Effectiveness of an online education intervention to enhance student perceptions of Respectful Maternity Care: A quasi-experimental study

Prativa Dhakal, Debra K Creedy, Jenny Gamble, Elizabeth Newnham, Rhona McInnes

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Background: Childbearing women's relationship with maternity care providers enhance childbirth outcomes. Students need to understand and offer respectful care. Objective: Evaluate effectiveness and impact of an online education intervention on nursing students' perceptions towards respectful maternity care during labour and childbirth in Nepal. Design: A quasi-experimental pre-post design was used. Participants: A total of 89 Third Year Bachelor of Nursing students (intervention n = 40; control n = 49) from three participating colleges. Methods: Students completed online pre and post-test surveys using the Students' Perceptions of Respectful Maternity Care scale and questions about impact of the intervention. The intervention group received six hours of education delivered online (three sessions x three weeks). ANCOVA and non-parametric Wilcoxon signed-rank tests measured effects. Results: Compared to controls, students in the intervention group reported a significant increase in perceptions towards respectful maternity care (F (1, 86) = 28.19, p < 0.001, η p 2 = 0.25). Participants reported a good understanding of respectful maternity care (75%), positive views about providing such care (82.5%), and a desire to use their new knowledge in practice (65%). Conclusion: Relatively few intervention studies to promote respectful maternity care in students have been published. This brief online intervention improved students' perceptions. The intervention package can be integrated into nursing or midwifery curricula and in-service training. A larger study with longer follow-up is needed to support current findings.

Original languageEnglish
Article number105405
Number of pages8
JournalNurse Education Today
Early online date16 May 2022
Publication statusPublished - Jul 2022

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Contributors LOD conceived the study design with support and input from GF, RM, RC, LJJ and KB. RM paid particular attention to designing the analysis plan and LJJ to designing the health economics plan. LOD led the successful application for funding with contributions from GF, RM, RC, LJJ and KB. GC supported by ELW oversees recruitment and data collection and LOD oversees the preparation of data in readiness for analysis. RM drafted the original cohort study analysis plan which was updated by JH. GC leads the children and young people’s study. KB leads the nested qualitative study. KB drafted the manuscript based on the approved study protocol V3.3 and all co-authors read, contributed to re-drafting and approved the submitted manuscript. All authors have agreed to be accountable for all aspects of the work. Funding This work is supported by the National Institute for Health Research (Health Services & Delivery Research programme) grant number 16/117/04. Disclaimer The views expressed are those of the authors and not necessarily those of the NIHR or the Department of Health and Social Care. Competing interests None declared. Patient and public involvement Patients and/or the public are involved in the design, conduct, reporting, and dissemination plans of this research. Refer to the Methods section for further details


  • Nursing students
  • Respectful maternity care
  • Midwifery
  • Intervention
  • Online survey
  • Perceptions
  • Education


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