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Evidence-based stillbirth prevention strategies: combining empirical and theoretical paradigms to inform health planning and decision-making.

Abstract：

INTRODUCTION:A global health project undertaken in Qatar on the Arabian Peninsula immersed undergraduate nursing students in hands-on learning to address the question: What strategies are effective in preventing stillbirth? Worldwide stillbirth estimates of 2.6 million per year and the high rate in the Eastern Mediterranean Region of 27 per 1,000 total live births provided the stimulus for this inquiry. METHODS:We used a dual empirical and theoretical approach that combined the principles of evidence-based practice and population health planning. Students were assisted to translate pre-appraised literature based on the 6S hierarchical pyramid of evidence. The PRECEDE-PROCEED (P-P) model served as an organizing template to assemble data extracted from the appraisal of 21 systematic literature reviews ± meta-analyses, 2 synopses of synthesized reports, and 9 individual studies summarizing stillbirth prevention strategies in low, middle, and high income countries. Consistent with elements of the P-P model, stillbirth prevention strategies were classified as social, epidemiological, educational, ecological, administrative, or policy. RESULTS:Ten recommendations with clear evidence of effectiveness in preventing stillbirth in low, middle, or high income countries were identified. Several other promising interventions were identified with weak, uncertain, or inconclusive evidence. These require further rigorous testing. LINKING EVIDENCE TO ACTION:Two complementary paradigms--evidence-based practice and an ecological population health program planning model--helped baccalaureate nursing students transfer research evidence into useable knowledge for practice. They learned the importance of comprehensive assessments and evidence-informed interventions. The multidimensional elements of the P-P model sensitized students to the complex interrelated factors influencing stillbirth and its prevention.

journal_name

Worldviews Evid Based Nurs

journal_title

Worldviews on evidence-based nursing

authors

King ML,Aden A,Tapa S,Jumah R,Khan S

doi

10.1111/wvn.12048

subject

Has Abstract

pub_date

2014-08-01 00:00:00

pages

258-65

issue

eissn

1545-102X

issn

1741-6787

journal_volume

pub_type

杂志文章,meta分析,评审

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Evidence-based stillbirth prevention strategies: combining empirical and theoretical paradigms to inform health planning and decision-making.