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Non-medical prescribing behaviour in midwifery practice: a mixed-methods review

Fontein-Kuipers, Yvonne; Brouns, Miek; Driessen, Els; Mestdagh, Eveline; Van Rompaey, Bart


Miek Brouns

Els Driessen

Eveline Mestdagh

Bart Van Rompaey


Background: Non-medical prescribing is a new skill in midwifery practice. Information is needed on whether this is an activity that is feasible, appropriate, meaningful and effective.

Aim: To report on the determinants of midwife prescribing behaviour to inform midwifery practice.

Method: A mixed-methods review using an integrated approach combining methodologically diverse data into a single mixed-methods synthesis. A systematic search of the literature was conducted. Data were categorised according the feasibility-appropriateness-meaningfulness-effectiveness (FAME) scale and thematised according the attitude, social-influence, self-efficacy (ASE) model. A thematic analysis, a Bayesian descriptive analysis and Bayesian Pearson correlations of the FAME-categories and ASE-themes were performed.

Findings: Seven studies showing moderate to good quality were included for synthesis. The FAME categories feasibility and appropriateness tended to affect the utility of midwife prescribing; meaningfulness and effectiveness were related to non-utility of prescribing. There were weak to moderate correlations between the FAME categories and the ASE themes social influence, intention, barriers and supportive factors and perceived knowledge (r-.41 to-.34 and r.37 to .56). ASE themes showed a strong negative correlation between attitude and self-efficacy (r-.70); weak positive correlations between attitude and social influence (r.31) and perceived knowledge (r.30); a weak positive correlation between self-efficacy and social influence (r.30), and a weak negative correlation with intention (r-.31); a moderate negative correlation between social influence and barriers/ supportive factors (r-.50); a weak negative correlation between barriers/supportive factors and perceived knowledge (r-.38).

Conclusion: Prescribing fits the midwife's professional role and maternity services and is enhanced by the midwife's willingness and supportive practice. Prescribing requires collaborative practice, meaningful relationships with women, (applied) knowledge, expertise, and theoretical, practical and logistic support in the clinical area. Implications. Midwives who consider prescribing or who are autonomous prescribers should be aware of their role and position as autonomous prescriber. They should reflect on their willingness to prescribe, self-efficacy, perceived knowledge, their cognitive beliefs about prescribing and the effect of prescribing on women in their care.

Journal Article Type Article
Acceptance Date Feb 8, 2019
Online Publication Date Jun 28, 2019
Publication Date Mar 28, 2019
Deposit Date Jan 10, 2022
Publicly Available Date Jan 11, 2022
Journal Evidence Based Midwifery
Print ISSN 1479-4489
Publisher Royal College of Midwives
Peer Reviewed Peer Reviewed
Volume 17
Issue 1
Pages 27-34
Keywords Behaviour; midwifery; mixed-methods review; non-medical prescribing; evidence-based midwifery
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Non-medical Prescribing Behaviour In Midwifery Practice: A Mixed-methods Review (81 Kb)

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