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研究生:Safella Lutfatul Jannah
研究生(外文):SAFELLA LUTFATUL JANNAH
論文名稱(外文):Exploring the Perceptions of Women’s and Midwives’ in Indonesia Regarding Autonomy and Respect during Labor and Delivery
指導教授(外文):CHIEN-HUEI KAO, C.N.M., R.N., PhD
口試委員(外文):Prof. CHIEH-YU LIUProf. TSAE-JYY WANG
口試日期:2020-06-05
學位類別:碩士
校院名稱:國立臺北護理健康大學
系所名稱:護理助產及婦女健康系護理助產研究所
學門:醫藥衛生學門
學類:護理學類
論文種類:學術論文
論文出版年:2020
畢業學年度:108
語文別:英文
論文頁數:133
外文關鍵詞:autonomy, decision making, respect, childbirth, perception, women centered care
IG URL:safellas
Facebook:Safella Lutfatul Jannah
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Background: Midwives must understand autonomy and respect in order to identify gaps and challenges in the quality of maternity care. To date, few studies have produced evidence about autonomy and respect as part of the quality of maternity care. Incorporating both the perspectives of women’s and midwives can help to pinpoint which aspects of care need to be strengthened to increase the quality of care.
Methods: This was a descriptive comparative study. A convenience sampling method was used to select 130 woman and 68 midwives from two hospitals and four health centres in Kudus Regency, Indonesia. After obtaining informed consent, women’s and midwives filled out questionnaires including one for demographic characteristics. The women’s then responded to the Mother’s Autonomy in Decision Making (MADM) scale and the Mothers on Respect index (MORi). In addition, this study modified the two questionnaires for midwives, creating two new instruments, the Midwives’ Views of Client’s Autonomy in decision making (MVCA) and the Midwives’ Views on Respectful Care (MVRC).
Results: Household income was the only factor associated with women’s perceptions of autonomy during labor and delivery. None of the demographic factors influenced women’s perceptions about respectful maternity care. However, age, religion, and work experience did impact midwives’ perceptions of respectful maternity care. Comparing women’s and midwives’ perceptions of autonomy in decision making, the women’s perceived they had been given greater autonomy than the midwives believed they had permitted. Conversely, the 68 midwives felt they had shown more respect for the women’s during labor and delivery than the women’s experienced themselves.
Conclusions: Differences in perceptions of women’s autonomy and respectful maternity care between midwives and women’s are a barrier to improving the quality of maternity care. Understanding the differences between women’s and midwives' perspectives is critical to understanding women’s preferences and needs, in order for midwives to know if their performance meets women’s expectations. Prioritizing respectful behavior, concern for women’s autonomy, and a comprehensive strategy for improving quality of maternity care should be implemented in order to empower women’s.

Contents
Acknowledge ii
Abstract iii
Contents v
List of Tables vii
List of Figures viii
Chapter I: Introduction
Section I : Background 1
Section II : The Purpose of the Study 5
Section III : Research Objectives 5
Section IV : Research Questions 5
Section V : Significance of the study 6
Section VI : Definition of Variables 7
Chapter II: Literature Review
Section I : Perceptions of Women’s and Midwives during Labor and Delivery 9
Section II : Introduction of Maternal Health Care during Labor and Delivery in
Indonesia 13
Section III : Related Studies about Autonomy and Respect during Labor and
Delivery 19
Chapter III: Research Methodology
Section I : Study Design 26
Section II : Study Setting 26
Section III : Sampling and Sample size 26
Section IV : Eligibility Criteria 27
Section V : Research Instruments 27
Section VI : Data Collection Process 32
Section VII : Conceptual Framework 35
Section VIII : Translation and Back Translation of Questionnaire 36
Section IX : Data Processing and Statistical Analysis 37
Section X : Ethical Consideration 40

Chapter IV: Results
Section I : Background of Participants 41
Section II : Mothers’ Autonomy in Decision Making and Mothers on respect 45
Section III : Midwives’ View of Clients’ Autonomy during Care and Respectful Care 52
Section IV : Comparing Women’s and Midwives’ Perception of Autonomy and Respect 57
Chapter V: Discussion
Section I : Results of the study 65
Section II : Whether the Midwives Provided Woman-Centered Care 76
Section III : Cultural and Social Status Influenced the Perceptions of the Women’s 83
Chapter V: Conclusion
Section I : Conclusion 87
Section II : Strengths and Limitations of the Study 89
Section III : Implications and Recommendations 89
References
Appendix

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