itudes toward clinical guidelines among obstetricians in Northern Ireland.

OBJECTIVES: To evaluate the attitudes of, and the influences on decisions made by, obstetricians in Northern Ireland in order to understand the feasibility of applying guidelines to obstetric practice. DESIGN: Cross-sectional postal survey. SETTING: Northern Ireland. POPULATION: Consultants, senior registrars, registrars, and senior house officers in obstetrics in Northern Ireland (n = 170). Responses were received from 68 x 8% (n = 117), with complete data available for 67 x 1% (n = 114). MAIN OUTCOME MEASURES: An attitudes score was constructed by consolidating responses to a variety of statements about guidelines. Individual responses to guidelines statements and the standardised attitudes T-score were analysed by demographic and practice characteristics. RESULTS: Attitudes toward guidelines were generally positive, with women practitioners more likely to have positive attitudes toward guidelines than did their male counterparts. Younger obstetricians were more likely to report that practitioners should incorporate guidelines into their practices. Doctors who responded that their decisions were influenced by specific tools related to guidelines, such as computerised databases, during the previous three months had more positive attitudes toward guidelines than doctors who did not use such tools. Furthermore, doctors based in teaching hospitals were more likely than others to have been influenced by the guidelines of professional societies. CONCLUSIONS: Generally guidelines appear to be quite well received, with doctors reporting that their practice often is influenced by them. Doctors who reported that their decisions were influenced by guidelines had an especially positive attitude toward them. However, some tools which target the application of evidence-based methods (e.g. computerised databases) are used infrequently by obstetricians. The challenge remains to encourage the further development of guidelines and tools that are useful and appropriate for practitioners.