Maternity care providers' involvement in research

Midwives' opinions and engagement with midwifery research: A cross-sectional study

BACKGROUND

Midwives' engagement in research is vital for advancing evidence-based practice and enhancing quality care. Despite the expectation that midwives incorporate evidence into their practice, the profession has historically been underrepresented in research.

AIM

To investigate midwives' opinions about midwifery research and assess their level of engagement in midwifery-led research.

METHODS

A cross-sectional design and a convenience-based sampling approach at one metropolitan hospital were used. Data were collected using an online survey with a combination of closed, multichoice and open-ended questions. Data were analysed using SPSS for descriptive and univariate statistics. Content analysis was used for free-text responses.

FINDINGS

Sixty midwives participated, with a response rate of 16 % (60/380). Most participants expressed positive attitudes toward research,. Less positive attitudes were obtained for confidence and access to resources. A small proportion reported they had authored or co-authored a peer-reviewed journal article (6.7 %), and presented at a conference (8.3 %) or within their healthcare organisation (18.3 %). Midwives reported significant barriers to engagement in research, particularly related to lack of time, low-confidence, and minimal research education.

DISCUSSION

The findings illustrate the recognition by midwives of the essential role that clinical experience, scientific knowledge, and research play in the practice and advancement of midwifery. However, midwives perceive there are barriers to their involvement in research.

CONCLUSION

Larger studies are needed to develop, implement and evaluate targeted interventions to promote midwifery-led research. Strategies are needed to increase midwives' engagement in research, including the provision of adequate time, involvement in research activities, and access to resources.

The application of a tool for supporting shared decision making in primiparous women during early labour - a descriptive survey of obstetric health care professionals' opinion

BACKGROUND

Interventions in maternity health care settings often need to be studied within everyday clinical work and with the contributions of the staff. Therefore, the health care workers on-site play an important role for research success. This explains why it is necessary not only to focus on the outcomes of the research project itself, but also to study the whole process.

OBJECTIVE

This study aimed to evaluate maternity care providers' satisfaction with the use of a preliminary long version of a standardised tool for supporting shared decision making in women during early labour.

METHODS

A cross-sectional survey was distributed to n = 607 maternity care professionals working in the study sites which applied a tool to support shared decision making in primiparous women in early labour. The data was collected using RedCap®. It was analysed descriptively, and logistic regression modelling was applied to find associations between the application of the tool and care as well as work organisation.

RESULTS

A total of 110 health care professionals answered the online survey including 95 (86.4%) midwives and 15 (15.3%) obstetricians. N = 36 (43.9%) midwives stated that they found the tool helpful in the provision of care, whereas 46 (56.1%) did not agree. There was great dissatisfaction with the length of the preliminary tool. The tool adversely impacted the timely management of early labour care. Midwives with greater work experience (OR 0.82, p = 0.02) and a higher workload (OR 0.97, 0.02) were less likely to agree that the tool facilitates their work organisation. Additionally, midwives with more work experience (OR 0.86) and a higher workload (OR 0.96) found the tool less likely to be useful for care provision. The implementation of the tool was challenging for many midwives (40.2%) and some feel their competencies are threatened by the tool (20.7%).

CONCLUSIONS

The involvement of maternity care providers in research is crucial for the success of projects, but they face challenges. Implementing a preliminary tool in clinical practice led to dissatisfaction mainly due to lack of time and partial understanding of its purpose. Providing adequate training and supportive leadership can help improve their understanding and satisfaction.

Theory-guided interviews identified behavioral barriers and enablers to healthcare professionals recruiting participants to maternity trials

OBJECTIVE

To conduct a behavioral investigation, using the Theoretical Domains Framework (TDF), to identify barriers and enablers to maternity healthcare professionals (HCP) inviting all eligible women to participate in a maternity care trial.

STUDY DESIGN AND SETTING

We invited HCP recruiters from maternity care trials in high priority research areas including, diabetes, preeclampsia and breastfeeding, from across Ireland and the UK, to take part in a semi-structured interview. Data collection was informed by the TDF, followed by inductive thematic analysis and deductive mapping to the TDF.

RESULTS

Twenty-two recruiters including midwives, nurses, allied health professionals and doctors were interviewed online or by telephone phone. Thematic analysis generated four global themes; Availability and accessibility of resources, Navigating the recruitment pathway, Prioritising clinical responsibilities over research responsibilities and The influence of colleagues and peers. Themes were mapped to the TDF, identifying 13 domains relevant to the behaviour.

CONCLUSION

This paper identifies the factors enabling or inhibiting maternity HCP recruiters to invite all eligible women to participate in a maternity care trial. The findings provide guidance for researchers designing trials for this population and the essential first step in developing a recruiter-focused behaviour change intervention to support recruitment to trials in maternity care.