Monari Francesca, Di Mario Simona, Facchinetti Fabio, Basevi Vittorio
Department of Obstetrics and Gynecology, University Hospital, Modena, Italy.
Birth. 2008 Jun;35(2):129-35. doi: 10.1111/j.1523-536X.2008.00226.x.
The cesarean section rate has increased worldwide over the past 20 years; in Italy, it is now more than 35 percent. Although clinical factors are important, the attitudes of health practitioners toward cesarean section need further investigation to correctly identify facilitators and barriers to changes. The objective of this study was to explore the attitudes toward cesarean section of midwives and obstetricians who worked in the same geographical area.
Face-to-face structured interviews using an adaptation of the Survey of Clinicians' Views on Caesarean Section, an anonymous questionnaire with 35 open and closed answers on practitioners' views on cesarean section, were conducted. The questionnaire was given to the entire group of midwives and obstetricians working in Modena, a northern Italian district.
Of 262 eligible practitioners, 248 were interviewed (response rate 94.6%). The midwives' attitudes toward cesarean section differed from those of the obstetricians. Sixty-five percent of midwives considered the rates of cesarean section in their hospitals to be too high compared with 34 percent of obstetricians (p < 0.001). Midwives were also less inclined to believe that cesarean section provides benefits to the mother (p = 0.02) or that it is indicated by previous cesarean delivery (p < 0.001). No differences were observed between male and female obstetricians.
In this survey, the attitudes toward cesarean section were correlated more with professional role than with gender. This information can help policy makers to shape interventions aimed at providing better care for pregnant and childbearing women.
在过去20年里，全球剖宫产率都有所上升；在意大利，目前已超过35%。尽管临床因素很重要，但医护人员对剖宫产的态度仍需进一步调查，以便正确识别促进改变和阻碍改变的因素。本研究的目的是探讨在同一地理区域工作的助产士和产科医生对剖宫产的态度。
采用改编自《临床医生对剖宫产的看法调查》的问卷进行面对面结构化访谈，这是一份关于从业者对剖宫产看法的匿名问卷，有35个开放式和封闭式问题。该问卷发放给了意大利北部摩德纳地区工作的所有助产士和产科医生。
在262名符合条件的从业者中，248人接受了访谈（回复率94.6%）。助产士对剖宫产的态度与产科医生不同。65%的助产士认为他们医院的剖宫产率过高，而产科医生的这一比例为34%（p<0.001）。助产士也不太倾向于认为剖宫产对母亲有益（p=0.02），或者认为既往剖宫产史是剖宫产的指征（p<0.001）。男性和女性产科医生之间未观察到差异。
在本次调查中，对剖宫产的态度与职业角色的相关性大于与性别的相关性。这些信息有助于政策制定者制定干预措施，为孕产妇提供更好的护理。
