13 General introduction healthcare professionals show certain behaviour can be explored with the Attitude, Social Norms, Self-efficacy (ASE) model (31–34). According to the ASE-model, individual experiences, beliefs, and values influence a person’s attitude, which subsequently, together with social norms and self-efficacy, shapes the intention to perform a specific behaviour (Figure 2). Factors described as ‘knowledge and skills’ and ‘barriers and facilitators’ interact with a person’s intentions until they translate in actual behaviour, such as the use of an intervention. For example, organisational factors in the professional environment, such as workload and volume targets, influence individual decision-making (behaviour) (19). In this example, we see that factors at the meso-level (professional environment) influence the micro-level (individual healthcare professional). A closer look at the midwife’s role as a healthcare professional in decisionmaking shows the influence of factors such as workload, setting (home or hospital), and regional protocols (35–37). In addition, more individual factors based on experience, beliefs, and values influence a midwife’s decisionmaking. Their attitudes to physiology, woman-centredness, and shared decision-making, as well as individual risk perception, have an influence (35,36). A midwife’s risk perception appears to be influenced by the social or medical model (38,39). Midwives who believe that pregnancy and birth are largely normal and healthy processes, think according to the social model. This model is characterised by the involvement of the pregnant woman, a holistic approach, and the social context. In contrast, the medical model is characterised by more monitoring, risk-thinking, and higher rates of interventions. Figure 2. The ASE-model (33) 1
RkJQdWJsaXNoZXIy MTk4NDMw