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如何发展孕产服务以有效地解决产妇肥胖问题?一项定性研究。

How can maternity services be developed to effectively address maternal obesity? A qualitative study.

机构信息

Health and Social Care Research Institute, School of Health and Social Care, Teesside University, Middlesbrough, Teesside TS1 3BA, UK.

出版信息

Midwifery. 2011 Oct;27(5):e170-7. doi: 10.1016/j.midw.2010.01.007. Epub 2010 Feb 25.

Abstract

OBJECTIVE

to identify developments in maternal obesity services and health-care practitioners' views on how maternity services need to be further developed to be more effective in the care of obese pregnant women.

DESIGN

follow-up qualitative study using purposive sampling, interviews and focus groups.

SETTING

10 maternity units in the North East Government Office Region of England, UK.

PARTICIPANTS

30 maternity unit health-care practitioners with personal experience of maternal obesity services.

MEASUREMENTS AND FINDINGS

semi-structured interviews and focus groups were carried out with health-care practitioners representing each National Health Service trust in the region that provides maternity services to identify views on the barriers, facilitators, advantages and disadvantages of developing maternal obesity services, and how maternity services can be more effective in managing maternal obesity. Transcripts were analysed using thematic content analysis. Three dominant themes emerged: questioning maternal obesity service development; psychosocial issues and maternal obesity service development; and the way forward.

KEY CONCLUSIONS

there has been a substantial improvement in the management of the health and safety aspects of maternal obesity over the last three years. However, more work is needed around the psychosocial issues, weight management and public health aspects of maternal obesity.

IMPLICATIONS FOR PRACTICE

to meet the needs of obese pregnant women, maternity services should consider the transition of care between pregnancy and the postnatal period, improve communication between hospital and public health services, and develop services that will engage pregnant women to address their obesity.

摘要

目的

确定孕产妇肥胖服务的发展情况,以及医疗保健从业者对于如何进一步发展产科服务以更有效地照顾肥胖孕妇的看法。

设计

采用目的性抽样、访谈和焦点小组的后续定性研究。

地点

英国英格兰东北部政府办公署区域的 10 家产科单位。

参与者

30 名有孕产妇肥胖服务个人经验的产科单位医疗保健从业者。

测量和发现

对代表该区域提供产科服务的每个国民保健服务信托机构的医疗保健从业者进行半结构化访谈和焦点小组讨论,以确定对发展孕产妇肥胖服务的障碍、促进因素、优势和劣势的看法,以及产科服务如何更有效地管理孕产妇肥胖。使用主题内容分析对记录进行分析。出现了三个主要主题:质疑孕产妇肥胖服务的发展;心理社会问题与孕产妇肥胖服务的发展;以及前进的道路。

主要结论

在过去三年中,孕产妇肥胖的健康和安全管理方面有了很大的改善。然而,在心理社会问题、体重管理和孕产妇肥胖的公共卫生方面还需要做更多的工作。

实践意义

为满足肥胖孕妇的需求,产科服务应考虑妊娠和产后期间护理的过渡,改善医院和公共卫生服务之间的沟通,并开发服务,以吸引孕妇解决肥胖问题。

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