Objectives:The successful implementation of evidence-based practice (EBP) can lead to appropriate and effective midwifery care during pregnancy, childbirth and in the postnatal period. However, levels of knowledge and confidence in one's ability to apply EBP are related to its effective implementation. This study aimed to investigate levels of knowledge, practice of and self-efficacy towards the use of EBP among midwives in East Iran. Methods: This cross-sectional study took place between January and February 2016 and involved 98 midwives employed at two hospitals and all four urban health care centres in Torbat-e Heydariyeh, Iran. Two subscales of the Evidence-Based Practice Questionnaire were used to assess participants' knowledge and practice of EBP, respectively, while a modified version of a previously described scale was used to determine self-efficacy. Results: A total of 76 midwives participated in the study (response rate: 77.6%). Mean knowledge, practice and self-efficacy scores were 4.48 ± 0.94, 3.53 ± 0.68 and 2.80 ± 0.81, respectively. Significant relationships were found between mean selfefficacy, practice and knowledge scores and proficiency in English language (P = 0.001 each) and statistical methods (P <0.050 each). Additionally, significant relationships were found between knowledge and practice of EBP and proficiency in the use of databases (P <0.050 each). Knowledge and self-efficacy scores were significantly correlated with practice (P = 0.001 each). Conclusion: These findings demonstrate a need for improvement in the self-efficacy, practice and knowledge of EBP among midwives in East Iran. Interventions that promote these factors may help increase the use of EBP in this population.

Background and aims:The use of EBP can provide appropriate and effective care in pregnancy, childbirth and postnatal period. Levels of knowledge and confidence in the ability likely related to implementation of evidence-based care. This study was carried out to investigate the level of midwifery knowledge, self-efficacy and practice toward evidence-based practice in the region east of Iran.Methods:A cross-sectional study was conducted in all midwives of two hospitals and health care centers in Torbat Heydariyeh, Iran in 2016. Survey instruments included the Evidence-Based Practice Questionnaire and self-efficacy in Evidence-Based Practice scale. Descriptive statistics and Pearson and Spearman correlation coefficient were employed to analyze the data.Results:The mean±SD scores of knowledge, self-efficacy and practice to implement EBP were 4.48±0.94, 3.53±0.68 and 2.80±0.81, respectively. A significant relationship were found between knowledge, self-efficacy and practice mean scores with proficiency in English language and statistical methods (p<0.05). Additionally, a highly significant relationship was found between knowledge and practice of midwives and proficiency in the use of databases (p<0.05). The midwives' mean scores in the two subscales of knowledge and self-efficacy was correlated with their scores practice toward EBP (P<0.05).Conclusion:This survey has shown the need to improve knowledge, self-efficacy and practice to assist in employing evidence based practice. Interventions that consider the relevant factors have been identified in this study, may help to increase knowledge, self-efficacy and practice regarding EBP.