
Social Assistive Robots for Children with Complex Disabilities
Pedro Encarnação, Albert M. Cook in Robotic Assistive Technologies, 2017
Learning from clinician and parental input (which specific goals need to be met) and incorporating these data into decision making is crucial for the success of a SAR. Using this knowledge in real-world environments to elicit a desired response from the child can significantly improve clinical outcomes. For example, a clinician working to elicit vocal engagement behaviors from a child can incorporate information about how the child responds to physical closeness to the SAR, and the parents’ knowledge of the types of output a child responds to can be used to initiate SAR-child engagement (Robins, Dautenhahn, and Dickerson 2009).
Exploring how parents of children with unilateral hearing loss make habilitation decisions: a qualitative study
Published in International Journal of Audiology, 2021
Saira Hussain, Helen Pryce, Amy Neary, Amanda Hall
Each of the interview transcripts were independently coded and these codes were compared across the transcripts. The two data sets were initially coded by researchers AN and SH, followed by blind-coding with researcher HP to ensure consistency across the codes. These codes maintained a wide view of all possible theoretical directions and preferentially used ‘in-vivo’ codes to preserve the participants’ language (Charmaz 2006) (summarising meaning statements using words from the participant to code them e.g. open coding). By exploring the operation, properties and dimensions of these codes the researcher condensed them into broader categories (axial coding). The relationships between these categories were explored to develop a framework of decision making. The category that explained the variation and was present in each transcript to explain variance is presented in the model below (selective coding).This model described variation within the data set. These findings were then compared to the wider literature.
Influence of visual clutter on the effect of navigated safety inspection: a case study on elevator installation
Published in International Journal of Occupational Safety and Ergonomics, 2019
Pin-Chao Liao, Xinlu Sun, Mei Liu, Yu-Nien Shih
This study focused on factors that might influence decision-making. As a conceptual process, decision-making can be influenced both by external factors, such as target templates, and internal human conceptual abilities such as experience. Recarte and Nunes [21] found that a considerable amount of mental workload would lead to the poor identification of targets during the decision-making stage in his study on driving performance. Hout and Goldinger [14] found that the width and precision of the target template in the working memory of observers would significantly affect the decision time to verify whether the item is the target. When studying the mechanism of people searching for an object based on some features, researchers established a cognitive model demonstrating that observers first recognize one or two alternatives, and then they use their knowledge stored in their long-term memory to make a judgment and decision. The role that the decision phase plays in visual search tasks varies in different areas. Studies in the industrial field found that inspectors spent most of the time in the search phase, thus utilizing less time for decision-making. Researchers in the medical field proposed that when searching for irregular organs in an X-ray scan, medicos spend a considerably large amount of time on deciding whether the item involves pathological changes.
Rethinking device abandonment: a capability approach focused model
Published in Augmentative and Alternative Communication, 2023
Andy Smidt, Roxanna N. Pebdani
In the Communication Capability Approach (Figure 2) the grey boxes are similar to the Robeyns model, and the green boxes include aspects of the Participation Model. The availability of devices, specialist assessment teams, funding for devices, and device trials will impact available resources. Conversion factors include the skills and attitudes of the person themselves as well as those of a range of people in a range of settings in which the person functions. Ultimately the interaction of resources and conversion factors results in a set of possible behaviors which are capability sets. Social context influences conversion factors and the capability set. Social influences on decision making, personal history and personality influence agency and choice. The combination of agency and capability results in the freedom to choose the actual achieved functioning. In AAC, the achieved functioning is the way in which the person chooses to communicate in any given situation.
Related Knowledge Centers
- Cognition
- Irrationality
- Problem Solving
- Psychological Research
- Tacit Knowledge
- Psychology
- Value
- Choice
- Knowledge
- Medical Diagnosis