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Barriers and facilitators of implementing the practice programme for upright positions in the second stage of labour: A mixed-method study

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机构: [1]Kings Coll London, Florence Nightingale Fac Nursing Midwifery & Palli, London, England [2]Hebei Univ, Affiliated Hosp, Dept Obstet, Baoding, Peoples R China [3]Hebei North Univ, Dept Nursing, Affiliated Hosp 1, Zhangjiakou, Peoples R China [4]Hebei Med Univ, Affiliated Hosp 4, Dept Obstet, Shijiazhuang, Peoples R China [5]Hebei Matern Hosp, Dept Obstet, Shijiazhuang, Peoples R China [6]Hebei Med Univ, Sch Nursing, Shijiazhuang 050017, Peoples R China
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关键词: CFIR implementation research mixed-method second stage of labour upright position

摘要:
Objective To explore the possible barriers and facilitators to implementing the Upright Positions in the Second Stage of Labour (UPSSL) programme in Chinese healthcare settings.Design A mixed-method convergent design with the guidance of Consolidated Framework for Implementation Research (CFIR).Methods An online survey study and semi-structured interviews were conducted between March and May 2023. Healthcare professionals were recruited from four hospitals in Shijiazhuang, China. One hundred and thirty-one participants completed the survey study, and 23 of them were interviewed individually. Descriptive statistics evaluated the possible barriers and facilitators of implementing the UPSSL programme within the CFIR framework quantitatively. Guided by the CFIR framework, qualitative data were analysed using directed content analysis to summarize healthcare professionals' perspectives on barriers and facilitators of the UPSSL programme.Results Multiple intersectional barriers and facilitators were identified from the survey and semi-interviews. Healthcare professionals believed that the UPSSL programme has a scientific evidence base, systematic contents, and possible benefits for women. However, various barriers existed at individual, system, and organizational levels. Major barriers included healthcare professionals and women's safety concerns towards the use of upright positions during childbirth, the healthcare professionals' unfamiliarity with assisting an upright position birth, poor adaptability of the programme protocol, inadequate facilities and staffing, and a lack of readiness to change in the clinical setting.Conclusions To facilitate the implementation of the UPSSL programme in China, tailored antenatal education on upright positions, especially addressing safety-related issues, should be provided to pregnant women, their families, or peers to enhance their understanding of and familiarity with such positions. Healthcare professionals should also be offered adequate training opportunities and necessary facilities. Furthermore, national-level policy changes might be required to address midwifery workforce shortages. Additionally, further research is warranted to select, adapt, and test effective implementation strategies for programme adoption.

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出版当年[2023]版:
大类 | 3 区 医学
小类 | 2 区 护理
最新[2025]版:
大类 | 2 区 医学
小类 | 1 区 护理
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出版当年[2023]版:
Q1 NURSING
最新[2023]版:
Q1 NURSING

影响因子: 最新[2023版] 最新五年平均 出版当年[2023版] 出版当年五年平均 出版前一年[2022版]

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第一作者机构: [1]Kings Coll London, Florence Nightingale Fac Nursing Midwifery & Palli, London, England
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通讯机构: [6]Hebei Med Univ, Sch Nursing, Shijiazhuang 050017, Peoples R China [*1]School of Nursing, Hebei Medical University, Shijiazhuang, 050017, China
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