Institute of Health and Care Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.
Health Promot Int. 2021 Aug 24;36(3):649-659. doi: 10.1093/heapro/daaa096.
Antenatal clinics in western Sweden have recently invested in a birth method called Confident Birth. In this study, we investigate midwives' and first line managers' perceptions regarding the method, and identify opportunities and obstacles in its implementation. Semi-structured individual interviews were conducted with ten midwives and five first line managers working in 19 antenatal clinics in western Sweden. The Consolidated Framework for Implementation Research was used in a directed content analysis approach. Intervention Characteristics-such as perceptions about the Confident Birth method-were found to have equipped the midwives with coping strategies that were useful for expecting parents during birth. Outer Setting-the method was implemented to harmonize the antenatal education, and provided a mean for a birth companionship of choice. Inner setting-included time-consuming preparations and insufficient information at all levels, which affected the implementation. Characteristics of individuals-, such as knowledge and believes in the method, where trust in the method was seen as an opportunity, while long experience of teaching other birth preparatory methods, affected how the Confident Birth method was perceived. Process-such as no strategy for ensuring that the core of the method remained intact or plans for guiding its implementation were major obstacles to successful implementation. The findings speak to the importance of adequate planning, time, information and communication throughout the process to have a successful implementation. Based on lessons learned from this study, we have developed recommendations for successful implementation of interventions, such as the Confident Birth, in antenatal care settings.
瑞典西部的一些产前诊所最近引进了一种名为“自信分娩”的分娩方法。本研究旨在调查助产士和一线管理人员对该方法的看法，并确定其实施过程中的机遇和障碍。研究人员对瑞典西部 19 家产前诊所的 10 名助产士和 5 名一线管理人员进行了半结构化的个人访谈。采用实施研究综合框架，对访谈内容进行了有针对性的内容分析。研究结果表明，干预措施的特征（如对自信分娩方法的看法）使助产士具备了应对策略，这对分娩期间的准父母很有用。外部环境——该方法旨在协调产前教育，并提供选择分娩陪伴的手段。内部环境——包括耗时的准备工作和各级信息不足，这都影响了方法的实施。个体特征——如对该方法的知识和信念，对方法的信任被视为一种机遇，而教授其他产前预备方法的丰富经验则影响了对自信分娩方法的看法。过程——如没有确保方法核心完整或指导其实施的计划，是成功实施的主要障碍。研究结果表明，在整个实施过程中，充分的规划、时间、信息和沟通对于成功实施至关重要。基于本研究的经验教训，我们为成功实施自信分娩等干预措施在产前保健环境中提出了建议。
