TY - JOUR
T1 - Facilitators and barriers to external cephalic version for breech presentation at term among health care providers in the Netherlands: a quantitative analysis
AU - Rosman, Ageeth N.
AU - Vlemmix, Floortje
AU - Beuckens, Antje
AU - Rijnders, Marlies E.
AU - Opmeer, Brent C.
AU - Mol, Ben Willem J.
AU - Kok, Marjolein
AU - Fleuren, Margot A. H.
PY - 2014/3
Y1 - 2014/3
N2 - 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. national online survey. the Netherlands. gynaecologists and midwives. 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. 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. self-efficacy appears to be the most significant determinant for counselling, advising and arranging an ECV. to improve adherence to the guidelines on ECV we must improve self-efficacy
AB - 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. national online survey. the Netherlands. gynaecologists and midwives. 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. 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. self-efficacy appears to be the most significant determinant for counselling, advising and arranging an ECV. to improve adherence to the guidelines on ECV we must improve self-efficacy
KW - Determinants
KW - External cephalic version
KW - Guidelines
KW - Implementation
U2 - https://doi.org/10.1016/j.midw.2014.01.002
DO - https://doi.org/10.1016/j.midw.2014.01.002
M3 - Article
C2 - 24530121
SN - 0266-6138
VL - 30
SP - e145-e150
JO - Midwifery
JF - Midwifery
IS - 3
ER -
