Women's decision-making about mode of birth after a previous caesarean section

2020 ◽  
Vol 28 (2) ◽  
pp. 104-113
Author(s):  
Simona Fumagalli ◽  
Elisabetta Colciago ◽  
Laura Antolini ◽  
Sofia Perego ◽  
Micaela Fiorasi ◽  
...  

Background Evidence on the safety and appropriateness of vaginal birth after caesarean (VBAC) appears clear, but knowledge about women's choice towards this mode of birth is limited. Aims To identify variables related to women's decision-making about whether to try for VBAC. Method and findings Cross-sectional study was conducted. Feelings of body failure towards the previous birth and the desire to have a vaginal birth were associated with maternal choice of VBAC. Women who perceived a repeated section as being dangerous for them opted for a VBAC (p=0.030). Opinion of women with the same experience and information found online were implicated into maternal decision-making. Conclusion This is the first Italian study to confirm that maternal choice is complex and involves many factors. Midwives and obstetricians should strive to provide an evidence-based midwifery care, in order to offer a VBAC as a safe birth option.

2015 ◽  
Vol 43 (2) ◽  
Author(s):  
Mechthild M. Gross ◽  
Andrea Matterne ◽  
Silvia Berlage ◽  
Annette Kaiser ◽  
Nicholas Lack ◽  
...  

AbstractRegional and interinstitutional variations have been recognized in the increasing incidence of caesarean section. Modes of birth after previous caesarean section vary widely, ranging from elective repeat caesarean section (ERCS) and unplanned repeat caesarean section (URCS) after trial of labour to vaginal birth after caesarean section (VBAC). This study describes interinstitutional variations in mode of birth after previous caesarean section in relation to regional indicators in Germany.A cross-sectional study using the birth registers of six maternity units (n=12,060) in five different German states (n=370,209). Indicators were tested by χThe percentages of women in the six units with previous caesarean section ranged from 11.9% to 15.9% (P=0.002). VBAC was planned for 36.0% to 49.8% (P=0.003) of these women, but actually completed in only 26.2% to 32.8% (P=0.66). Depending on the indicator, the units studied deviated from the regional data by up to 32% [relative risk 0.68 (0.47–0.97)] in respect of completed VBAC among all initiated VBAC.There is substantial interinstitutional variation in mode of birth following previous caesarean section. This variation is in addition to regional patterns.


2015 ◽  
Vol 95 (4) ◽  
pp. 568-578 ◽  
Author(s):  
Patricia J. Manns ◽  
Amy V. Norton ◽  
Johanna Darrah

Background Curricula changes in physical therapist education programs in Canada emphasize evidence-based practice skills, including literature retrieval and evaluation. Do graduates use these skills in practice? Objectives The aim of this study was to evaluate the use of research information in the clinical decision making of therapists with different years of experience and evidence-based practice preparation. Perceptions about evidence-based practice were explored qualitatively. Design A cross-sectional study with 4 graduating cohorts was conducted. Methods Eighty physical therapists representing 4 different graduating cohorts participated in interviews focused on 2 clinical scenarios. Participants had varying years of clinical experience (range=1–15 years) and academic knowledge of evidence-based practice skills. Therapists discussed the effectiveness of interventions related to the scenarios and identified the sources of information used to reach decisions. Participants also answered general questions related to evidence-based practice knowledge. Results Recent graduates demonstrated better knowledge of evidence-based practice skills compared with therapists with 6 to 15 years of clinical experience. However, all groups used clinical experience most frequently as their source of information for clinical decisions. Research evidence was infrequently included in decision making. Limitations This study used a convenience sample of therapists who agreed to volunteer for the study. Conclusions The results suggest a knowledge-to-practice gap; graduates are not using the new skills to inform their practice. Tailoring academic evidence-based activities more to the time constraints of clinical practice may help students to be more successful in applying evidence in practice. Academic programs need to do more to create and nurture environments in both academic and clinical settings to ensure students practice using evidence-based practice skills across settings.


BMJ Open ◽  
2021 ◽  
Vol 11 (6) ◽  
pp. e044372
Author(s):  
Mat Nawi Zanaridah ◽  
Mohd Noor Norhayati ◽  
Zakaria Rosnani

ObjectivesTo determine the level of knowledge and practice of evidence-based medicine (EBM) and the attitudes towards it and to identify the factors associated with its practice among primary care practitioners in Selangor, Malaysia.SettingThis cross-sectional study was conducted in randomly selected health clinics in Selangor. Data were collected from primary care physicians using self-administered questionnaires on knowledge, practice and attitudes regarding EBM.ParticipantsThe study included 225 respondents working in either government or private clinics. It excluded house officers and those working in public and private universities or who were retired from practice.ResultsA total of 32.9% had a high level of EBM knowledge, 12% had a positive attitude towards EBM and 0.4% had a good level of its practice. The factors significantly associated with EBM practice were ethnicity, attitude, length of work experience as a primary care practitioner and quick access to online reference applications on mobile phones.ConclusionsAlthough many physicians have suboptimal knowledge of EBM and low levels of practising it, majority of them have a neutral attitude towards EBM practice. Extensive experience as a primary care practitioner, quick access to online references on a mobile phone and good attitude towards EBM were associated with its practice.


Author(s):  
Shu-Chun Lin ◽  
Lee-Fen Ni ◽  
Yu-Ming Wang ◽  
Shu Hsin Lee ◽  
Hung-Chang Liao ◽  
...  

The COVID-19 pandemic may cause a nursing shortage. Prelicensure nursing students who are exposed to high-stress COVID-19 events are related to defective career decision-making. This study validated the COVID-19 attitude scale and clarified how their attitudes about COVID-19 affected their behavioral intentions toward career decision-making. We conducted a cross-sectional study and recruited a convenience sample of 362 prelicensure nursing students from Northern and Central Taiwan. Two measurements were applied, including the Nursing Students Career Decision-making instrument and COVID-19 attitude scale. We used AMOS (version 22.0) to perform a confirmatory factor analysis. The Cronbach α of the COVID-19 attitude scale was 0.74 and consisted of four factors. The most positive attitude was the nursing belief factor, and the least positive factor was emotional burden. Prelicensure nursing students’ COVID-19 attitudes were significantly positively associated with their career decision-making attitudes and perceived control (ß = 0.41 and ß = 0.40, respectively; p < 0.001). All the key latent variables explained significantly 23% of the variance in the career decision-making behavioral intentions module. In conclusion, the COVID-19 attitude scale is valid. Although the prelicensure nursing students’ COVID-19 attitudes had no direct effect on career decision-making intentions, they had a direct effect on career decision-making attitudes and the perceived control.


2021 ◽  
Vol 18 (1) ◽  
Author(s):  
Asrat Hailu Dagne ◽  
Mekonnen Haile Beshah ◽  
Bekalu Getnet Kassa ◽  
Eyaya Habtie Dagnaw

Abstract Background Implementation of evidence-based practice is crucial to enhance quality health care, professional development, and cost-effective health service. However, many factors influence the implementation of evidence-based practice. Therefore, this study aimed to assess the implementation of evidence-based practice and associated factors among nurses and midwives. Methods Institutional-based cross-sectional study design was conducted to assess the implementation of evidence-based practice and associated factors from February 15 to March 15, 2019, among 790 nurses and midwives. Data were entered into EpiData version 3.1 then exported to SPSS version 20 for statistical analysis. Categorical variables were presented as frequency tables. Continuous variables were presented as descriptive measures, expressed as mean and standard deviation. Cronbach’s alpha was used to measure reliability, mean, standard deviation, and inter-items correlation of the factors. Independent variables with a probability value (P-value) of less than 0.2 in the Chi-square analysis were entered in the multivariable logistic regression model. Statistically significant associated factors were identified at probability value (P-value) less than 0.05 and adjusted odds ratio with a 95% confidence interval. Results The mean age of participants was 28.35 (SD ± 4.5) years. This study revealed that 34.7% (95% CI 31.5–38%) of participants implemented evidence-based practice moderately or desirably. Age of participants (AOR = 5.98, CI 1.34–26.7), barriers of implementation of evidence-based practice (AOR = 4.8, CI 2.2–10.6), the attitude of participants (AOR = 5.02, CI 1.2–21.5), nursing/midwifery work index (AOR = 3.9, CI 1.4–10.87), self-efficacy of implementation of evidence-based practice skills (AOR = 12.5, CI 5.7–27.5) and knowledge of participants (AOR = 3.06, CI 1.6–5.77) were statistically significant associated factors of implementation of evidence-based practice Concussion Implementation of evidence-based practice of nurses and midwives was poor. Age of participants, barriers of implementation of evidence-based practice, the attitude of participants, self-efficacy of implementation of evidence-based practice skills, nursing/midwifery work index, and knowledge of participants were found to be predictors of implementation of evidence-based practice. Insufficient time and difficulty in judging the quality of research papers and reports were the most common barriers to the implementation of evidence-based practice.


Heliyon ◽  
2021 ◽  
pp. e07755
Author(s):  
Victoria Bam ◽  
Alberta Yemotsoo Lomotey ◽  
Abigail Kusi-Amponsah Diji ◽  
Hayford Isaac Budu ◽  
Dorothy Bamfo-Ennin ◽  
...  

Author(s):  
Amarjot Singh Gill ◽  
Nistara Singh Chawla ◽  
Sandeep Singh Saini

Background: The practices of various health-care professionals have been improvised to accommodate the on-going covid-19 pandemic situation. Different guidelines have been set in place to ease the process of re-opening of non-elective healthcare services like out-patient physiotherapy clinics. Although the measures taken should be guided by evidence based information, major consensus amongst practicing therapists needs to guide the India physiotherapy clinics. Objective: To identify and present the opinions of different physiotherapists about the various strategies for re-opening the out-patient physiotherapy clinics. Methods: An online cross-sectional survey was conducted. Over 169 participants were selected to participate in the survey according to the pre-decided inclusion and exclusion criteria. The data was collected and saved via google forms. Result and conclusion: A majority of respondents had a consensus over different strategies for re-opening the physiotherapy OPDs. These were regarding different measures to be adapted including modifications in the clinic infrastructure and the practice pattern. This would help in smoothly re-instating the physiotherapy services post the covid-19 lockdown.


2019 ◽  
Vol 34 (6) ◽  
pp. 521-527
Author(s):  
Ibrahim Saleh Al-Busaidi ◽  
Saud Zahran Al Suleimani ◽  
Jonas Usbal Dupo ◽  
Nasser Khalfan Al Sulaimi ◽  
Vijayalakshmi Gopalan Nair

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