Ageeth N Rosman1, Floortje Vlemmix2, Antje Beuckens3, Marlies E Rijnders4, Brent C Opmeer5, Ben Willem J Mol6, Marjolein Kok2, Margot A H Fleuren7. 1. Department of Obstetrics and Gynecology, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands. Electronic address: a.n.rosman@amc.uva.nl. 2. Department of Obstetrics and Gynecology, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands. 3. The Royal Dutch Organisation for Midwives, Utrecht, The Netherlands. 4. TNO Department of Child Health, Leiden, The Netherlands. 5. Clinical Research Unit, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands. 6. The Robinson Institute | School of Paediatrics and Reproductive Health, University of Adelaide, 5000 SA Australia. 7. TNO Department of Life Style, Leiden, The Netherlands.
Abstract
OBJECTIVE: guidelines recommend that external cephalic version (ECV) should be offered to all women with a fetus in breech presentation at term. However, only 50-60% of the women receive an ECV attempt. We explored the determinants (barriers and facilitators) affecting the uptake of the guidelines among gynaecologists and midwives in the Netherlands. DESIGN: national online survey. SETTING: the Netherlands. PARTICIPANTS: gynaecologists and midwives. MEASUREMENTS: in the online survey, we identified the determinants that positively or negatively influenced the professionals׳ adherence to three key recommendations in the guidelines: (a) counselling, (b) advising for ECV, (c) arranging an ECV. Determinants were identified in a previously performed qualitative study and were categorised into five underlying constructs; attitude towards ECV, professional obligation, outcome expectations, self-efficacy and preconditions for successful ECV. We performed a multivariate analysis to assess the importance of the different constructs for adherence to the guideline. FINDINGS: 364 professionals responded to the survey. Adherence varied: 84% counselled, 73% advised, and 82% arranged an ECV for (almost) all their clients. Although 90% of respondents considered ECV to be an effective treatment for preventing caesarean childbirths, only 30% agreed that 'every client should undergo ECV'. Self-efficacy (perceived skills) was the most important determinant influencing adherence. KEY CONCLUSIONS: self-efficacy appears to be the most significant determinant for counselling, advising and arranging an ECV. IMPLICATIONS FOR PRACTICE: to improve adherence to the guidelines on ECV we must improve self-efficacy.
OBJECTIVE: guidelines recommend that external cephalic version (ECV) should be offered to all women with a fetus in breech presentation at term. However, only 50-60% of the women receive an ECV attempt. We explored the determinants (barriers and facilitators) affecting the uptake of the guidelines among gynaecologists and midwives in the Netherlands. DESIGN: national online survey. SETTING: the Netherlands. PARTICIPANTS: gynaecologists and midwives. MEASUREMENTS: in the online survey, we identified the determinants that positively or negatively influenced the professionals׳ adherence to three key recommendations in the guidelines: (a) counselling, (b) advising for ECV, (c) arranging an ECV. Determinants were identified in a previously performed qualitative study and were categorised into five underlying constructs; attitude towards ECV, professional obligation, outcome expectations, self-efficacy and preconditions for successful ECV. We performed a multivariate analysis to assess the importance of the different constructs for adherence to the guideline. FINDINGS: 364 professionals responded to the survey. Adherence varied: 84% counselled, 73% advised, and 82% arranged an ECV for (almost) all their clients. Although 90% of respondents considered ECV to be an effective treatment for preventing caesarean childbirths, only 30% agreed that 'every client should undergo ECV'. Self-efficacy (perceived skills) was the most important determinant influencing adherence. KEY CONCLUSIONS: self-efficacy appears to be the most significant determinant for counselling, advising and arranging an ECV. IMPLICATIONS FOR PRACTICE: to improve adherence to the guidelines on ECV we must improve self-efficacy.
Authors: J Burgos; L Rodríguez; P Cobos; C Osuna; M Del Mar Centeno; R Larrieta; T Martínez-Astorquiza; L Fernández-Llebrez Journal: J Perinatol Date: 2015-07-16 Impact factor: 2.521
Authors: Carolyn F Weiniger; Deirdre J Lyell; Lawrence C Tsen; Alexander J Butwick; BatZion Shachar; William M Callaghan; Andreea A Creanga; Brian T Bateman Journal: BMC Pregnancy Childbirth Date: 2016-07-08 Impact factor: 3.007
Authors: Rianne M J J van der Kleij; Mathilde R Crone; Theo G W M Paulussen; Vivan M van de Gaar; Ria Reis Journal: BMC Public Health Date: 2015-10-08 Impact factor: 3.295