Barriers to Implementing Evidence-Based Intrapartum Care: A Descriptive Exploratory Qualitative Study

Iravani, Mina; Janghorbani, Mohsen; Zarean, Elahe; Bahrami, Masoud

doi:10.5812/ircmj.21471

Cited by 21 publications

(48 citation statements)

References 32 publications

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“…A study undertaken in Iran between 2013 and 2014 showed that key barriers to adopting evidence-based practices were lack of knowledge and skills, lack of motivation to change or adopt new behavior, lack of decision-making authority, fear of legal action, and poor health professional-patient communication. Other significant barriers included shortage of equipment and inappropriate physical structure of birth settings and the fact that the decisions taken by doctors often go against the norms of best practice 21 . Both studies showed that women had limited capacity to influence change [21][22][23][24] .…”

Section: Discussionmentioning

confidence: 99%

Avaliação das boas práticas de atenção ao parto por profissionais dos hospitais públicos do Distrito Federal, Brasil

Carvalho

Amorim

Santana

et al. 2019

Ciênc. saúde coletiva

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Resumo O objetivo deste artigo é avaliar a adesão às boas práticas de atenção ao parto e nascimento, entre médicos, enfermeiros e residentes dos programas de residência em obstetrícia, dos hospitais públicos do Distrito Federal (DF). Estudo transversal do tipo inquérito aplicado a profissionais em 11 hospitais públicos do DF de janeiro a março de 2015. Instrumento com 20 questões sociodemográficas e 39 itens do tipo escala Likert. Para análise estatística, os profissionais foram separados em 4 grupos (enfermeiros, enfermeiro residentes, médicos e médicos residentes). Foram também avaliados os escores de cada hospital estudado. A dimensão processo de trabalho apresentou os maiores escores em relação as demais dimensões. Na comparação entre os grupos e entre os hospitais não foram observadas diferenças significativas em nenhuma das dimensões. A maioria dos profissionais estimula o parto natural. É necessário reforçar as ações para maior adesão às boas práticas de atenção ao parto, tanto na organização da rede de serviços quanto nas atitudes e valores da formação dos novos profissionais de saúde.

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Section: Discussionmentioning

confidence: 99%

Avaliação das boas práticas de atenção ao parto por profissionais dos hospitais públicos do Distrito Federal, Brasil

Carvalho

Amorim

Santana

et al. 2019

Ciênc. saúde coletiva

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“…However Iranian midwives today have little authority in providing childbirth care and for the most part the perinatal care process is managed by obstetricians in teaching hospitals. In some non-teaching public hospitals, childbirth care is performed by midwives under the obstetricians' supervision [20].…”

Section: Setting and Participantsmentioning

confidence: 99%

Midwives’ perspectives of respectful maternity care during childbirth: A qualitative study

et al. 2020

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The adoption of respectful maternity care during labor and birth is a complex process which needs both scientific and interpersonal skills of providers. In this regard, identifying the potential barriers and applying effective strategies for implementing respectful maternity care are essential. This study aimed to explore the perceptions of Iranian midwives regarding respectful maternity care during labor and childbirth. This was a qualitative study which was conducted from September-December 2018 in two non-teaching public hospitals in Tehran, Iran. Twenty-four semi-structured interviews were conducted with midwives, who had more than one year work experience in labor and childbirth units, through a purposive sampling method. A content analysis approach was used to analyze the data and identify themes. Three themes were extracted including "showing empathy", "women-centered care" and "protecting rights". Showing empathy reflects that "establishing a friendly relationship" and "being with women". Women-centered care encompassed "keeping women safe" and "participating in decision making". Protecting rights reflected a need for "safeguarding dignity" as well as "giving equal care" and "preparing appropriate environment". Iranian midwives considered respectful maternity care a broader concept than just preventing mistreatment. Providing supportive care through friendly interaction with women was the first step for providing respectful maternity care. Respectful care is also promoted by providing safe care, implementing evidence-based care and involving women in their care as well as by providing an appropriate environment for women, families and caregivers. OPEN ACCESS Citation: Moridi M, Pazandeh F, Hajian S, Potrata B (2020) Midwives' perspectives of respectful maternity care during childbirth: A qualitative study. PLoS ONE 15(3): e0229941. https://doi.org/ 10.

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“…These findings are consistent with other studies in low‐ and middle‐income countries. For example, workforce shortages and heavy workload were identified as key barriers to evidence‐based nursing care in Iran (Iravani, Janghorbani, Zarean, & Bahrami, ) and to quality midwifery care in Philippines and Indonesia (Filby, McConville, & Portela, ). Lack of material resources such as equipment, supplies and facilities were identified as significant barriers to optimal surgical care in India and Bangladesh (Grimes, Bowman, Dodgion, & Lavy, ) and in the implementation of maternal and perinatal health guidelines in Myanmar (Vogel et al., ).…”

Section: Discussionmentioning

confidence: 99%

“…Another project‐specific barrier identified in the current study was related to consumers’ knowledge, beliefs and financial resources. It is quite unexpected that only one project acknowledged this issue, given that many studies in low‐ and middle‐income countries have reported poor health literacy, patients’ misconceptions and financial constraints as key barriers to the delivery of EBHC (Iravani et al., ; Ritchie et al., ). Even though implementation studies tend to focus on organizational and health provider factors and less so on consumers and least of all on policymakers, the literature supports a multilevel analysis in which implementation planning equally involves examining those who receive health care (i.e., consumers and community; Ritchie et al., ; Vogel et al., ) as well as the government system responsible for regulating health policies and reforms (Mosquera et al., ; Ritchie et al., ).…”

Section: Discussionmentioning

confidence: 99%

Barriers and Facilitators to Implementing Evidence in African Health Care: A Content Analysis With Implications for Action

Lizarondo

Lockwood

McArthur

2019

Worldviews Ev Based Nurs

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Background: Culture-and context-specific issues in African countries such as those related to language, resources, technology, infrastructure and access to available research may confound evidence implementation efforts. Understanding the factors that support or inhibit the implementation of strategies aimed at improving care and health outcomes specific to their context is important.Aims: The aim of this study was to determine barriers and facilitators to evidence implementation in African healthcare settings, based on implementation projects undertaken as part of the Joanna Briggs Institute (JBI) Clinical Fellowship program.Methods: Reports of implementation projects conducted in Africa were obtained from the JBI database and printed monographs associated with the fellowship program. A purpose-built data extraction form was used to collect data from individual reports. Data were analysed using content analysis.Results: Eleven published and nine unpublished implementation reports were reviewed. The most frequently reported barriers to evidence implementation operate at the health organization or health practitioner level. Health organization-level barriers relate to human resources, material resources and policy issues. Health practitioner-level barriers relate to practitioners' knowledge and skills around evidence-based practice, and attitudes to change. Barriers at the government and consumer levels were uncommon. Only a few facilitators were identified and were related to health practitioners' attitudes or support from the organization's management.Linking Evidence to Action: The study identified a core set of barriers and facilitators in African healthcare settings, which are common to other low-and middle-income countries. These can be used to develop a method by which implementation programs can systematically undertake barrier or facilitator analysis. Future research should aim to develop a process by which these barriers and facilitators can be prioritised so that a structured decision support procedure can be established.

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Barriers to Implementing Evidence-Based Intrapartum Care: A Descriptive Exploratory Qualitative Study

Cited by 21 publications

References 32 publications

Avaliação das boas práticas de atenção ao parto por profissionais dos hospitais públicos do Distrito Federal, Brasil

Avaliação das boas práticas de atenção ao parto por profissionais dos hospitais públicos do Distrito Federal, Brasil

Midwives’ perspectives of respectful maternity care during childbirth: A qualitative study

Barriers and Facilitators to Implementing Evidence in African Health Care: A Content Analysis With Implications for Action

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