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.