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助产士、家庭医生及产科患者对孕期体重增加的理解比较:少数女性报告接受了正确的咨询。

Comparison of midwifery, family medicine, and obstetric patients' understanding of weight gain during pregnancy: a minority of women report correct counselling.

作者信息

McDonald Sarah D, Pullenayegum Eleanor, Bracken Keyna, Chen Ann Marie, McDonald Helen, Malott Anne, Hutchison Robert, Haley Susan, Lutsiv Olha, Taylor Valerie H, Good Catherine, Hutton Eileen, Sword Wendy

机构信息

Division of Maternal-Fetal Medicine, McMaster University, Hamilton ON; Department of Obstetrics & Gynecology, McMaster University, Hamilton ONC; Clinical Epidemiology and Biostatistics McMaster University, Hamilton ON; Department of Radiology, McMaster University, Hamilton ON.

Clinical Epidemiology and Biostatistics McMaster University, Hamilton ON; Biostatistics Unit, St. Joseph's Healthcare, Hamilton ON.

出版信息

J Obstet Gynaecol Can. 2012 Feb;34(2):129-135. doi: 10.1016/S1701-2163(16)35155-6.

Abstract

OBJECTIVE

We hypothesized that differences in models of care between health care providers would result in variations in patients' reports of counselling. Our objective was to compare what women reported being advised about weight gain during pregnancy and the risks of inappropriate weight gain according to their type of health care provider.

METHODS

A cross-sectional survey was conducted using a self-administered questionnaire at obstetric, midwifery, and family medicine clinics in Hamilton, Ontario. Women were eligible to participate if they had had at least one prenatal visit, could read English, and had a live, singleton pregnancy.

RESULTS

Three hundred and eight women completed the survey, a 93% response rate. Care for 90% of the group was divided approximately evenly between midwives, family physicians, and obstetricians. A minority of women looked after by any of the types of care providers reported being counselled correctly about how much weight to gain during pregnancy (16.3%, 10.3%, 9.2%, and 5.7% of patients of midwives, family physicians, obstetricians, or other types of care providers, respectively, P = 0.349). A minority of women with any category of care provider was planning to gain an amount of weight that fell within the guidelines or reported being told that there were risks to themselves or their babies with inappropriate gain.

CONCLUSION

In this study comparing reported counselling between patients of obstetricians, midwives, family physicians, and other health care providers, low rates of counselling about gestational weight gain were universally reported. There is a common need for more effective counselling.

摘要

目的

我们假设医疗服务提供者之间护理模式的差异会导致患者咨询报告的差异。我们的目的是比较女性根据其医疗服务提供者类型报告的关于孕期体重增加的建议以及体重增加不当的风险。

方法

在安大略省汉密尔顿的产科、助产和家庭医学诊所使用自填式问卷进行了一项横断面调查。如果女性至少进行过一次产前检查、能阅读英语且怀有单胎活产妊娠,则有资格参与。

结果

308名女性完成了调查,回复率为93%。该组中90%的护理在助产士、家庭医生和产科医生之间大致平均分配。由任何类型的护理提供者照顾的少数女性报告称在孕期应增加多少体重方面得到了正确的咨询(助产士、家庭医生、产科医生或其他类型护理提供者的患者中分别为16.3%、10.3%、9.2%和5.7%,P = 0.349)。任何类别护理提供者照顾的少数女性计划增加的体重在指南范围内,或报告被告知体重增加不当对自身或婴儿有风险。

结论

在这项比较产科医生、助产士、家庭医生和其他医疗服务提供者的患者所报告咨询情况的研究中,普遍报告了关于孕期体重增加的咨询率较低。普遍需要更有效的咨询。

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