妊娠体重过度增加的初级和二级预防机会：全科医生的观点。
Opportunities for primary and secondary prevention of excess gestational weight gain: General Practitioners' perspectives.
机构信息
Centre for Physical Activity and Nutrition Research, Deakin University, Melbourne, Australia.
出版信息
BMC Fam Pract. 2011 Nov 4;12:124. doi: 10.1186/1471-2296-12-124.
BACKGROUND
The impact of excess gestational weight gain (GWG) on maternal and child health outcomes is well documented. Understanding how health care providers view and manage GWG may assist with influencing healthy gestational weight outcomes. This study aimed to assess General Practitioner's (GPs) perspectives regarding the management and assessment of GWG and to understand how GPs can be best supported to provide healthy GWG advice to pregnant women.
METHODS
Descriptive qualitative research methods utilising semi - structured interview questions to assess GPs perspectives and management of GWG. GPs participating in shared antenatal care in Geelong, Victoria and Sydney, New South Wales were invited to participate in semi - structured, individual interviews via telephone or in person. Interviews were digitally recorded and transcribed verbatim. Data was analysed utilising thematic analysis for common emerging themes.
RESULTS
Twenty eight GPs participated, 14 from each state. Common themes emerged relating to awareness of the implications of excess GWG, advice regarding weight gain, regularity of gestational weighing by GPs, options for GPs to seek support to provide healthy lifestyle behaviour advice and barriers to engaging pregnant women about their weight. GPs perspectives concerning excess GWG were varied. They frequently acknowledged maternal and child health complications resulting from excess GWG yet weighing practices and GWG advice appeared to be inconsistent. The preferred support option to promote healthy weight was referral to allied health practitioners yet GPs noted that cost and limited access were barriers to achieving this.
CONCLUSIONS
GPs were aware of the importance of healthy GWG yet routine weighing was not standard practice for diverse reasons. Management of GWG and perspectives of the issue varied widely. Time efficient and cost effective interventions may assist GPs in ensuring women are supported in achieving healthy GWG to provide optimal maternal and infant health outcomes.
背景
过度妊娠体重增加（GWG）对母婴健康结果的影响已有充分记录。了解医疗保健提供者如何看待和管理 GWG 可能有助于影响健康的妊娠体重结果。本研究旨在评估全科医生（GP）对 GWG 管理和评估的看法，并了解如何最好地支持 GP 为孕妇提供健康的 GWG 建议。
方法
使用半结构化访谈问题描述定性研究方法来评估 GP 对 GWG 的看法和管理。邀请参与 Geelong，维多利亚州和悉尼，新南威尔士州共享产前保健的 GP 通过电话或亲自参加半结构化的个人访谈。访谈以数字方式记录并逐字转录。使用主题分析对常见的新兴主题进行数据分析。
结果
28 名 GP 参与了研究，每个州有 14 名。出现了与认识到过多 GWG 的影响，关于体重增加的建议，GP 定期进行妊娠称重，GP 寻求支持提供健康生活方式行为建议的选择以及让孕妇关注体重的障碍有关的共同主题。GP 对过多 GWG 的看法各不相同。他们经常承认过多 GWG 会导致母婴健康并发症，但称重做法和 GWG 建议似乎不一致。促进健康体重的首选支持选项是向联合健康从业者转介，但 GP 指出，成本和有限的获取途径是实现这一目标的障碍。
结论
GP 意识到健康 GWG 的重要性，但出于各种原因，常规称重不是标准做法。GWG 的管理和对该问题的看法差异很大。高效且具有成本效益的干预措施可能有助于 GP 确保妇女得到支持，以实现健康的 GWG，从而提供最佳的母婴健康结果。
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