The effect of organizational belonging and profession on cliniciansʼ attitudes toward supporting vaginal birth and interprofessional teamwork—a cross‐sectional study

Abstract Introduction The aim of this study was to investigate the effect of organizational belonging and profession on clinicians' attitudes toward supporting vaginal birth and interprofessional teamwork in Swedish maternity care. Material and methods The study used a cross‐sectional design, w...

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Main Authors: Karin Johnson, Charlotte Elvander, Kari Johansson, Sissel Saltvedt, Malin Edqvist
Format: Article
Language:English
Published: Wiley 2023-03-01
Series:Acta Obstetricia et Gynecologica Scandinavica
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Online Access:https://doi.org/10.1111/aogs.14502
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author Karin Johnson
Charlotte Elvander
Kari Johansson
Sissel Saltvedt
Malin Edqvist
author_facet Karin Johnson
Charlotte Elvander
Kari Johansson
Sissel Saltvedt
Malin Edqvist
author_sort Karin Johnson
collection DOAJ
description Abstract Introduction The aim of this study was to investigate the effect of organizational belonging and profession on clinicians' attitudes toward supporting vaginal birth and interprofessional teamwork in Swedish maternity care. Material and methods The study used a cross‐sectional design, with a web‐based survey sent to midwives, physicians and nurse assistants at five labor wards in Sweden. The survey consisted of two validated scales: the Swedish version of the Labor Culture Survey (S‐LCS), measuring attitudes toward supporting vaginal birth, and the Assessment of Collaborative Environments (ACE‐15), measuring attitudes toward interprofessional teamwork. Two‐way ANOVA was conducted to assess the main effect of and interaction effect between organizational belonging and profession for the different subscales of the S‐LCS and the ACE‐15, together with Tukey's honest significant difference post‐hoc analysis and partial eta squared to determine effect size. The relation between the subscales was assessed using the Pearson's correlation analysis. Results A total of 539 midwives, physicians and nurse assistants completed the survey. Organizational belonging significantly influenced attitudes toward supporting vaginal birth and interprofessional teamwork, with the largest effect for Positive team culture (F = 38.88, effect size = 0.25, p < 0.001). The effect of profession was strongest for the subscale Best practices (F = 59.43, effect size = 0.20, p < 0.001), with midwives being more supportive of strategies proposed to support vaginal birth than physicians and nurse assistants. A significant interaction effect was found for four of the subscales of the S‐LCS, with the strongest effect for items reflecting the Unpredictability of vaginal birth (F = 4.49, effect size = 0.07, p < 0.001). Labor ward culture (unit microculture) specifically related to supporting vaginal birth was strongly correlated to interprofessional teamwork (r = 0.598, p < 0.001). Conclusions In the current study, both organizational belonging and profession influenced attitudes toward supporting vaginal birth and interprofessional teamwork. Positive team culture was positively correlated to an organizational culture supportive of vaginal birth. Interventions to support vaginal births should include efforts to strengthen teamwork between professions, as well as considering women's values, preferences and informed choices.
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spelling doaj-art-84462de6371141da8a6ce01dcc0d0e3d2025-08-20T03:30:57ZengWileyActa Obstetricia et Gynecologica Scandinavica0001-63491600-04122023-03-01102335536910.1111/aogs.14502The effect of organizational belonging and profession on cliniciansʼ attitudes toward supporting vaginal birth and interprofessional teamwork—a cross‐sectional studyKarin Johnson0Charlotte Elvander1Kari Johansson2Sissel Saltvedt3Malin Edqvist4Clinical Epidemiology Division, Department of Medicine Solna Karolinska Institutet Solna SwedenClinical Epidemiology Division, Department of Medicine Solna Karolinska Institutet Solna SwedenClinical Epidemiology Division, Department of Medicine Solna Karolinska Institutet Solna SwedenDepartment of Women's Health and Health professions Karolinska University Hospital Stockholm SwedenClinical Epidemiology Division, Department of Medicine Solna Karolinska Institutet Solna SwedenAbstract Introduction The aim of this study was to investigate the effect of organizational belonging and profession on clinicians' attitudes toward supporting vaginal birth and interprofessional teamwork in Swedish maternity care. Material and methods The study used a cross‐sectional design, with a web‐based survey sent to midwives, physicians and nurse assistants at five labor wards in Sweden. The survey consisted of two validated scales: the Swedish version of the Labor Culture Survey (S‐LCS), measuring attitudes toward supporting vaginal birth, and the Assessment of Collaborative Environments (ACE‐15), measuring attitudes toward interprofessional teamwork. Two‐way ANOVA was conducted to assess the main effect of and interaction effect between organizational belonging and profession for the different subscales of the S‐LCS and the ACE‐15, together with Tukey's honest significant difference post‐hoc analysis and partial eta squared to determine effect size. The relation between the subscales was assessed using the Pearson's correlation analysis. Results A total of 539 midwives, physicians and nurse assistants completed the survey. Organizational belonging significantly influenced attitudes toward supporting vaginal birth and interprofessional teamwork, with the largest effect for Positive team culture (F = 38.88, effect size = 0.25, p < 0.001). The effect of profession was strongest for the subscale Best practices (F = 59.43, effect size = 0.20, p < 0.001), with midwives being more supportive of strategies proposed to support vaginal birth than physicians and nurse assistants. A significant interaction effect was found for four of the subscales of the S‐LCS, with the strongest effect for items reflecting the Unpredictability of vaginal birth (F = 4.49, effect size = 0.07, p < 0.001). Labor ward culture (unit microculture) specifically related to supporting vaginal birth was strongly correlated to interprofessional teamwork (r = 0.598, p < 0.001). Conclusions In the current study, both organizational belonging and profession influenced attitudes toward supporting vaginal birth and interprofessional teamwork. Positive team culture was positively correlated to an organizational culture supportive of vaginal birth. Interventions to support vaginal births should include efforts to strengthen teamwork between professions, as well as considering women's values, preferences and informed choices.https://doi.org/10.1111/aogs.14502cesarean sectioninterprofessional teamworkorganizational cultureprofessional attitudesvaginal birth
spellingShingle Karin Johnson
Charlotte Elvander
Kari Johansson
Sissel Saltvedt
Malin Edqvist
The effect of organizational belonging and profession on cliniciansʼ attitudes toward supporting vaginal birth and interprofessional teamwork—a cross‐sectional study
Acta Obstetricia et Gynecologica Scandinavica
cesarean section
interprofessional teamwork
organizational culture
professional attitudes
vaginal birth
title The effect of organizational belonging and profession on cliniciansʼ attitudes toward supporting vaginal birth and interprofessional teamwork—a cross‐sectional study
title_full The effect of organizational belonging and profession on cliniciansʼ attitudes toward supporting vaginal birth and interprofessional teamwork—a cross‐sectional study
title_fullStr The effect of organizational belonging and profession on cliniciansʼ attitudes toward supporting vaginal birth and interprofessional teamwork—a cross‐sectional study
title_full_unstemmed The effect of organizational belonging and profession on cliniciansʼ attitudes toward supporting vaginal birth and interprofessional teamwork—a cross‐sectional study
title_short The effect of organizational belonging and profession on cliniciansʼ attitudes toward supporting vaginal birth and interprofessional teamwork—a cross‐sectional study
title_sort effect of organizational belonging and profession on clinicians attitudes toward supporting vaginal birth and interprofessional teamwork a cross sectional study
topic cesarean section
interprofessional teamwork
organizational culture
professional attitudes
vaginal birth
url https://doi.org/10.1111/aogs.14502
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