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