Skip to main content

Table 3 Determinants related to identifying risk factors or screening for GBS colonization, mentioned by care providers (n = 25)

From: Barriers and facilitators related to the uptake of four strategies to prevent neonatal early-onset group B haemolytic streptococcus disease: a qualitative study

Key activities Determinants Screening strategy 1.2 Risk-based strategy1,2 Combination strategy1,2 Dutch guideline 1,2
Identifying risk factors Procedural clarity (guideline) 3 3 3 3
Unclear definition previous child with EOGBS N N N N
No standard cut-off point urinary tract infection despite guideline N N N N
No standard procedure PROM (referral after 18, 24, > 24 hours) N N N N
Correctness (guideline) 1 1 1 1
Symptoms of urinary tract infection are often missed N N N N
Social support by other care providers (user) 2 2 2 2
No adequate history taking of previous child with EOGBS N N N N
Not standard GBS detection in urine culture by general practitioner, therefore AB treatment not directed at GBS because status unknown N N N N
Legislation and regulations (socio-political context) 1 1 1 1
Data exchange between care providers of previous pregnancy N N N N
Screening for GBS colonization (swab taking) Procedural clarity (guideline) 1 0 1 1
Local differences in swab taking (vaginal /vs vaginal rectal /vs urine) N   N N
Correctness (guideline) 0 0 0 1
Test result swab taken during birth not available in time     N
Compatibility with current guideline (guideline) 1 0 1 0
Collaboration with laboratory already in place P   P  
Personal benefits / drawbacks (user) 1 0 1 0
Extra work for primary care midwives N   N  
Outcome expectations (user) 4 0 4 0
Sensitivity/specificity swab not 100% because of intermittent carrier status N   N  
Women can adequately take swab themselves (validity culture) N/P   N/P  
Swab result not available for every woman at time of birth N   N  
Client/patient satisfaction (user) 3 0 3 0
Women do not like swab taking N   N  
Women prefer swab taking for reassurance P   P  
Increases anxiety in women and partners N   N  
Social support by other care provider (user) 2 0 2 0
Data exchange culture results N/P   N/P  
Self-efficacy (user) 1 0 1 0
Confidence in discussing test results with women P   P  
Knowledge (user) 1 0 1 0
Care providers know how to take a swab P   P  
Time available (organisational context) 1 0 1 0
Time consuming because of providing information and swab taking N   N  
Staff capacity (organisational context) 1 0 1 0
Sufficient capacity laboratory personnel P   P  
Material resources and facilities (organisational context) 3 0 3 0
Easy to administer in primary care P   P  
Swabs not available N   N  
Often delay if culture taken in primary care N   N  
Financial resources (organisational context) 2 0 2 0
Increased costs in primary care (swab taking) N   N  
Increased costs in laboratory personnel N   N  
  Total numbers of determinants, related to 28 7 28 9
the guideline itself 6 4 6 6
the user (care provider) 14 2 14 2
the organisational context 7 0 7 0
the socio-political context 1 1 1 1
  1. 1P’ = positive determinant; ‘N’ = negative determinant; ‘N/P’ = both negative and positive determinant. 2 The numbers in each row reflect how many issues related to the determinant were mentioned by the care providers