In addition to their more traditional clinical role, midwives are expected to perform various health promotion practice behaviours (HePPBes) such as informing pregnant women about the benefits of physical activity during pregnancy and asking women about their alcohol consumption. There is evidence to suggest several barriers exist to performing HePPBes. The aim of the study was to investigate the barriers and facilitators midwives perceive to undertaking HePPBes. The research compromised of two studies. Study 1: midwives based in a community setting (N = 11) took part in semi-structured interviews underpinned by the theoretical domains framework (TDF). Interviews were analysed using a direct content analysis approach to identify important barriers or facilitators to undertaking HePPBes. Study 2: midwives (N = 505) completed an online questionnaire assessing views on their HePPBes including free text responses (n = 61) which were coded into TDF domains. Study 2 confirmed and supplemented the barriers and facilitators identified in study 1. Midwives’ perceived a multitude of barriers and facilitators to carrying out HePPBes. Key barriers were requirements to perform an increasing amount of HePPBes on top of existing clinical work load, midwives’ cognitive resources, the quality of relationships with pregnant women, a lack of continuity of care and difficulty accessing appropriate training. Key facilitators included midwives’ motivation to support pregnant women to address their health. Study 1 highlighted strategies that midwives use to overcome the barriers they face in carrying out their HePPBes. Despite high levels of motivation to carry out their health promotion practice, midwives perceive numerous barriers to carrying out these tasks in a timely and effective manner. Interventions that support midwives by addressing key barriers and facilitators to help pregnant women address their health behaviours are urgently needed.

中文翻译：

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调查助产士在多种健康促进实践行为中的障碍和促进者：使用理论领域框架的定性研究

除了传统的临床作用外，预计助产士还会执行各种健康促进行为（HePPB），例如告知孕妇怀孕期间体育锻炼的益处以及询问妇女饮酒的情况。有证据表明，在执行HePPB方面存在若干障碍。该研究的目的是调查助产士对进行HePPB的障碍和促进者。该研究折衷为两项研究。研究1：以社区为背景的助产士（N = 11）参加了以理论领域框架（TDF）为基础的半结构式访谈。使用直接内容分析方法对访谈进行了分析，以找出进行HePPB的重要障碍或促进者。研究2：助产士（N = 505）完成了在线问卷调查，评估了他们对HePPB的看法，包括被编码到TDF域中的自由文本回复（n = 61）。研究2确认并补充了研究1中确定的障碍和促进者。助产士意识到实施HePPB的众多障碍和促进者。主要障碍是在现有临床工作量，助产士的认知资源，与孕妇的关系质量，缺乏护理的连续性以及难以接受适当培训的基础上，执行越来越多的HePPBs的要求。关键协助者包括助产士鼓励孕妇改善健康的动机。研究1强调了助产士用来克服他们在执行HePPB时面临的障碍的策略。尽管进行健康促进实践的动机很高，助产士仍意识到在及时有效地执行这些任务方面存在许多障碍。迫切需要通过解决关键障碍和协助者来帮助助产士的干预措施，以帮助孕妇解决其健康行为。