Seijmonsbergen-Schermers Anna E, Hammiche Fatima, de Klerk Hannah, Keulen Judit K J, Bax Caroline J, Peters Lilian L, Verhoeven Corine J
Department of Midwifery Science, Amsterdam UMC Location Vrije Universiteit Amsterdam, Amsterdam, the Netherlands.
Midwifery Academy Amsterdam Groningen, Inholland, Amsterdam, the Netherlands.
PLoS One. 2025 Aug 18;20(8):e0329843. doi: 10.1371/journal.pone.0329843. eCollection 2025.
To examine the experiences, perspectives, and impact on daily work of maternity care providers regarding the updated Dutch national guideline on the management of late-term pregnancies.
This was a cross-sectional survey for maternity care providers in the Netherlands in 2024.
An online questionnaire was developed, improved on the basis of four semi-structured interviews, piloted, and distributed to primary care and hospital-based midwives, residents, and obstetricians. A 5-point Likert Scale was used for most questions. Descriptive analyses and data visualisation were performed. Linear regressions were performed to assess the association between characteristics and agreement with and adherence to the recommendations. The main outcome measures were awareness of the guideline, agreement with and adherence to the recommendations, opinions and perspectives on the impact of the guideline, and experiences of participants regarding the guideline.
A total of 643 care providers were included, of whom 53% were primary care midwives, 29% obstetricians/residents and 19% hospital-based midwives. There was 72% agreement and 87% adherence to "offer induction of labour (IOL) at 41 weeks alongside expectant management". Although 92% agreed with "discuss the advantages and disadvantages", only 67% agreed with "specify perinatal outcomes" and 63% agreed with "specify outcomes for nulliparous versus multiparous women". Adherence to these and to recommendations regarding monitoring were lower (43-59%). There was uncertainty among 45% about the benefits of the guideline, with only 17% believing in maternal and 20% believing in neonatal benefits.
Care providers widely agreed with and adhered to the recommendation to offer IOL at 41 weeks, but adherence to specific elements of shared decision-making was lower, and care providers expressed limited confidence on the benefits of the policy for mother and child.
探讨荷兰产科护理人员对更新后的荷兰晚期妊娠管理国家指南的体验、观点及其对日常工作的影响。
这是一项针对2024年荷兰产科护理人员的横断面调查。
设计了一份在线问卷，在4次半结构化访谈的基础上进行完善，进行预试验后分发给基层医疗和医院的助产士、住院医师及产科医生。大多数问题采用5级李克特量表。进行描述性分析和数据可视化。进行线性回归以评估特征与对建议的认同及遵循之间的关联。主要结局指标包括对指南的知晓度、对建议的认同及遵循情况、对指南影响的意见和观点以及参与者对指南的体验。
共纳入643名护理人员，其中53%为基层医疗助产士，29%为产科医生/住院医师，19%为医院助产士。对于“在41周时提供引产（IOL）并同时进行期待管理”，有72%的人表示认同，87%的人表示遵循。尽管92%的人同意“讨论利弊”，但只有67%的人同意“明确围产期结局”，63%的人同意“明确初产妇与经产妇的结局”。对这些以及关于监测的建议的遵循率较低（43%-59%）。45%的人对该指南的益处存在不确定性，只有17%的人认为对母亲有益，20%的人认为对新生儿有益。
护理人员广泛认同并遵循在41周时提供引产的建议，但对共同决策具体要素的遵循率较低，护理人员对该政策对母婴的益处信心有限。
