115 lines
3.7 KiB
YAML
115 lines
3.7 KiB
YAML
abstract: 'Objective To establish the views and experiences of healthcare
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professionals in relation to interventions targeted at them to reduce
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unnecessary caesareans.
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Design Qualitative evidence synthesis.
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Setting Studies undertaken in high-income, middle-income and low-income
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settings.
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Data sources Seven databases (CINAHL, MEDLINE, PsychINFO, Embase, Global
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Index Medicus, POPLINE and African Journals Online). Studies published
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between 1985 and June 2017, with no language or geographical
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restrictions. We hand-searched reference lists and key citations using
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Google Scholar.
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Study selection Qualitative or mixed-method studies reporting health
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professionals'' views.
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Data extraction and synthesis Two authors independently assessed study
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quality prior to extraction of primary data and authors''
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interpretations. The data were compared and contrasted, then grouped
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into summary of findings (SoFs) statements, themes and a line of
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argument synthesis. All SoFs were Confidence in the Evidence from
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Reviews of Qualitative research (GRADE-CERQual) assessed.
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Results 17 papers were included, involving 483 health professionals from
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17 countries (nine high-income, six middle-income and two low-income).
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Fourteen SoFs were identified, resulting in three core themes:
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philosophy of birth (four SoFs); (2) social and cultural context (five
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SoFs); and (3) negotiation within system (five SoFs). The resulting line
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of argument suggests three key mechanisms of effect for change or
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resistance to change: prior beliefs about birth; willingness or not to
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engage with change, especially where this entailed potential loss of
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income or status (including medicolegal barriers); and capacity or not
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to influence local community and healthcare service norms and values
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relating to caesarean provision.
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Conclusion For maternity care health professionals, there is a
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synergistic relationship between their underpinning philosophy of birth,
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the social and cultural context they are working within and the extent
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to which they were prepared to negotiate within health system resources
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to reduce caesarean rates. These findings identify potential mechanisms
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of effect that could improve the design and efficacy of change
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programmes to reduce unnecessary caesareans.'
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affiliation: 'Kingdon, C (Corresponding Author), Univ Cent Lancashire, Sch Community
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Hlth \& Midwifery, Fac Hlth \& Wellbeing, Preston, Lancs, England.
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Kingdon, Carol; Downe, Soo, Univ Cent Lancashire, Sch Community Hlth \& Midwifery,
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Fac Hlth \& Wellbeing, Preston, Lancs, England.
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Betran, Ana Pilar, WHO, Dept Reprod Hlth \& Res, Geneva, Switzerland.'
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article-number: e025073
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author: Kingdon, Carol and Downe, Soo and Betran, Ana Pilar
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author-email: ckingdon@uclan.ac.uk
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author_list:
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- family: Kingdon
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given: Carol
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- family: Downe
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given: Soo
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- family: Betran
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given: Ana Pilar
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da: '2023-09-28'
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doi: 10.1136/bmjopen-2018-025073
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files: []
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issn: 2044-6055
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journal: BMJ OPEN
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keywords-plus: 'OPTIMAL SEARCH STRATEGIES; VAGINAL BIRTH; MIXED-METHOD; CLINICAL
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PATHWAY; MATERNAL REQUEST; OBSTETRICIANS; DELIVERY; RATES; WOMEN; CHOICE'
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language: English
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month: DEC
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number: '12'
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number-of-cited-references: '89'
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orcid-numbers: Kingdon, Carol/0000-0002-5958-9257
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papis_id: a12bcccb4bec3e22b3a9377b58160bfc
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ref: Kingdon2018interventionstargete
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times-cited: '14'
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title: 'Interventions targeted at health professionals to reduce unnecessary caesarean
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sections: a qualitative evidence synthesis'
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type: article
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unique-id: WOS:000455309300158
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usage-count-last-180-days: '1'
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usage-count-since-2013: '6'
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volume: '8'
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web-of-science-categories: Medicine, General \& Internal
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year: '2018'
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