title: Physicians' perception of the "Guidelines for Obstetrical Practice in Japan" and the reasons for different compliances.
abstract: The "Guidelines for Obstetrical Practice in Japan" are the first consensus-based guidelines in the field of obstetrics and were published in 2008 owing to an obstetric medical care crisis in Japan. The Guidelines describe appropriate methods for obstetric care and were based on consensus among obstetricians in Japan. Originally, the Guidelines were not intended to be a rulebook to limit physician discretion; however, from a medical care litigation standpoint, medical practices that conform to the Guidelines are following the "medical standard". The present study aimed to investigate obstetricians' perceptions of the Guidelines, to assess the degree of compliance, and to consider the implication of physician discretion in medical litigation. A questionnaire exploring the perception of the Guidelines was completed by 341 obstetricians was conducted from February 2009 until May 2009; questionnaires were evaluated using simple aggregation, correlation analysis, and principal component analysis. Although more than 80% of physicians responded that content of the Guidelines was appropriate, only 34.7% complied with recommendation level A. Our findings suggest that the rate of compliance to the Guidelines should be improved, reasons for noncompliance should be clarified, and Guidelines that are easier for patients to understand should be drafted.
authors.affiliation: Department of Research Development, Division of Public Health, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University.
authors.forename: Yuko
authors.initials: Y
authors.lastname: Ojiro
authors.affiliation: Department of Comprehensive Reproductive Medicine, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University.
authors.forename: Toshiro
authors.initials: T
authors.lastname: Kubota
authors.affiliation: Department of Research Development, Division of Public Health, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University.
authors.forename: Kozo
authors.initials: K
authors.lastname: Takase
mesh_terms: D001291:Attitude of Health Personnel; D032921:Consensus; D006287:Health Planning Guidelines; D006801:Humans; D007564:Japan; D007603:Jurisprudence; D009774:Obstetrics / Q000941:ethics / Q000592:standards*; D010349:Patient Compliance; D010465:Perception; D010820:Physicians / Q000592:standards*; D017410:Practice Guidelines as Topic; D025341:Principal Component Analysis; D018709:Statistics, Nonparametric; D011795:Surveys and Questionnaires