Midwives' perceptions of communication during videotaped counseling for prenatal anomaly tests: how do they relate to clients' perceptions and independent observations?
OBJECTIVE
This study aimed to provide insight into Dutch midwives' self-evaluation of prenatal counseling for anomaly screening in real life practice and, the degree of congruence of midwives' self-assessments with clients' perceptions and with observed performance.


METHODS
Counseling sessions were videotaped. We used the QUOTE(prenatal) questionnaire to have each midwife (N = 20) and her client (N = 240) rate the prenatal counseling that they had together. We used an adapted version of the RIAS video-coding system to assess actual counseling during videotaped prenatal counseling (N = 240).


RESULTS
Midwives perceived the following functions of counseling performed well: 100% of Client-Counselor relation (CCR); 80% of Health Education (HE); and 17% Decision-Making Support (DMS). Congruence on HE of midwives with observers and with clients was ≥ 75%; congruence on DMS was higher between midwives and observers (80%) compared to midwives and clients (62%).


CONCLUSIONS
Midwives perceive that during prenatal counseling the CCR and HE functions of counseling were performed well, whereas DMS was not. Furthermore, this study shows incongruence between midwives and clients about the discussion during DMS, indicating DMS is more difficult to assess than HE.


CONCLUSIONS
The best way to measure prenatal counseling practice might be by using assessments of different sources within one study.
Department of Midwifery Science, VU University Medical Centre, Amsterdam, The Netherlands. Electronic address: linda.martin@INHOLLAND.nl.
Linda
L
Martin
Department of Midwifery Science, VU University Medical Centre, Amsterdam, The Netherlands; Faculty of Theology, VU University, Amsterdam, The Netherlands.
Janneke T
JT
Gitsels-van der Wal
Department of Midwifery Science, VU University Medical Centre, Amsterdam, The Netherlands.
Monique T R
MT
Pereboom
Department of Midwifery Science, VU University Medical Centre, Amsterdam, The Netherlands.
Evelien R
ER
Spelten
Department of Midwifery Science, VU University Medical Centre, Amsterdam, The Netherlands; Obstetrics & Gynecology, Midwifery Education Program, McMaster University, Hamilton, Canada.
Eileen K
EK
Hutton
NIVEL (Netherlands Institute for Health Services Research), Utrecht, The Netherlands; Department of Primary and Community Care, Radboud University Medical Center, Nijmegen, The Netherlands; Department of Health Sciences, Buskerud and Vestfold University College, Drammen, Norway.
Sandra
S
van Dulmen
D000328:Adult; D001291:Attitude of Health Personnel; D003142:Communication; D000013:Congenital Abnormalities / Q000175:diagnosis* / Q000235:genetics; D003376:Counseling / Q000379:methods*; D003430:Cross-Sectional Studies; D005260:Female; D058015:Health Communication; D006266:Health Education; D006801:Humans; D008875:Middle Aged; D008880:Midwifery / Q000379:methods*; D009426:Netherlands; D009721:Nurse Midwives / Q000523:psychology*; D010465:Perception; D011247:Pregnancy; D011295:Prenatal Care; D012647:Self-Assessment; D011795:Surveys and Questionnaires; D014741:Video Recording
Health communication; Prenatal anomaly screening; Prenatal counseling; Quality of communication; Self-assessment; Video recordings