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.
基金:
This manuscript was supported by Samp;T Program of Hebei (Grant No.22377777D). Funding agencies did not involve in the study design, data collection, data analysis or the writing of this manuscript. The statements made herein are solely the responsibility [22377777D]; Samp;T Program of Hebei
第一作者机构:[1]Kings Coll London, Florence Nightingale Fac Nursing Midwifery & Palli, London, England
通讯作者:
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
推荐引用方式(GB/T 7714):
Huang Jing,Wang Bei,Sun Kejuan,et al.Barriers and facilitators of implementing the practice programme for upright positions in the second stage of labour: A mixed-method study[J].JOURNAL OF ADVANCED NURSING.2023,doi:10.1111/jan.15927.
APA:
Huang, Jing,Wang, Bei,Sun, Kejuan,Zhang, Huixin,Bai, Fan...&Zang, Yu.(2023).Barriers and facilitators of implementing the practice programme for upright positions in the second stage of labour: A mixed-method study.JOURNAL OF ADVANCED NURSING,,
MLA:
Huang, Jing,et al."Barriers and facilitators of implementing the practice programme for upright positions in the second stage of labour: A mixed-method study".JOURNAL OF ADVANCED NURSING .(2023)