Implementing midwifery continuity of care models in regional Australia: A constructivist grounded theory study.

Prussing, E; Browne, G; Dowse, E; Hartz, D; Cummins, A

Implementing midwifery continuity of care models in regional Australia: A constructivist grounded theory study.

Prussing, E Browne, G Dowse, E Hartz, D Cummins, A

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Publisher:: Elsevier BV
Publication Type:: Journal Article
Citation:: Women Birth, 2022, pp. S1871-5192(22)00045-2
Issue Date:: 2022-04-08

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Field	Value	Language
dc.contributor.author	Prussing, E
dc.contributor.author	Browne, G
dc.contributor.author	Dowse, E
dc.contributor.author	Hartz, D
dc.contributor.author	Cummins, A
dc.date.accessioned	2022-12-01T01:18:41Z
dc.date.available	2022-03-16
dc.date.available	2022-12-01T01:18:41Z
dc.date.issued	2022-04-08
dc.identifier.citation	Women Birth, 2022, pp. S1871-5192(22)00045-2
dc.identifier.issn	1871-5192
dc.identifier.issn	1878-1799
dc.identifier.uri	http://hdl.handle.net/10453/163973
dc.description.abstract	PROBLEM/BACKGROUND: Strong international evidence demonstrates significantly improved outcomes for women and their babies when supported by midwifery continuity of care models. Despite this, widespread implementation has not been achieved, especially in regional settings. AIM: To develop a theoretical understanding of the factors that facilitate or inhibit the implementation of midwifery continuity models within regional settings. METHODS: A Constructivist Grounded Theory approach was used to collect and analyse data from 34 interviews with regional public hospital key informants. RESULTS: Three concepts of theory emerged: 'engaging the gatekeepers', 'midwives lacking confidence' and 'women rallying together'. The concepts of theory and sub-categories generated a substantive theory: A partnership between midwives and women is required to build confidence and enable the promotion of current evidence; this is essential for engaging key hospital stakeholders to invest in the implementation of midwifery continuity of care models. DISCUSSION: The findings from this research suggest that midwives and women can significantly influence the implementation of midwifery continuity models within their local maternity services, particularly in regional settings. Midwives' reluctance to transition is based on a lack of confidence and knowledge of what it is really like to work in midwifery continuity models. Similarly, women require education to increase awareness of continuity of care benefits, and a partnership between women and midwives can be a strong political force to overcome many of the barriers. CONCLUSION: Implementation of midwifery continuity of care needs a coordinated ground up approach in which midwives partner with women and promote widespread dissemination of evidence for this model, directed towards consumers, midwives, and hospital management to increase awareness of the benefits.
dc.format	Print-Electronic
dc.language	eng
dc.publisher	Elsevier BV
dc.relation.ispartof	Women Birth
dc.relation.isbasedon	10.1016/j.wombi.2022.03.006
dc.rights	info:eu-repo/semantics/openAccess
dc.subject	11 Medical and Health Sciences
dc.subject.classification	Obstetrics & Reproductive Medicine
dc.title	Implementing midwifery continuity of care models in regional Australia: A constructivist grounded theory study.
dc.type	Journal Article
utslib.location.activity	Netherlands
utslib.for	11 Medical and Health Sciences
pubs.organisational-group	/University of Technology Sydney
pubs.organisational-group	/University of Technology Sydney/Faculty of Health
utslib.copyright.status	open_access	*
dc.date.updated	2022-12-01T01:18:40Z
pubs.publication-status	Published online

Abstract:

PROBLEM/BACKGROUND: Strong international evidence demonstrates significantly improved outcomes for women and their babies when supported by midwifery continuity of care models. Despite this, widespread implementation has not been achieved, especially in regional settings. AIM: To develop a theoretical understanding of the factors that facilitate or inhibit the implementation of midwifery continuity models within regional settings. METHODS: A Constructivist Grounded Theory approach was used to collect and analyse data from 34 interviews with regional public hospital key informants. RESULTS: Three concepts of theory emerged: 'engaging the gatekeepers', 'midwives lacking confidence' and 'women rallying together'. The concepts of theory and sub-categories generated a substantive theory: A partnership between midwives and women is required to build confidence and enable the promotion of current evidence; this is essential for engaging key hospital stakeholders to invest in the implementation of midwifery continuity of care models. DISCUSSION: The findings from this research suggest that midwives and women can significantly influence the implementation of midwifery continuity models within their local maternity services, particularly in regional settings. Midwives' reluctance to transition is based on a lack of confidence and knowledge of what it is really like to work in midwifery continuity models. Similarly, women require education to increase awareness of continuity of care benefits, and a partnership between women and midwives can be a strong political force to overcome many of the barriers. CONCLUSION: Implementation of midwifery continuity of care needs a coordinated ground up approach in which midwives partner with women and promote widespread dissemination of evidence for this model, directed towards consumers, midwives, and hospital management to increase awareness of the benefits.

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http://hdl.handle.net/10453/163973